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PLEASE FOLLOW THE INSTRUCTIONS CLOSELY BELOW:
The articles needed to complete this paper is attached.
By the end of this activity, you will be able to identify and discuss advantages and disadvantages of a cohort study design surrounding a controversial public health topic. Additionally, you will be able to present persuasive conclusions in an objective manner by utilizing knowledge of study design to support and defend your position of choice, and synthesize the findings of a landmark cohort study from multiple perspectives.
Before beginning this activity, review the faculty notes and readings in the text.
As you read the article, “Oral Contraceptive Use and Mortality during 12 Years of Follow Up: The Nurses’ Health Study” [PDF file size 1.4 MB] I would like you to relate the contents of the article to the faculty notes and readings, paying particular attention to the components of the cohort study design as well as the practical implications of the study. The safety of oral contraceptives has been hotly debated with regards to many health outcomes, including mortality and cancer. This paper was one of many produced from the findings of the Nurses’ Health Study, a large scale prospective cohort study of female registered nurses which first began follow up in 1976.
It is understood that you may have minimal background in some of the medical terminology and statistical methods described in the paper. However, comprehending these components fully is not critical to evaluating the study design.
As you read, think about the reasons an epidemiologist would choose to use a cohort design. What are the advantages/disadvantages or a cohort study specific to the health outcome (mortality) and exposure (oral contraceptives)? Think about whether they are common or rare, easy or difficult to measure, and if the findings might apply to the population in general.
As you read, think about the potential public health implications of a study like this. Consider the author’s conclusion (in the very last paragraph), and whether you think the study design was strong enough (and free of bias) to justify their statement.
Studies such as this often make headlines and have the potential to impact treatment of millions of individuals. How might the study’s cohort design (compared to other options you have learned about) been an advantage in testing the study’s hypothesis? How might the findings from this study have affected standards of care (the normal diagnostic or treatment process for a specific condition) for contraception needs?
In a short essay format, 1 2 single spaced pages, write one side of a debate about the safety of oral contraceptives based on this study. Choose either to support the author’s conclusion, or to argue that it is misguided. You should not base your debate on conjecture, pre formed personal opinion, or even more recent findings from the Nurses’ Health Study, if you are aware of them – instead focus on the study itself and the decisions made in its design and conduction. As you formulate your argument, you may also include any possible impacts on public health or medical practice. The faculty notes and readings present the basic issues for the cohort design that can help you to guide your essay. In addition, use the points below to help you to write an organized, concise argument.
- The basic design and structure of the cohort, including inclusion/exclusion criteria, how it was identified and followed. Think about possible sources of bias, or information that may have been useful but was not collected, or why you think bias was unlikely to have been operative.
- Think about how the choice of a cohort design compares to other design options in testing the study’s hypothesis.
- Consider that the findings from this study may affect standards of care (the normal diagnostic or treatment process for a specific condition) for contraception needs, and what impacts that may have (how many people affected, costs, etc.).
- Based on what you have learned about the strengths of a cohort design and the findings of the study, determine if you think the author’s conclusion is justified. Decide if there be anything you might do differently or any additional study you might prefer to conduct to further support these findings.
- Based on what you have learned about the strengths of a cohort design and the findings of the study, determine if you think the author’s conclusion is justified, or needs more support.
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To review the criteria on what will be expected of you in the Written Assignment, please refer to the Written Assignment Rubric.