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Teaching the Science Base of MCH. Donna Strobino, PhD. TEACHING THE SCIENCE BASE OF MCH . OBJECTIVE: To present examples of approaches to teaching the evidence base of MCH. ASSUMPTIONS OF EXAMPLES. SOLID GROUNDING IN: Biostatistics Epidemiology
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Teaching the Science Base of MCH Donna Strobino, PhD
TEACHING THE SCIENCE BASE OF MCH OBJECTIVE: To present examples of approaches to teaching the evidence base of MCH
ASSUMPTIONS OF EXAMPLES SOLID GROUNDING IN: • Biostatistics • Epidemiology • Evaluation or Study Design in the Social Sciences or Health Services Research
EXAMPLES OF APPROACHES • Critiquing a research article • Synthesizing the literature on an intervention/program • Translation of a study to practice or policy • Debating the science • Choosing measures for population-based data
CRITQUE OF A SCIENTIFIC ARTICLE: OBJECTIVE Participants demonstrate • Knowledge of critical study methods that affect the validity of inference • The link of study objectives and rationale to study results and conclusion • Objective evaluation of strengths and weaknesses of study
FOCI OF THE CRITIQUE • Study Objectives and Rationale • Study methods • Study design • Sample: who, where, when, how many • Variable Measures
FOCI OF CRITIQUE • Study Results • Text consistent with data in tables • Consistent with study methods • Study Conclusions • Consistent with objectives • Consistent with findings
EXAMPLES OF STUDIES Study Design • Case Control Study of Stillbirths • Stillbirths of all birth weights • Controls: Live births > 2500 grams • Sister pairs • Teenage mothers • Mothers in their early 20’s
EXAMPLES OF STUDIES Sample Restrictions • Require repeated interviews during pregnancy of high-risk women; very low follow-up • Sample bias versus recall bias • Reduce sample by half because of data on gestational age • Sample bias versus measurement bias
EXAMPLES OF STUDIES • Timing of measurement of risk factors: hematocrit at delivery • Poorly constructed measures of underlying concept: racism • Analysis determines results: Longitudinal data on repeated births • Text misrepresents data in tables: data sources for measuring druguse
SYNTHESIZING THE LITERATURE: OBJECTIVES Students learn: • How to conduct a literature search • How to determine the most appropriate criteria for inclusions of studies in a review • To succinctly, but comprehensively describe studies • Evaluate the evidence • Make conclusions about theintervention
LECTURE POINTS • Important aspects of study methods • Content of a study description • Information for doing a search • Criteria for selection of studies • Selecting the studies to highlight • Synthesizing/compiling the evidence
ASSIGNMENTS • Topic and selection of studies • Criteria for selecting studies • List of studies • Paper presenting the evidence • Description of the intervention • Description of studies and critique • Conclusions about the evidence
EVALUATING LITERATURE FOR POLICY OR PRACTICE OBJECTIVE: Students will show: • Ability to evaluate the evidence • Ability to determine limits of inferences • Ability to translate study findings for programs, practice, andpolicy
ARTICLE SELECTION • Gold standard design? • Sample exclusions • Appropriate age range? • Secondary prevention • Clinical interpretations:To whom should the results be applied? • Controversial politically
DEBATING THE SCIENCE OBJECTIVES: Students will show: • Understanding of the science underlying the debate • A balance of the strengths and weaknesses of the science • Knowledge of the reasons for policy recommendations
UNIVERSAL BREAST CANCER SCREENING: WOMEN 40-49 Debate: Pro and Con • Hinges on interpretation of studies • Requires additional population data • Regardless of position, must present in writing both sites; requiring a synthesis of the literature.
BIRTH CERTIFICATE ANALYSIS: OBJECTIVES Student will show: • Knowledge of the vital statistics system and its uses • Knowledge of data for surveillance and research • Knowledge of the constraints in collecting population-based data • Knowledge of measurement of items on the certificate
APPROACH TO PAPER • Geopolitical area • VS System in that area • Content of current certificate • Recommendations for changes • System of data acquisition • Format of form • Content/measurement of items
TESTING PREPARATION TO UNDERTAKE RESEARCH Take-home exam: Objective: To test student’s ability to: • Critically analyze research in their area of interest • Synthesize and integrate both concepts and methods learned in course work
Exam: Using 1-2 Research Articles Focus of questions about articles: • Conceptual basis of the research • Conceptual framework • Variables and their conceptualization • Study methods • Study design • Sampling plan • Statistical analysis
DrPH versus PhD Students • DrPH students: • Program, policy or practice implications of the study • PhD students: • Research implications of the study