VET656 (2019, s2)
Assessment 1: Epidemiological study design
Health research plays a central role in improving health of the population and stimulating national economic growth. Health research supports health systems in the delivery of better, fairer and more equitable health care to people. It does so by identifying the challenges and providing best solutions, monitoring how health systems perform and producing new knowledge for better technologies and improved approaches to public health. The World Health Organisation (WHO) affirms that all national and international health policies: (i) should be based on valid scientific evidence; (ii) that such evidence requires research; and (iii) that the application of the knowledge, information and technology emanating from health research has enormous potential in promoting health.
Shifting epidemiological trends in disease patterns, rapid increase in populations, new and emerging health problems, increasing commercial interests of the private health sector and ever shrinking financial resources all contribute to the global inequity in health care. It is therefore important that research addresses priorities and focuses on the most important health issues, conditions and determinants. This will enable health research to serve as a driver for health policy and practice.
The objective of the assignment is to deepen your understanding of the issues involved in choosing and developing study designs by considering a real public health problem. It is designed to enable students to work through the process of coming up with a research question related to public health and then consider what methodology and methods could be used to answer it. There is no right or wrong answer so feel free to be as creative as you wish. Just be mindful of the advantages and limitations of the different epidemiological study designs SPECIFIC TO YOUR RESEARCH QUESTION when developing your research proposal.
Group List and Public Health Topic
Please refer to the group list available under “Assessment 1” on the LMS
Part 1. Develop a research question.
In your assigned groups, develop a research question on the public health topic assigned to your group. Some examples:
Public Health Topic 1. Decreasing the burden of stroke.
Will reducing salt intake reduce the risk of stroke? Stroke results from either a blockage in one of the arteries supplying the brain or bleeding from one of these arteries into the brain. Stroke carries a high risk of death and is a major cause of disability worldwide. Hypertension (high blood pressure) is an established risk factor for stroke. Among people with high blood pressure, reducing blood pressure using anti-hypertensive medication substantially reduces the risk of stroke. High salt intake is one factor that contributes to high blood pressure. The extent to which salt intake is a risk factor for stroke remains controversial. The food industry argues that just because high salt intake is associated with higher blood pressure, it does not mean that higher salt intake causes stroke or that reducing salt will prevent strokes. The association between salt intake and stroke is an important question because salt intake is potentially modifiable both for individuals (for example by following dietary advice) and for populations (for example by reducing the salt added to processed foods). What approach would you take to investigate the association between salt intake and risk of stroke?
Public Health Topic 2. Decreasing hospital admission rates due to acute asthma in children
In children with acute asthma, does dexamethasone given orally reduce the hospital admission rate? Asthma is a chronic inflammatory disorder of the airways. Corticosteroids reduce airway hyper-responsiveness, inhibit inflammatory cell migration and activation, and block late-phase reaction to allergens. Inhaled steroids improve control of asthma and are safe and well tolerated by children, however they do not improve acute exacerbations. Oral corticosteroids may be more effective have known sides effects and convincing a child to take oral steroids can be difficult. What sort of study could be used to determine whether prescribing oral medication to children with acute asthma is likely to reduce asthma-related hospital admissions?
Public Health Topic 3. Reducing the Global Burden of Respiratory Infections in Infants
What is the impact of indoor air pollution on respiratory infections in infants? There is evidence that indoor air pollution from cooking fires is related to respiratory disease in children and adults in some situations. The health minister has just attended a meeting where this was discussed and is keen to do something about it. In the area where you work, although respiratory infections are an important cause of morbidity and mortality, especially amongst young infants, no one believes that indoor pollution can be important because people spend so much of their time outside. You have persuaded the minister that it would be useful to assess the impact of indoor air pollution on respiratory infections in infants before rushing ahead with any interventions. What approaches could you use?
Part 3. Epidemiological study design
Written Report – 80% of the mark for Assessment 1.
Submission: The written report is due at 5pm on Monday 23rd of September.
Each person will develop a research proposal designed to answer a specific research question related to the topic decided by their group in Part 1. This is an individual assignment but you are welcome to discuss your ideas with the other members of your group and with other students in your class. The research topic remains the same for each student in the group however each student must design a study that is unique. For example, it may be conducted in a different geographical location, or answer a different question related to the public health topic. For example, Student 1 designs their study in Tibet, Student 2 designs their study in the Viet Nam and Student 3 designs their study in Australia. You must agree with the other members of the group which location you all choose. You can all use the same study design. However, it must be applicable and justified in the geographical location you have decided upon.
Students must adhere to the structure, (see below) and be no more than 2,500 words in length.
The written report should be of the highest standard of written scientific English and should display evidence of critical thinking and rigorous scientific consideration of the topic and appropriate references.
Structure: The study design is written as a research proposal and should include the following sections:
1. Title of the project: The title should be no more than 20 words
2. Study duration: in months
3. Project Summary: The project summary is like an abstract and it should be no more than 300 words. It should summarise all the central elements of the protocol, for example the rationale, objectives, methods, populations, time frame, and expected outcomes. It should stand on its own, and not refer the reader to points in the project description.
4. Rationale and Background: The Rationale specifies the reasons for conducting the research in the light of current knowledge. It should include a well-documented statement of the need or problem that is the basis of the project, the cause of this problem and its possible solutions. It is the equivalent to the introduction in a research paper and it puts the proposal in context. It should answer the question of why and what: why the research needs to be done and what will be its relevance. The magnitude, frequency, affected geographical areas, ethnic and gender considerations of the problem should be followed by a brief description of the most relevant studies published on the subject (with references).
5. Study goals and objectives: Goals are broad statements of what the proposal hopes to accomplish. They create a setting for the proposal. Specific objectives are statements of the research question. Objectives should be simple (not complex), specific (not vague), and stated in advance (not after the research is done). Please refer to the SMART objectives provided on the LMS.
6. Study design and methods: The scientific integrity of the study and the credibility of the study data depend substantially on the study design and methodology. The design of the study should include information on the type of study, the research population or the sampling frame, who can take part (e.g. inclusion and exclusion criteria, withdrawal criteria etc.), and the expected duration of the study. This section should contain:
a. Study area
b. Sampling design
c. Sample size considerations (NOTE: you do not need to perform a sample size calculation)
d. Data analysis (NOTE: only include what you have learned in this unit, we are not expecting complicated analysis). What measures of disease frequency will you use? What measures of association? Remember this is dependent upon your choice of study design e. Ethical considerations
f. Study limitations – here you need to consider any potential error and bias
7. Study impact: What are the expected outcomes of your study? How do you anticipate the results will be used? For example, how will your results be used to inform current public health policy?
8. Project management arrangements: Who will be involved in the project? What organisations, institutions and individuals will you need to include to enable you to conduct the study? Ask yourself what disciplines, sectors or areas of expertise will you need to include.
The research proposal will be assessed according to the following criteria:
Category Mark (100%)
Adherence to instructions to authors 5
Knowledge of main concepts, terminology, and frameworks related to the subject 20
Evidence of critical and creative thinking 20
Communication of information and idea, including significance and relevance of the topic 20
Quality of argument and writing 15
Sentence structure, spelling and grammar 10
Data sources and references 10
Please refer to the assessment rubric on the LMS.