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Did the prevention strategy work?

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Did the prevention strategy work?

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  1. xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx xxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxx How to Evaluate Did the prevention strategy work? Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  2. Hypotheses 1 How is this disease distributed? 2 Is there an association? 3 Is the association causal? 4 What should be done to prevent the disease? Was is worth the effort? Should we continue it? 5 Did the prevention strategy work? Where are we and where are we going? What’s my hypothesis? Did the exposure and the disease turn up together? Why did the exposure and the disease turn up together? What should I do? What should society do? Investigation 5-2 Intro to Epidemiology – Investigation 5-2: How to Evaluate

  3. O E O Random Assignment Healthy People O E - O ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Review Trial Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  4. O E O Healthy People O E - O ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Review Cohort Study Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  5. E O E E - O E ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Review Case-Control Study Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  6. E E O - O Review Cross- Sectional Study ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  7. Review Epi Speak Risk Management Steps taken to reduce the levels of risk to which an individual or a population is exposed. Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  8. “Diet and Exercise Dramatically Delay Type 2 Diabetes” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  9. 1 2 3 “Diet and Exercise Dramatically Delay Type 2 Diabetes” Group Intervention Description % Developed Diabetes Lifestyle Intervention Participants received intensive training in diet, exercise, and behavior modification skills aimed at reducing weight by 7% through a low-fat diet and exercising for 150 minutes a week. 14% Metformin & Information Participants received treatment with the drug metformin (850 mg twice a day) and received information on diet and exercise. 22% Placebo & Information Participants received placebo pills, in place of metformin, and received information on diet and exercise. 29% Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  10. Epi Teams Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  11. “Diet and Exercise Dramatically Delay Type 2 Diabetes” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  12. E O O Trial Cohort Study Case-Control Study O E E E O O Random Assignment Healthy People Healthy People E O O E E E - - - - O E Cross- Sectional Study E O O O O ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Time Time Time 1 “Diet and Exercise Dramatically Delay Type 2 Diabetes” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  13. Epi Speak Epi Speak Random Assignment Assignment of individuals to groups by chance. Random assignment should make the groups similar at the start of the study. Random assignment should not be confused with haphazard assignment. Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  14. Epi Speak Epi Speak Placebo An inactive medication or procedure. In a trial, placebos are given to the control group. Because a placebo is an inactive medication or procedure, it means “no exposure.” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  15. 2 “Diet and Exercise Dramatically Delay Type 2 Diabetes” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  16. 3 1 14% Lifestyle Intervention O 22% 2 Metformin & Information O - 3 29% Placebo & Information O Trial 3,234 people at high risk for type 2 diabetes Random Assignment Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  17. 4 “Diet and Exercise Dramatically Delay Type 2 Diabetes” Type 2 diabetes “… is strongly associated with obesity (more than 80% of people with type 2 diabetes are overweight), inactivity, family history of diabetes, and racial or ethnic background.” Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  18. “Diet and Exercise Dramatically Delay Type 2 Diabetes” No Type 2 Diabetes Type 2 Diabetes Risks Type 2 Diabetes Relative Risk Total 40 40 % 40 60 Obesity 100 100 4 times as likely a b c d No Obesity 10 10 90 100 10 % 100 Count Divide Compare Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  19. An independent group of experts that periodically reviews and evaluates study data. It is interested in safety of participants, study conduct and progress, and preliminary findings. It can make recommendations about continuation, modification, or termination of the study. Epi Speak Epi Speak External Data Monitoring Board Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  20. 5 “Diet and Exercise Dramatically Delay Type 2 Diabetes” External Data Monitoring Board Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  21. E O O Trial Cohort Study Case-Control Study O E E E O O Random Assignment Healthy People Healthy People E O O E E E - - - - O E Cross- Sectional Study E O O O O ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Time Time Time Ideal Conditions? / Everyday Conditions? Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  22. O E O Healthy People O E - O ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time 6 Lifestyle Intervention Effectiveness Cohort Study Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  23. Type 2 Diabetes Lifestyle Intervention O Type 2 Diabetes - No Lifestyle Intervention O Effectiveness: Cohort Study People at high risk for type 2 diabetes Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  24. E O E E - O E ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time 7 Lifestyle Intervention Effectiveness Case-Control Study Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  25. Lifestyle Intervention No Lifestyle Intervention Lifestyle Intervention - No Lifestyle Intervention Effectiveness: Case-Control Study People with type 2 diabetes People without type 2 diabetes but at high risk Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  26. E E O - O 8 Lifestyle Intervention Effectiveness Cross- Sectional Study ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  27. Lifestyle Intervention No Lifestyle Intervention Type 2 Diabetes - No Type 2 Diabetes Effectiveness: Cross-Sectional Study Cross- Sectional Study Time Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  28. Time O E O O E O - Essential Question 5 Did the prevention strategy work? Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

  29. Investigation 5-2 has ended. CDC How to Evaluate Intro to Epidemiology – Investigation 5-2: How to Evaluate Investigation 5-2

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