COH 315 Wk. 4 finals pt 1

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Jan 9, 2024

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COH 315 – Dec 2023 Week 4 – Final Pt. 1 COH 315: Principles of Epidemiology Final Part 1 Calculations and Interpretations: Answer the following questions in the space provided. Show all of your work. 1. Evidence of an increased risk of lung cancer associated with cigarette smoking was sought by Doll and Hill. In one study, 649 lung cancer cases were matched by age, and gender to 649 controls; 647 of the cases and 622 of the control had a history of smoking cigarettes. a. Name the type of study. Case Study b. Create the appropriate 2X2 table for the study. (2 points) Lung Cancer Controls Smokers 647 622 Nonsmokers 2 27 Total 649 649 c. Calculate the appropriate measure of association for the study. (4 points) Odds ratio exp. Of cases: 642/2 = 323.5 Odds ratio exp. Of controls 622/27 = 23.03 Odds ratio exp. Of exposure: 647(27)/622(22) = 14.04 d. Interpret the results. (2 points) Odds ration greater than greater than 1, exposure is greater than the controls. The possibility of smokers developing cancer is 14 times versus the non-smokers. 2. In another study, the smoking habits of 34,445 male physicians were obtained by mailed questionnaires. Deaths among these physicians over the subsequent years were identified though contact with the office of the Registrar General. The death rates from lung cancer of these physicians classified by smoking habits were : Standardized Death Rates per 1000 Persons Aged 35 or More per Year

Nonsmokers 0.07 Cigarette Smokers 0.96 a. Name the type of study. (2 points) Cohort Study b. Calculate the Relative Risk for smokers as compared to nonsmokers. (6 points) 0.96/0.7 = 13.71 c. Interpret the results (2 points) The risk of the disease is greater versus the unexposed group since the relative risk is above 1. Exposure can be interpreted as a risk factor for the disease. Secondhand smoke exposure can cause 13.71 times more prone to death versus the non-exposed. Annual Death Rates per 100,000 Persons Exposure Category Lung Cancer Coronary Heart Disease Heavy Smokers 166 599 Nonsmokers 7 422 a. Calculate the relative risk from Lung Cancer Mortality for Heavy Smokers compared to non smokers. ( 4 points) 166 per 100000 = 0.00166 7 per 100000 = 0.00007 0.00166/0.00007 = 23.71 b. Calculate the attributable risk of Lung Cancer from smoking. (4 points) 0.00166 – 0.00007 = 0.00159 c. Interpret the results. (2 points) 159 incidence cases per 100000 population can be correlated with smokers to lung cancer. d. Calculate the percent attributable risk of Coronary Heart Disease due to smoking (4 points).

599 per 100000 = 0.00599 422 per 100000 = 0.00422 0.00599/0.00422 = 1.41943 (Relative risk) [(1.41943 – 1)/ 1.419143] (100) = 2.9549 = 29.54% e. Interpret the results. (2 points) 29.54% of coronary heart disease morbidity is caused by smoking. 29.54% of morbidity from CHD in users could have been prevented when they do stop smoking 3. Convert the following incidence rates to attributable risk using the additive model: (5 points) Incidence Rates Relative Risks Factor A Factor A _ + _ + Factor B - 3.0 9.0 0.0 6.0 9.0-3.0 _____________________________________ __________________________________ + 15.0 21.00 15.0-3.0 12.0 18.0 21.0 – 3.0 4. Calculate the concordance rate for the following data: (5 points) Twin 1 Has Leukemia Does Not Have Leukemia Twin 2 Has Leukemia 14 1 Does Not Have Leukemia 26 36 [(14/40)(40/77) + (14/15)(15/77)] / [(40/77) + (15/77)] 0.18182 + 0.22078 / .71429

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0.056364 (100) = 56.36% There is a 56.36 chance for the second twin to develop leukemia.

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