Before beginning this activity, review the Module Notes and readings

Before beginning this activity, review the Module Notes and readings on estimating disease risk (you may want to review the study designs in the previous module as well).

Now that you have learned about the major study designs and how to estimate risk, you are ready to combine this information into estimation and interpretation of epidemiologic data. This assignment builds upon the examples in your previously completed study designs assignment. As you work through each question, remember that the design dictates the appropriate measure of effect to be calculated.

In a MS Word or similar document, with each question numbered, respond to each of the questions below. Be sure to show all of your math. Use standard mathematical operators: divide (/), multiply (x), add (+), and subtract (-), and include parentheses to show the order of operations where necessary.

1. To examine the association between indoor mold exposure and asthma among children, a random sample of households in Detroit, Michigan is recruited to participate in a study in 2011. Parents are interviewed about the child’s current lower respiratory symptoms, and air samples are taken inside the home on the same day as the interview to measure mold concentration. Calculate the absolute measure of association for this study and interpret it using a complete sentence.

diagram1 Asthma No Asthma
Mold found
In >2 rooms 100 900 1000
Of home
_____________________________________
Mold found
In 1 room 100 1900 2000
Or less
200 2000
2. To examine whether insurance coverage is associated with discharge to a specialized post-acute care facility (e.g., rehabilitation, skilled nursing, etc.) after a trauma hospitalization, 2960 trauma patients from the National Trauma Databank in 2006 were assessed. The likelihood of discharge to a specialized facility was compared between trauma patients with Medicaid versus other insurance coverage. Calculate the ratio measure of association for this study and interpret it using a complete sentence.

diagram2 Discharge to special No discharge to special
Facility Facility
Medicaid covered 80 1920 2000

Other insurance 80 920 1000
_____________________________________________________________________________________
160 2840
3. A study examines the association between family history of cancer and risk of laryngeal cancer. Laryngeal cancers were identified from a registry between 1992 and 2009 and histologically confirmed. Cancer patients were contacted and asked about laryngeal cancer history in any first-degree relative along with other risk factors. Calculate and interpret the appropriate measure of association.

diagram3 Laryngeal cancer controls
family history
of cancer 65 120 185

No cancer
Family history 20 135 155
85 255

4. A study that found that adult residents of a small town in New York who ate fish from a local PCB-contaminated river had a 1.5 times higher incidence rate of liver cancer compared to residents in the same town who did not consume fish from the same source during childhood. Calculate and interpret the appropriate absolute measure of association.

Diagram4 Liver Cancer No liver cancer person-
Years exposure
Ate fish from
River 20 years ago 90 900 11,000
No fish from river
20 years ago 90 1900 19,000
180 2800 30,000

Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Be sure to check your work and correct any spelling or grammatical errors before you upload it. When you are ready to submit your work, click “Browse My Computer” and find your file. Once you have located your file, click “Open” and, if successful, the file name will appear under the Attached files heading. Scroll to the bottom of the page and click “Submit.”

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Before beginning this activity, review the Module Notes and readings essay Wise Papers.