INSTRUCTIONS- should contain 400–500 words. Each thread should cite at least two references to support the information you present AND 1 biblical reference. Each thread should adhere to AMA writing guidelines and any references included in the thread should be formatted in AMA style. Since this is a personal discussion, you are allowed to use first person perspective; however, you should maintain professional decorum.
REPLIES:- Each reply should be at least 200–250 words and should adhere to AMA writing guidelines. Each reply must include one reference to support the information you present and 1 biblical reference.
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The initial question-
An epidemiologist found five cases of “big toe cancer” in the Yukon Territory. Because there were only a few cases, the epidemiologist decided to conduct a matched case-control study to determine whether shoe size larger than 9 is a risk factor for big toe cancer. Cases were individually matched to one control for daily activity, history of athlete’s foot, and history of ingrown toenails. The following data were gathered:
Shoe size > 9
Pair Case Control
1 Yes No
2 No No
3 No Yes
4 Yes Yes
5 No Yes
- Compute the proper measure of association.
- Interpret your results.
- If you were to investigate a rare cancer in Lynchburg, where might you look for data?
- What would be necessary legally and ethically to be able to utilize this data set(s)?
RESPOND TO CLASSMATE #1-
An epidemiologist found five cases of “big toe cancer” in the Yukon Territory. Because there were only a few cases, the epidemiologist decided to conduct a matched case-control study to determine whether shoe size larger than 9 is a risk factor for big toe cancer. Cases were individually matched to one control for daily activity, history of athlete’s foot, and history of ingrown toenails. The following data were gathered:
Shoe size > 9
Pair Case Control
1 Yes No
2 No No
3 No Yes
4 Yes Yes
5 No Yes
- Compute the proper measure of association.
|
CASE |
CONTROL |
|
|
Exposure (YES) |
2(A) |
3(B) |
|
Exposure (NO) |
3(C) |
2(D) |
Proportion of cases exposed: A/ (A+C)= 2/5= 0.4
Proportion of controls exposed: B/(B+D)= 3/5= 0.6
OR: (AD)/(BC)= 4/9= .44
- Interpret your results.
If the proportion of cases exposed is higher than that of the proportion of controls exposed, then big toe cancer is associated with larger shoe size.
Since only 40% of cases were exposed, as opposed to 60% of controls, history of shoe size does not result in big toe cancer. Shoe size, among the other factors (daily activity, history of athlete’s foot, and history of ingrown toenails), could potentially serve as protective factors, but more research would be required. OR of <1 supports this.1
- If you were to investigate a rare cancer in Lynchburg, where might you look for data?
It would be a good idea to check with the Health Department to see if there are statistics or raw data available on cancer rates in the Greater Lynchburg Area. Although it can be more difficult (if not impossible) to get patient data from local hospitals or specialist centers due to HIPAA laws, it may be worth trying to speak to the offices of Centra’s Alan B. Pearson Regional Cancer Center.1,2 At this facility, they treat a broad range of cancers, including lung, prostate, breast, brain, kidney, bladder, ovarian, lymphoma, leukemia, colon, uterine, and rectal, for patients from across central Virginia.2
The Health Department, or possibly even Parks & Rec or other sections of the local government, may also be useful in assessing any potential risk factors for cancer in the area.
- What would be necessary legally and ethically to be able to utilize this data set(s)?
Privacy for any patients whose information is used as part of the study is paramount.1 This would include any written informed consent demanded by law, any alteration of files that does not corrupt the data being examined (changing or redacting name, addresses, or any other PII), and written consent before verifying to an outside source that any patient participated in the study.1 Honest and ethical communication with the community and organizations being utilized is preferable. If any direct communication with the patient/subject occurs, fully briefing them on the scope and utilization of their information is required.
References
1. Friis R, Sellers T. Epidemiology For Public Health Practice. Burlington, Mass.: Jones & Bartlett Learning; 2014.
2. Alan B. Pearson Regional Cancer Center | Centra Health – Central Virginia’s Comprehensive Medical Resource. Centrahealthcom. 2018. Available at: https://www.centrahealth.com/cancer.
RESPOND TO CLASSMATE #2-
- Compute the proper measure of association.
|
CASE |
CONTROL |
|
|
Exposure (YES) |
2(A) |
3(B) |
|
Exposure (NO) |
3(C) |
2(D) |
Proportion of cases exposed is: A/(A+C)= 2/5=0.4
Proportion of controls exposed is: B/(B+D)=3/5=0.6
OR: (A/D)/(BC)=4/9=.44
- If proportion of cases are exposed to a higher rate than that of the exposed controls, then the association between big toe cancer and larger shoe size has a correlation.
- If you were to investigate a rare cancer in Lynchburg, where might you look for data?
If I was to look or investigate a rare cancer in Lynchburg, I would look into the Virginia Cancer Registry- Virginia Department of Health. The Virginia Cancer Registry is a partner in statewide activities to promote cancer prevention, early detection, and successful treatment and care. The cancer information collected by the VCR describes the impact of cancer in Virginia and is used to assist cancer control and prevention programs and initiatives. [1]
- What would be necessary legally and ethically to be able to utilize this data set(s)?
I believe HIPPA is the main thing that will be in place. Even though it should automatically be taken place during any patient that either stays in the hospital, having a procedure done in a facitlity, or living in a nursing home special precaution should take place to ensure that HIPPA should be in place. HIPPA is a law signed by Former President Bill Clinton to secure that medical information is kept safe. [2]
- Virginia Cancer Registry- Virginia Department of Health. http://www.vdh.virginia.gov/virginia-cancer-regist…
- Health Information Privacy. 2018. https://www.hhs.gov/hipaa/for-individuals/guidance…
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