Case Control Research
Order Instructions:
Case Control Research
The critique of an epidemiologic study involves an assessment of the methods of data collection (which includes the type of study design), the analysis of the data and the interpretation of the data. For this application you are to read the following case control research article. After reading the article, complete the Case Control Template is below
•Lamontagne, F., Garant, M., Carvalho, J., Lanthier, L., Smieja, M., & Pilon, D. (2008). Pneumococcal vaccination and risk of myocardial infarction. Canadian Medical Association Journal, 179(8), 773-777.
Use the Academic Search Premier database, and search using the article’s Accession Number: 34526279
Case-Control Study
Submitted By (make sure your name and date are included here):
Article Citation in APA format:
Research Question:
Health Outcome of Interest:
Exposure(s) of Interest:
Diagnostic Criteria for Cases:
Case Ascertainment (include whether this was a single site or multi-site study):
Number of Cases (include information, if available, about the number who participated and the number who refused; indicate whether any information was provided about those who refused to participate):
Control Population (type/number/selection):
Type(s)/Method(s) of Data Collection (e.g. questionnaire, medical records, whether or not there was any procedure for validating some or the data):
Type of Data Analysis:
Results/Main Findings of Study:
Assessment of Bias (selection/information):
Assessment of Confounders:
Comments:
SAMPLE ANSWER
Case-Control Study
Article Citation in APA format: Lamontagne, F., Garant, M., Carvalho, J., Lanthier, L., Smieja, M., & Pilon, D. (2008). Pneumococcal Vaccination and Risk of Myocardial Infarction. Canadian Medical Association Journal, 179(8), 773-777.
Research Question/Hypothesis: in this article, the research question for the case study is not stated. However, the hypothesis is specified. The hypothesis was that: pneumococcal vaccination will be able to protect patients from myocardial infarction.
Health Outcome of Interest: patients being free from myocardial infarction
Exposure(s) of Interest: the authors regarded patients to have had the exposure to pneumococcal polysaccharide vaccine if these patients had been given this vaccine within the ten years prior to the index date, as documented in the Logivac database. Exposure was stratified by the interval between vaccination and index data (Lamontagne et al., 2008).
Diagnostic Criteria for Cases: patients who took part are those who were considered to be at high risk of having myocardial infarction, and had been admitted at the health care organization between 1/1/1997 and 12/31/2003. The risk for myocardial infarction is defined as the presence of diabetes; hypertension; or dyslipidemia in women aged over 50 years and in men aged over 45 years (Lamontagne et al., 2008; Lachaine, Rinfret & Merikle, 2006).
Case Ascertainment (include whether this was a single site or multi-site study): this was a single site study given that the authors carried out a case-control study of patients at risk of myocardial infarction, and these patients had been admitted at only one healthcare organization, which was a tertiary care hospital in Quebec, Canada.
Number of Cases (include information, if available, about the number who participated and the number who refused; indicate whether any information was provided about those who refused to participate):
There were 999 cases. The cases, according to the authors, were less likely compared to controls to have been vaccinated. The cases were matched according to sex, age, as well as year of hospitalization. For cases, the authors considered the admittance date for myocardial infarction to be the date of index (Lamontagne et al., 2008). No information is provided about the participants who refused to participate.
Control Population (type/number/selection): there were 3,996 controls in this study who were matched according to sex, age, as well as year of hospital admission. Controls were defined as patients who had 1 or more of the described risk factors as stated in the medical record, and had not been earlier diagnosed with atherosclerotic disease, and who never experienced a new myocardial infarction all through the study period. The authors only included those patients who had been admitted to the surgical departments of the hospital. For the controls, the authors considered the admission date into one of the departments as the index date. Four controls were matched to every case basing on sex; index, within 12 months; and age, within 24 months (Lamontagne et al., 2008).
Type(s)/Method(s) of Data Collection (e.g. questionnaire, medical records, whether or not there was any procedure for validating some or the data):
Data was collected through the use of medical records. Two sources of data collection were used. The first one was the research-purpose database of the hospital. This database, besides demographic data, comprised, for every hospital administration from the year 1996, complete information on all secondary and primary diagnoses, which were coded appropriate to the International Classification of Diseases, version 9. Logivac database was also utilized; a database that is maintained by the government and records all pneumococcal vaccination that have been administered in Quebec (Grayston, Kronmal & Jackson, 2005; Hansson, 2005).
Type of Data Analysis: The authors performed statistical analysis in which they estimated exposure to the pneumococcal polysaccharide vaccine at 20 percent. The authors utilized conditional logistic regression in estimating adjusted OR and 95 percent CI for new myocardial infarctions in relation to receiving of the pneumococcal polysaccharide vaccine. They performed both multivariable and univariable analyses and several covariables were incorporated. For all analyses, the authors matched controls and cases by index date, sex and age (Lamontagne et al., 2008).
Results/Main Findings of Study: Compared to controls, cases had a less likelihood of having been vaccinated – 95 percent confidence level 0.40-0.70, adjusted odds ration 0.53. The putative protective role of the pneumococcal polysaccharide vaccine was not noticed for patients who had been administered with the vaccine up to 12 months prior to the myocardial infarction. On the contrary, if vaccination had been administered 24 months or more prior to the hospital admission, then the association was stronger (Lamontagne et al., 2008).
Assessment of Bias (selection/information): At 3,999, the number of controls who were selected to take part in the study was considerably high compared to the cases, who were just 999.
Assessment of Confounders: After several modifying and confounding variables were considered, the findings showed that the chances of having received a vaccination within the group who had experienced myocardial infarction was roughly ½ that within the control group. In this study, there might have been residual confounding. It is of note that other cardiovascular risk factors including medication use, tobacco use, obesity, and lifestyle factors for instance exercise and diet could not be included in the model given that these traits are not documented within the research database (Lamontagne et al., 2008).
Comments: the study is of major importance since it demonstrates that there is an effect of pneumococcal vaccination in decreasing the incidents of new myocardial infarction. Nonetheless, the population of this study was restricted to only one hospital comprising largely Caucasian males. As such, future study should incorporate participants from other demographics and from multiple sites.
References
Grayston, J. T., Kronmal, R. A., & Jackson, L. A. (2005). Azithromycin for the Secondary Prevention of Coronary Events. N Engl J Med 2005;352:1637-45.
Hansson, G. K. (2005). Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med, 352:1685-95
Lachaine, J., Rinfret, S., & Merikle, E. P. (2006). Persistence and Adherence to Cholesterol Lowering Agents: Evidence from Régie de l’assurance maladie du Québec data. Am Heart J 2006;152:164-9.
We can write this or a similar paper for you! Simply fill the order form!
