Real world Case 13.1.html notes
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Apr 3, 2024
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Real-World Case 13.1
Researchers were interested in assessing the relationship between obesity and breast cancer recurrence and
fatality in postmenopausal African American and Caucasian women with primary breast cancer. Data was collected on women with primary breast cancer and included the following variables:
•
Age
•
Age at diagnosis of breast cancer
•
Weight
•
Height
•
Data of diagnosis of breast cancer
•
Menopausal status
•
Diagnosis and coding of tumor (histopathology and topography)
•
Stage of tumor
•
Size of tumor
•
Number of positive lymph nodes
•
Estrogen receptor analysis
•
Progesterone receptor analysis
•
Site of distant metastasis
•
First course of treatment (surgery, radiation, chemotherapy)
•
Additional treatment
•
Five-year recurrence and survival rates
Recurrence and survival status were determined by reviewing the cancer registry follow-up data and health
record information across the multiple healthcare sites involved in this study. The cancer registries were
accredited by the American College of Surgeons and used active follow-up on all cancer patients.
Postmenopausal status was determined as subjects older than 55 years
. In subjects younger than age 55,
postmenopausal status was determined by consulting the cancer registry data and health records (hospital and
physician office). Premenopausal patients and patients whose menopausal status could not be determined
from the data were excluded from the study. Body mass index (BMI) was based on height and weight
collected from the health record or cancer registry at the date of diagnosis only. Values greater than 27 were
considered to indicate obesity. The effect of weight changes during the follow-up period was not evaluated.
Real-World Case Questions
1.
Identify how obesity was determined in this group of patients.
The body mass index or also known as the BMI, was conducted using the patients height and weight,
which was collected from their cancer registry and health record(s) at the time and date of their diagnosis.
2.
Justify the importance of collecting the other variables when studying the relationship between obesity and
breast cancer recurrence.
All information that has been gathered helps find the variables that may or may not have something to do
with all the patients. Each patient has had breast cancer of some form; however, this does not show the
data that shows what has caused the cancer to happen in the patient(s). All this information will pull
together information that my all be, or some have something in relation to one another.
3.
Postmenopausal status was determined as subjects older than 55 years. Recommend a better method
to determine whether the women in this study were postmenopausal.
There have been better ways and opportunities to prove that a woman have begun postmenopausal,
because age does not necessarily mean a woman has started this milestone in her life. Doctors and
researchers have found that testing a woman for follicle-stimulating hormone (FSH), after a woman has
not had a period for over 12 months or one year. This hormone check helps the doctor know when a
woman is in postmenopausal status or not at all.
4.
Identify the type of study design used. If it was found that obesity and breast cancer recurrence were related; what type of study could be
conducted to test whether changes in diet may make a difference in the recurrence of breast cancer
in women who have had primary breast cancer in the recurrence of breast cancer in women who
have had primary breast cancer.
The type of study design that was used to determine that obesity and breast cancer recurrence were and/or
are related descriptive studies
. Descriptive studies is a type of research that is exploratory in nature and
generates new hypotheses from the data that was collected. The research study type for whether diet would
make a difference would be experimental type, utilizing different forms of cause and effect to determine
the outcome.
5.
This study did not examine premenopausal women. It did not look at races other than African
American. Determine if this is a limitation. Defend your response of why or why not.
This study had not mentioned whom they were going to research and who they were going to exclude in
this research study; however, this may have been a controlled case that was meant for research in African
American women only. The article mentions postmenopausal women and there was the mention of African
American women, which brings to point that this research study was case-controlled with postmenopausal,
African American women; whom were or are breast cancer patients that were obese.
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