Critical Appraisal of Sleep, Breast Cancer and Public Health Concerns

This report presents a critical appraisal of a case-control study examining the relationship between self-reported sleep duration, sleep quality, and breast cancer risk. The study, conducted in Western Australia, involved 1000 cases and 2000 age-matched controls. The appraisal evaluates the study's title, abstract, introduction, methods (including settings, participants, study design, and statistical methods), results, and discussion/conclusion. The report highlights strengths such as the large sample size and clear presentation of methods, while also noting weaknesses like potential recall bias and the lack of graphical result presentation. The report also examines the statistical methods employed and the limitations of the study, such as the focus on sleep factors and the potential for misclassification bias. Overall, the appraisal offers a comprehensive overview of the study's findings, limitations, and its contribution to understanding the complex relationship between sleep and breast cancer. The study concludes that it does not provide evidence to support an association between self-reported sleep duration and breast cancer.

Critical Appraisal of Emerging Public
Health Challenges

Table of Contents
Article : Self Reported Sleep Duration, Sleep Quality and Breast Cancer Risk in a Population
Based Case Control..........................................................................................................................1
1. Description...................................................................................................................................1
2. Article Critique ...........................................................................................................................1
2.1 Title and Abstract.............................................................................................................1
2.2 Introduction......................................................................................................................2
2.3 Materials and Methods...............................................................................................................2
2.3.1 Settings and participants................................................................................................2
2.3.2 Study Design.................................................................................................................3
2.3.3 Statistical Methods........................................................................................................3
2.4 Results........................................................................................................................................3
2.5 Discussion and conclusion.........................................................................................................4
REFERENCES................................................................................................................................5

Article : Self Reported Sleep Duration, Sleep Quality and Breast Cancer Risk
in a Population Based Case Control.
1. Description
Article base on the study of Breast cancer and showing that it is one of the most common
disease which diagnosed in invasive cancers. In other words, Several studies has found that lack
of sleep cause risk of breast cancer. According to data In Australia and globally Breast cancer is
the leading cancer found in Women. Present study is also stated the two biological models which
has been proposed and explained how poor sleep can directly affect the development of cancer.
Overall, the aimed of this study is to investigate the relationship between breasts cancer
and 3 domains of sleep. Besides, this study also conducted a deep review of 1000 cases and 2000
age matched controls (Dini and et.al., 2018). Controls were women between the age group of 18-
80 living in Western Australia. All these participants were randomly selected from the electrol
roll. Present paper is clearly makes the sense which is easy to understand the purpose of the
study.
2. Article Critique
2.1 Title and Abstract
Present study is effectively accomplish the aim of the study but could have been done
more better if they adopt the tool of research critique checklist. Meanwhile, the purpose of
Abstract is to provides the short and informative and balanced summary. The strength of the
study is to conduct large population based case which significantly described the relationship
between sleep durations on workdays and non workdays and including subjective sleep quality.
In order to read the study, reader clearly get understand that what has been done throughout the
research. Study also mentioned some keywords through everything is easily get understand like
“Impaired Immune system”, “Metabolic pathways”, Obesity, Circadian rhythm, sleep etc
(Monteiro and et.al., 2018). Present study is approved by the human research ethics committees
of the Western Australian Department of Health and the University of Western Australian. Study
also conducted survey and asked to participants to complete a self administered postal
questionnaire that contained questions on demographic, reproductive and lifestyle factors or
related to sleep.
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2.2 Introduction
Research consists most important part which is introduction. As same with this research,
introduction of the study briefly explained the overview of Self reported sleep duration, quality
of sleep and breasts cancer. From which it clearly stated that due to lack of quality sleep risk
breasts cancer has been increased (Rashid and et.al., 2017). Introduction part also clearly
mentioned the aim of the study is to examine the relationship between breast cancer and 3
domains of sleep. Also it explained the cases based on the issue alike cases were female residents
in Australia. Introduction also described that major part of the study is based on hypothesis
study. Study conducted survey on selection bias which is based on information on age, socio-
economic status. Further to conduct a data analysis researcher has been taken selection bias and
misclassification bias. Under which selection bias data is base on age, socio-economic status.
Besides, misclassification bias is based on our exposure variables (Sharma and Singh, 2017). So
the study wants to find that weather the sleep factor is playing a major role in breast cancer or
not. Introduction is the significant part of the study which helps to elaborate the study into briefly
manner and also explained the purposeful study to find out the results.
2.3 Materials and Methods
2.3.1 Settings and participants
This study was conducted in Western Australia which was a case control study of
environmental and occupational risk factors for breast cancer. In this research, researchers have
used descriptive categories in order to describe the locations, setting as well as relevant dates. All
of these categories has been fairly achieved by the research. The participants which where
involved in the research were the female residents of Western Australia which were aged
between 18 and 80 years. Also, the sample size of 1000 cases and 2000 ages matched control
was calculated which was based on expected number as well as recruitment rate of breast cancer
patients in Western Australia. The questionnaire which were filled by the participants had 95%
of response from the participants. 5% of data was missing and another drawback of this research
was misclassification bias which was manly due to exposure variables which where categorical.
This research has achieved its aim of increase of risk of breast cancer which was expected to
detect and for this Western Australia was chosen but it was not explained why this particular area
was chosen. Also, Exclusion and inclusion criteria was discussed in the study, those cases where
excluded if the cancer was not invasive which have increased the quality of research.
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2.3.2 Study Design
The study design of this study was descriptive and logical which made it easy for readers
to understand the measure which were taken in order to assess the disability and frailty of the
chosen participants. In this research, frailty index was chosen but does not explain the reason
behind it (Clark and et.al., 2016). There are various other frailty assessment tool which could
have used like clinical frailty scale which determines person's level of frailty. One of the
weakness of the study design was that the way that disease was reported, this research was based
on there activities such as sleep duration, sleep quality and risk of breast cancer which could
have created a bias while reporting the risk of breast cancer in females. But the major advantage
of this research is that all three activities where well linked with each in order to provide
appropriate results.
2.3.3 Statistical Methods
Statistical analysis of this research was thoroughly describes and the method which was
used for this research was polytomous regression modes were used in order to determine the odd
ratios. In this report stratified analysis was also conducted for three characteristics of the
circadian rhythm. The statistical methods which were used for this research have made it easier
for researcher to replicate the study. The weakness of this study is that not a single reason was
given why 1000 participants were selected for the researcher which where followed. Women
which were selected for this research were aged between 18 and 80 years and were randomly
selected by the researchers through electoral roll (Shokouh and et.al., 2017). The participants
which were chose for the study have to complete self-administrated postal questionnaires on
their reproductive, demographic as well as lifestyle factors in order to get proper results. Various
statistical analysis which were conducted in this research by researchers is Stata 12 and
Microsoft Excel 2010 which were the most tools used for statistical analysis. Also, all statistical
test which were used in this research were two-sided which has increased the quality of the result
and have make effective presentation of data.
2.4 Results
Results of this research were presented in a proper systematic manner which has
increased the quality of the research. There were different table used in order to present the
results which were based on the replies from the participants. Each result of the research were
describes the variables which are being measured and compared (Tucker Lima and et.al., 2017).
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In the study use of tables were properly made which have made it easy to make proper
comparison as well as associate the results with variables. This is also the strength of the
research, but the weakness of the study the results where not presented in the graphical from. The
results of the study was limited to primary objective of the research i.e. sleep duration, sleep
quality and breast risk in a population. This research could have presented various other social
determinants of health and their association with risk of breast cancer in females, the mortality,
frailty and disability. This could be used by the researchers in their future study.
2.5 Discussion and conclusion
From the above study it has been based on the topic Self reported sleep duration, quality
of sleep and breasts cancer”. From the participation study of 2994 approximately 5% had
missing data, leaving 2828 for sleep duration analysis and 2827 for sleep quality analysis. As per
the results, it has been outlined that after conducting survey of sleep duration only 5% of
respondents fell into the the last categories which is 8 hours.
Limitation of the study is it demonstrate and focus on only sleep factor besides there are
some more factors through which breast cancer is diagnosed (Valente and Pitts, 2017). Due to
recall bias if the study it affects the results, since sleep is not widely recognized by the public as
a possible risk for cancer. The aim of the study is not fully analysed that the cancer is diagnosed
only due to sleep quality, sleep duration. Overall, the it has been analysed from the study that it
does not provide evidence to support an association between self reported sleep duration lead a
breasts cancer. So in order to recommend this study, it required to addressed and measure the
epidemiologic in sleep.
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REFERENCES
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