Epidemiology in the News: Randomized Trials

According to the Centers for Disease Control (CDC), asthma is a leading chronic illness in children ages 5 to 17, a leading cause of school absenteeism, and the third highest cause of hospitalizations in children younger than 15 (2011). The costs associated with treating this chronic illness are high.

A number of randomized control trials have examined the effect of instituting a home management program for treating asthma in combination with pharmaceuticals. These studies found that, by implementing a structured home management program, the morbidity, severity, and frequency of asthmatic episodes were reduced (Agrawl, Singh, Mathew, & Malhi, 2005). Recent research is also exploring how and when to cut back on levels of medication as asthma episodes become controlled, further reducing the cost of this chronic illness; however, controversy remains over the long-term effects of reducing levels of medication due to the disparateness of asthma (Rogers & Reiberman, 2012).

For this Discussion, you are asked to identify an example of an experimental study design in the popular literature and consider the ethical implications of the randomized control trial design.

To prepare:

Search the Internet and credible websites to locate a news piece or article that features a randomized trial study design. The article should be from a widely distributed news source, accessible to and written for a lay audience. Possible sources include, but are not limited to, online magazines, online newspapers, and health news websites. Be sure to include a link to the article in your posting. You may not select an article already posted by one of your colleagues for this Discussion.

Critically analyze the following aspects of the research study:

Purpose

Study population

Length of the trial

Data collection methods

Outcome measures

Results and conclusions

Ethical issues associated with the study

Ask yourself: How did this research study benefit from its randomized design? What was discovered by randomization that might not otherwise have been demonstrated?

By tomorrow 03/20/2018 , write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive scholarly response that addresses the following:

1) Summarize the research study addressing the aspects bulleted above. In your posting, provide a link to the article you selected.

2) Identify and discuss the ethical issues associated with this study.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 8, “Experimental Study Designs”

This chapter examines experimental and quasi-experimental study designs.

Johnson, T. S. (2010). A brief review of pharmacotherapeutic treatment options in smoking cessation: Bupropion versus varenicline. Journal of the American Academy of Nurse Practitioners, 22(10), 557–563.

The authors of this article explored treatment options for smoking cessation by examining the research literature, including looking at the results of randomized control trials. This article provides an example of how such a literature review can influence practice demonstrate the use and benefits of randomized control trial study designs.

Milligan, K., Niccols, A., Sword, W., Thabane, L., Henderson, J., Smith, A., & Liu, J. (2010). Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: A meta-analysis. Substance Abuse Treatment, Prevention & Policy, 5, 21–34.

This article examines programs that integrate substance abuse treatment and pregnancy, parenting, or child services. The authors conclude that there is a need for funding of high-quality randomized control trial and improved reporting practices. This article also demonstrates the application of analytic research designs to explore a population health problem.

Talaat, M., Afifi, S., Dueger, E., El-Ashry, N., Marfin, A., Kandeel, A., Mohareb, E., & El-Sayed, N. (2011). Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerging Infectious Diseases, 17(4), 619–625.

This research study used a randomized control trial to examine the association between hand washing and reducing influenza. As you review this article, notice how they structured the research study and how they measured the association between hand washing and absenteeism.

Physicians’ Health Study (2010). Retrieved from http://phs.bwh.harvard.edu

This large-scale, randomized clinical trial that began in 1982 was designed to test the effectiveness of aspirin and beta carotene in preventing heart attacks (myocardial infarctions, or MIs) in male physicians aged 40–84. The first phase of the trial, which included more than 22,000 study subjects, demonstrated that low-dose aspirin does, in fact, reduce the risk of a first MI by 44%. This article provides a good example of the types of large-scale studies conducted using epidemiologic principles that lead to improved population health.

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Experimental studies [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 5 minutes.

In this program, the presenters discuss experimental studies, including the effect of randomization and blinding on study results.

Optional Resources

Groopman, J. (2006, December 18) Medical dispatch—The right to a trial: Should dying patients have access to experimental drugs? New Yorker, 82(42), 40–47.

Dorak, M. T. (2006). Epidemiologic study designs [PowerPoint presentation]. Retrieved from http://www.dorak.info/epi/design.ppt

Ibrahim, M., Alexander, L., Shy, C., & Farr, S. (2000). Randomized trials. ERIC Notebook, 10, 1–4. Retrieved from http://cphp.sph.unc.edu/trainingpackages/ERIC/eric_notebook_10.pdf