Question1
a)
Describe a possible way in which measurement bias may have occurred in this study when classifying participants as either having or not having depression? (2-3 sentences)
b)
Would the bias described in Question 10a be better described as differential or non-differential measurement/misclassification bias? Please justify why. (1-2 sentences)
Question 2:
What stratified analysis was undertaken? What did the results of this analysis show? (1 paragraph)
Question 3:
Based on your critical examination of the study, would you consider this study to be internally valid? Please justify your decision by summarising the likely roles chance, bias and confounding have on the measure of association (as explored in this Assignment and using your own critical appraisal skills). (2-4 paragraphs).
Question 4:
Do you think the findings of this study are generalisable to other populations? Please justify your answer. (1 paragraph)
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General practice Depression as a risk factor for ischaemic heart disease in men: population based casecontrol study Julia HippisleyCox, Katherine Fielding, Mike Pringle Department of Furthermore, the overall relation between depres Abstract General Practice, sion, ischaemic heart disease, and cholesterol concen The Medical Objective: To determine the relation between tration is unclear. Some evidence shows that low School, Queen’s depression, anxiety, and use of antidepressants and Medical Centre, cholesterol concentration may be related to depres Nottingham the onset of ischaemic heart disease. 11 12–15 sion and increased risk of suicide. Other evidence NG7 2UH Design: Population based casecontrol study. shows that no relation exists between low and declining Julia HippisleyCox Setting: All 5623 patients registered with one general 16–18 lecturer in general cholesterol concentration and depression or sui practice practice. 19 20 cide. If ischaemic heart disease is associated with Mike Pringle Subjects: 188 male cases with ischaemic heart disease hyperlipidaemia, and depression is associated with low professor of general matched by age to 485 male controls without practice cholesterol concentration, then a lower prevalence of ischaemic heart disease; 139 female cases with depression in patients who subsequently develop Trent Institute for ischaemic heart disease matched by age to 412 female Health Services ischaemic heart disease would be expected. Research, The controls. We aimed to determine whether (a) an association Medical School, Mainoutcomemeasure: Adjusted odds ratios Queen’s Medical exists between ischaemic heart disease and depression, calculated by conditional logistic regression. Centre (b) depression occurs before or after the onset of Katherine Fielding Results: The risk of ischaemic heart disease was three ischaemic heart disease, and (c) the relation between lecturer in medical times higher among men with a recorded diagnosis of depression…
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