Evaluating a Stillbirth Research Study

This assignment critically analyzes a research study investigating the factors contributing to stillbirth. Students evaluate the study's design, including the appropriateness of measures used, potential confounding variables, and the consideration of blinding. They assess the accuracy and reliability of the results, considering factors like P-values, confidence intervals, and the impact of adjustments. Additionally, students explore the generalizability of the findings to other populations and discuss how they align with existing evidence. The assignment requires a thorough understanding of research methodology and statistical analysis.

Assignment

INTRODUCTION
In the present report, there are two articles given. In order to make proper analysis of
these two articles there is tools used that contains 11 questions. In depth analyses can be made
using these questions. There are three sections in this tool that contains questions like does the
research conducted have valid trial, results obtained from the research and benefits that are
attained locally from results.
Study 1: Obesity paradox and mortality in adults with and without incident type 2
diabetes: a matched population-level cohort study
(A)
1.
Yes, research is highly focused and clear. The issues focused here is related with obesity.
 Population is studied for patients with type two diabetes and individuals who don’t.
 Main risk of the study is to make proper evaluation of the data collected.
 Both beneficial and harmful effects are discussed.
2.
Yes
 Research has used appropriate way of answering questions.
 The study questions are answered and the researcher has made use of primary data to
gather information.
3.
Yes, study conducted acceptable recruits because total number of cases considered are
about.
 Precisely cases are defined
 10464 patients with incident T2D compared with individuals with 31020 people who
have never developed T2D of UK
 There was reliable system for selecting
 Time frame is relevant to exposure
 There was sufficient number of cases selected
 Power calculation included
4.
1

Yes, investigator has used appropriate way in selecting controls as proper evaluation was
done and comparison were done by people with T2D and other who do not have.
 Controls were represented of defined population which was UK.
 Specific about the population were individuals with type 2 diabetes and people who did
not.
 Non response were not high. Yes the non-respondents were different in some ways.
 Selection of respondents are done randomly and so all had equal chance of being
selected.
 Sufficient number of control were chosen.
5.
Yes, measures are taken for minimum biasness as considerations is made for people who
never smoke and still it causes their body mass index to get raised.
 Exposure was clearly defined
 It reflects what they were expected or supposed to measure
 Measurement methods were simple
 Exposure precede the outcome
6. (a)
Author has missed the part for genetic factors.
(b)
No, there are no restriction design or related models used and there are no potential
confounding factors are not considered.
7.
From the research it is found that individuals who never smoke, danger for causing death
increases by 25Kg/m2. The paradox of obesity in every smokers who have T2D or don’t claim
for choosing biasness. However, this supports involvement of effect adjustment caused due to
smoking.
 The analysis made were appropriate for the results
 Difference found are not high
(B)
8.
The Pvalue is less than 1 which shows that the hypothesis that was developed is accepted.
2

The authors have considered all the important factors for carrying out the research in effective
manner. Further the rate of risk estimated is low.
 Mostly all the variables are considered.
9.
Yes, we trust given result because the sample size take is high and they have made use of
random sampling method, this has provided equal changes of being selected.
 This is due to confounding factors
 No Bradford Hills criteria is not considered
(C)
10.
Yes, result is applicable for resident people because obesity is an issue that can be happen
to anyone. There are different set of reasons that can be identified for this type of issue.
 Local people will be able to identify the ways through which issues due to type 2 diabetes
can be reduced.
11.
By considering all study, with evidences that are available the study is fit. Researcher has
considered case control studies for consistency.
Case Study 2: A Population-based Case-Control Study of Stillbirth: The Relationship of
Significant Life Events to the Racial Disparity for African Americans
(A)
1.
Yes, research has clearly stated the problems which is increased rate of stillbirth.
 Women in 5 US catchment areas are considered from two years. More specifically, that is
from March 2006 to September 2008.
 There is increased risk of stillbirth for at least 50%. Further, there are 13 significant life
events (SLE) listed among which women have experienced 3 or more SLE factors.
 The study focus on harmful effects that are faced by women who face stillbirth situation.
Further, there are reasons that are listed due to which this condition arises.
2.
No, methods applied are not appropriate for answering queries.
3

 Case study is not appropriate way of answering the questions for this research.
 The research has addressed all the research questions.
3.
Yes, study conducted acceptable recruits as there are proper data given in accordance
with the research topic.
 Case is defined precisely as the comparison is made from the women of Africa and
America.
 Population is taken from US but there is not defined population.
 No reliable system was selected for choosing case studies.
 Cases are incidents that occurred during the year 2006 to 2008.
 Time frame of the study is relevant to exposure but the data is not recent.
 Yes sufficient number of cases are selected which occurred during two years.
 Yes there was power calculation done.
4.
No, in appropriate way, controls were not chosen.
 Two populations are compared one of US and other of Africa but total number is not
properly defined.
 Nothing special about the controls found
 Populations were randomly selected
 There are no sufficient number of control selected
5.
No, exposure was not correctly evaluated in minimizing biasness.
 Exposure of the research was clearly defined by the measure taken were not appropriate.
 Objective measures were taken by authors.
 The measures reflects what they were suppose to measure
 Yes, the measurements were simple in cases and controls.
 Study does not incorporate blinding where feasible.
 The temporal relations were correct.
6. (a)
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The rate of SLEs will increase the risk due to increased consumption of drugs, alcohol
and smoking. Further, intermediate variables were not included in the model. Moreover, authors
have accounted genetic as confounding factor.
(b)
Yes, for designing analysis, factors of confounding are considered which includes
modelling stratified.
7.
Result of the research displays, women need to take care of their health by make sure that
they do not consume alcohol or drug. Age also plays negative impact on increasing stillbirth in
conditions in which age is high.
 Bottom line includes taking healthy diet and avoiding elements that harm health.
 The analysis is appropriate for the design.
 Exposure and outcome are strong.
 Adjustment has not made much difference
(B)
8.
Result are not accurate. The rate of risk estimated is high for women when they do not have
proper diet.
 No P-value given
 95% confidence interval.
 Important variables are considered.
 Refusing to participate were not evaluated.
9.
Yes, we trust the conducted research because rate of stillbirth are increasing.
 The results are effective due to confounding
 Methods and design are sufficiently flawed to make the result reliable.
 Bradford Hills criteria is not considered
(C)
10.
Yes, research can be implemented for residential people.
 Similar to the local population
5

 Local setting is not likely to be different that of the study.
 Results are beneficial in determining the causes and the harm faced by women.
11.
Yes, research is fit with other existing evidence.
 Control case studies are considered for evidence.
REFERENCES
Badrick, E., Sperrin, M., Buchan, I. E. and Renehan, A.G., 2017. Obesity paradox and mortality
in adults with and without incident type 2 diabetes: a matched population-level cohort
study. BMJ Open Diabetes Research and Care. 5(1). pp.e000369.
Hogue, C. J., Parker, C. B., Willinger, M., Temple, J. R., Bann, C. M., Silver, R. M., Dudley, D.
J., Koch, M. A., Coustan, D. R., Stoll, B. J. and Reddy, U. M., 2013. A population-based
case-control study of stillbirth: the relationship of significant life events to the racial
disparity for African Americans. American Journal of Epidemiology. 177(8). pp.755-767.
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