DNP 825 Topic 2 Discussion Question Two

DNP 825 Topic 2 Discussion Question Two

Which epidemiological study design would you use to evaluate an intervention in your practice? Provide a description of the chosen population and the identified intervention. Provide support as to why you believe that the design you chose is the best option including the strengths and weaknesses of the design you have chosen.

In epidemiology, researchers are interested in measuring or assessing the relationship of exposure with a disease or an outcome. As a first step, they define the hypothesis based on the research question and then decide which study design will be best suited to answer that question. How the researcher conducts the investigation is directed by the chosen study design. The study designs can be broadly classified as experimental or observational based on the approach used to assess whether exposure and an outcome are associated. In an experimental study design, researchers assign patients to intervention and control/comparison groups in an attempt to isolate the effects of the intervention. Being able to control various aspects of the experimental study design enables the researchers to identify

causal links between interventions and outcomes of interest. In several instances, an experimental study design may not be feasible or suitable; observational studies are conducted in such situations. As the name indicates, observational studies involve merely observing the patients in a non-controlled environment without actually interfering or manipulating with other aspects of the study and therefore are non-experimental. The observation can be prospective, retrospective, or current, depending on the subtype of an observational study.[1]

Observational Studies

Case-Control Studies

Case-control studies are used to determine the degree of associations between various risk factors and outcomes. The factors that affect the risk of a disease are called exposures. Case-control studies can help identify beneficial or harmful exposures. As the name suggests, there are two groups of patient cases and controls in a case-control study. Cases are patients who have a particular disease, condition, or disability. Controls are those patients that do not have the disease. Typically, researchers identify appropriate representative controls for the cases that they are studying from the general population. Then they retrospectively look in the past for the possible exposures these patients might have had to a risk factor. Selecting the patients for the control group is a very critical component of research based on case-control studies. Due to the retrospective nature of the study design, case-control studies are subject to recall bias. Case-control studies are inexpensive, efficient, and often less time-consuming to conduct. This study design is especially suitable for rare diseases that have long latency periods.[2]

Case-Crossover Studies

Case-crossover studies are helpful to study triggers within an individual. When the researcher is studying a transient exposure or risk factor, the case-crossover design is useful. This is a relatively new study design where there is a case and a control component, both of which come from the same individual. Each case is self-matched by serving as its own control. Determining the control and case components period is a critical and difficult aspect of a case-crossover study.[3]

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Cohort Studies

Cohort studies initially classify patients into two groups based on their exposure status. Cohorts are followed over time to see who develops the disease in the exposed and non-exposed groups. Cohort studies can be retrospective or prospective. Incidence can be directly calculated from a cohort study as you begin with exposed and unexposed patients, unlike a case-control study where you start with diseased and non-diseased patients. Relative risk is the measure of effect for a cohort study. Cohort studies are subject to very low recall bias, and multiple outcomes can be studied simultaneously. One of the disadvantages of cohort studies is that they are more prone to selection bias. Studying rare diseases and outcomes that have long follow-up periods can be very expensive and time-consuming using cohort studies.[4]

Cross-Sectional Studies

Cross-sectional studies are observational in nature and give a snapshot of the characteristics of study subjects in a single point of time. Unlike cohort studies, cross-sectional studies do not have a follow-up period and therefore are relatively simple to conduct. As the exposure status/outcome of interest information is collected in a single moment in time, often by surveys, cross-sectional study design cannot provide a cause-effect relationship and is the weakest of the observational designs. This study design is generally used to assess the prevalence of a disease in a population.[5]

Ecological Studies

Ecological studies are used when data at an individual level is unavailable, or large-scale comparisons are needed to study the population-level effect of exposures on a disease condition. Therefore, ecological study results are applicable only at the population level. The types of measures in ecological studies are aggregates of individual-level data. These studies, therefore, are subject to a type of confounding called an ecological fallacy, which occurs when relationships identified at group level data are assumed to be true for individuals. Ecological studies are generally used in public health research.[6]

Experimental Studies

Randomized Clinical Trials

Randomized clinical trials or randomized control trials (RCT) are considered the gold standard of study design. In an RCT, the researcher randomly assigns the subjects to a control group and an experimental group. Randomization in RCT avoids confounding and minimizes selection bias. This enables the researcher to have similar experimental and control groups, thereby enabling them to isolate the effect of an intervention. The experimental group gets the exposure/treatment, which can be an agent involved in causation, prevention, or treatment of a disease. The control group receives no treatment, a placebo treatment, or another standard of care treatment depending on the study’s objective. The groups are then followed prospectively to see who develops the outcome of interest. RCT’s are expensive, and researchers using this study design often face issues with the integrity of randomization due to refusals, drops outs, crossovers, and non-compliance.

Participation for MSN

Threaded Discussion Guiding Principles

The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

Participation Guidelines

Each weekly threaded discussion is worth up to 25 points. Students must post a minimum of two times in each graded thread. The two posts in each individual thread must be on separate days. The student must provide an answer to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. If the student does not provide an answer to each graded thread topic (not a response to a student peer) before the Wednesday deadline, 5 points are deducted for each discussion thread in which late entry occurs (up to a 10-point deduction for that week). Subsequent posts, including essential responses to peers, must occur by the Sunday deadline, 11:59 p.m. MT of each week.

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in Threaded Discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the Grammar, Syntax, APA category.

Grading Rubric Guidelines

Performance Category	10	8	6	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	8	6	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread)	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements per discussion thread	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement per discussion thread	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.

DNP 825 Topic 2 Discussion Question Two