the 12 questions from essay

1 . State the purpose of this study and the hypotheses to be explored.

2 . Fully describe the study cohort. Explain why members of this cohort had to be free of duodenal ulcer, gastric ulcer, and cancer.

3 . Describe how exposures were measured and state your opinion of the validity of the approaches utilized.

• . Subj ects were categorized according to quintiles of intake of various types of fiber, nutrients, and fat. Is this approach reasonable, in light of the analyses to be performed? Explain .
• . What is the common closing date? Were .a11 subj ects followed until this date? Explain.

Explain how cases were identified. Do you agree with the authors! rationale for excluding “probable cases”? Discuss,

Describe the men who were excluded from the analysis, and explain why they were excluded. Also, with reference to one of Hill s criteria for causation; explain why a subanalysis using only 93 cases was performed.

8 . Explain why the RR’s were adjusted for age and total energy intake, but not for sex or socioeconomic status. Explain why the multivariate RR ^t s were calculated, and interpret the fact that they are very similar to the corresponding RR ^t s .

Discuss the roles that selection bias and information bias may have played in determining the results of this study. To what populations (if any) are the results generalizable?

10 . Summarize the statistically significant results . Does the number of relative risks presented, and •the number of significant results which emerged, concern • you with regard to the “mul tiple comparisons issue? Explain.

• The authors did not have information on the history of H . pylori infection of men in this cohort. Is this a major limitation to the study, in light of the role that this infection is thought to play in ‘the etiology of duodenal ulcer? Discuss .
• With reference to Hill’ s criteria, and looking only at information provided in this paper, with what confidence can you state what causes duodenal ulcer? Defend your answer .

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