Interpreting Epidemiologic Evidence

Evaluating the strength of epidemiologic evidence is inherently challenging, both for those new to the field and for experienced researchers. This book offers a strategy for assessing epidemiologic research findings, explicitly describing the goals and products of research

Evaluating the strength or persuasiveness of epidemiologic evidence is inherently challenging, both for those new to the field and for experienced researchers. There are a myriad of potential biases to consider, but little guidance about how to asses the likely impact on study results. This book offers a strategy for assessing epidemiologic research findings, explicitly describing the goals and products of epidemiologic research in order to better evaluate it successes and limitations. The focus throughout is on practical tools for making optimal use of available data to assess whether hypothesized biases are operative and to anticipate concerns at the point of study design in order to ensure that needed information is generated. Specific tools for assessing the presence and impact of selection bias in both cohort and case-control studies, bias from non-response, confounding, exposure measurement error, disease measurement error, and random error are identified and evaluated. The potential value of each approach as well as its limitations are discussed, using examples from the published literature. Such information should help those who generate and interpret epidemiologic research to apply methodological principles more effectively to substantive issues, leading to a more accurate appraisal of the current evidence and greater clarity about research needs.

"Evaluating the strength of epidemiologic evidence is inherently challenging, both for those new to the field and for experienced researchers. This book offers a strategy for assessing epidemiologic research findings, explicitly describing the goals and products of research."--[Source inconnue].

First edition published in 2002. Second edition published in 2008.

This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media.