Compare and contrast the cohort study approach with case-control studies. Determine which you believe is most effective and explain why. Provide specific examples to support your response or cohort studies.
Cohort is defined as one of the ten divisions of a Roman legion, consisting of 300 to 600 men, and a group or band united in a struggle (Fleming, 2008, pg. 295).
This word is used to identify a group of people who are identified at the beginning of a study and followed by prospectively for a period to observe what happens to them. If the intention is to focus on a particular population or on people with particular exposures, the retrospective cohort design is preferable. If the particular focus is on the disease, then the case control design would have many advantages. Even when wanting to use a cohort design, putting together the resources needed may be difficult and expensive. They require long term committment and also it may be hard to obtain sufficiently comprehensive information from the past. An important strength of the cohort design is the ability to directly measure relative and attributable risk (Fleming, 2008, p. 298).
With control studies, controls must be chosen very carefully. An unexpected link can possibly exist between the controls and the exposure being studied. This can inturn bias the results and compromise the value of the study. The advantages of case control studies is that they can be done quickly and at a low cost. The strength of cohort studies is the ability to directly measure relative and attitbutable risk. The need to estimate the same rates is a weakness of case control studies. I think the most effective would be case control studies. They are inexpensive and an efficient way to measure the effect of exposures. It determines the extent of relationships between risk factors and outcomes. It is suited for rare diseases with long latency periods or exposures over a long period (Fleming, 2008, p. 290).
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Identify the advantages and disadvantages of developing and utilizing the cohort study methodology over the case-control study. Provide specific examples to support your response.
There are many advantages to using the cohort study over the case-control study. The first would be that the case control design acknowledges time while the cohort study incorporates the passage of time.One can calculate incidence and relative risk directly rather than by estimate. Determining casuality is less of an issue in a cohort study since exposures precede the onset of disease by of the study design (Fleming, 2008, 317).
Misclassification bias is less of a problem since exposures are systematically and regularly documented during follow-up activities. The cohort disease can also be used to study multiple outcomes, or multiple exposures as long as these variables are measured. A major disadvantage of the cohort disease is that it is very expensive, time consuming, and potentially biased by attrition, as subjects are lost to follow-up (Fleming, 2008, 317).
It can also be difficult to model changes in exposure over time or crossovers. It’s also almost impossible to study rare diseases.
Fleming, S.T. (2008).
Managerial epidemiology: Concepts and cases (2nd ed.).
Chicago Health Administration Press
Analyze the various factors that go into clinical trial methodologies (including randomization, historical controls, crossover studies, sample size, duration, and masking), and determine which presents the greatest challenges. Make at least two recommendations for addressing the challenges you have identified. Provide specific examples to support your response.
The Essay on Controlling Security Threat Groups
With the increase of street gangs, prisons see a rise in gang activity such as race related crime, drug trafficking, and inmate protection. "Today's street gangs are becoming tomorrow's prison gangs. Institutional managers report that the "drive-by shooting mentality" has moved into the prisons and jails as the young offenders have been convicted of various gang-related offenses." (Carlson, Peter ...
The purpose of conducting a randomized clinical trial is to determine whether a particular treatment, agent, or program has a significant effect on the onset of the disease, course of illness, or in the case of health services research, other outcomes, such as utilization of services (Fleming, 2008, p. 326).
Treatment effects is the change in measureable outcome between the treatment and control groups. Sample sizing is difficult to decide on. These are the most expensive type of epidemiological inquiry. Historical controls are groups that are chosen who have the disease for a clinical trial to be done. In crossover studies, patients are randomly assigned to treatment and control groups. Duration is the time period assigned for clinical trials.Masking is based on the premise that patients, clinicians, and researchers ought not to be aware of whether a patient is receiving an experimental agent, treatment, or program.The randomization depends on the study design and the individual patient, group practice, or geographic area such as zip code or census district (Fleming, 2008, p. 324).
One recommendation would be to reduce the cost of studies is to conduct 2 experiments simutaneously on the same group of subjects. Another recommendation would be to make sure that there is enough time in the trials to which the exposures will have an effect.
Compare the differences (not similarities) between community trials versus traditional randomized clinical trials (RCT).
Determine if a community trial would produce more accurate results versus the RCT on sexually transmitted diseases. Provide specific examples to support your response.
Community trials are for certain kinds of interventions to increase the unit of analysis from the individual subject or patient to a larger community unit. These interventions are easier or less costly to deliver through some common venue or when it may be difficult to prevent treatment contamination. They are done in cities, towns, regions or census tracts. Randomized clinical trials are done through the use of hospital firms. Patients are randomly assigned and the outcomes of which can be routinely evaluated and improved. RCT’s purpose is to ensure that two groups are alike in all characteristics other than the treatment understudy. I definitely think a community trial would produce more accurate results versus the RCT because you want to reach out to the community to possibly prevent STD’s. Interventions dealing with risk factor modification and behavioral change may be delivered more effectively through some community vehicles such as education programs in the mass media (Fleming, 2008, p. 347).
The Essay on The Treatment Of Patients With Communicable Diseases part 1
The Treatment of Patients with Communicable Diseases Contemporary medical care reached many significant results in treating various kinds of diseases. Although for some of the diseases the treatment and cure is yet to be invented. This category of diseases, called communicable includes AIDS, cancer and several other kinds of diseases. For physicians and dentist this is a pretty difficult task to ...
Fleming, S.T. (2008).
Managerial epidemiology: Concepts and cases (2nd ed.).
Chicago Health Administration Press
