In the News

Is the
association
causal?

RR = 7

In the News
Detectives in the Classroom – Investigation 3-1: In the News
 Where are we and where are we going?

1. How is this disease distributed and what

hypotheses might explain that distribution?

2. Is there an association between the hypothesized

cause and the disease?

3. Is the association causal?

4. What should individuals and society do when

preventable causes of disease are found?

5. Did the prevention strategy work?

Detectives in the Classroom – Investigation 3-1: In the News

 Where are we and where are we going?
1 2
How is this disease Hypotheses Is there
distributed? an association?
What’s
Did the exposure and
my hypothesis?
the disease turn up
together?
3
Is the association
causal? Why did the exposure
and the disease turn up
together?

4
What should be done
to prevent the disease?

5
Did the prevention
strategy work?

Detectives in the Classroom – Investigation 3-1: In the News

 What does it mean? 1

Association Found
Between Coffee and Diabetes
Detectives in the Classroom – Investigation 3-1: In the News
 What does it mean?

Tied Related
Associated Linked
What do we mean when we say that
there is an association between two things?
Things that are associated
are linked in some way
that makes them
turn up together.

Detectives in the Classroom – Investigation 3-1: In the News

 Association
Things that are associated are linked in some way
that makes them turn up
together.

Why di
Happy Jennife d
Birthday r and Michae
t l
togethe u rn up
r
at the
party?

Detectives in the Classroom – Investigation 3-1: In the News

 Things that Turn Up Together
Things that are associated are linked in some way
that makes them turn up
together.

Detectives in the Classroom – Investigation 3-1: In the News

 Review

p i Tal k
E Association

Things that are linked in

some way that makes them
turn up together.

Detectives in the Classroom – Investigation 3-1: In the News

 In the News
Suicide Higher in Smoking Linked to YouthFamily Meals Are
Areas with Guns Eating Disorders Good for Mental Health

Study Links Study Concludes:

Iron Movies Influence
Deficiency Youth
to Math Smoking
Lack of High School Study Links
Scores
Diploma Tied to
US Death Spanking
Rate to
Depressed Teens More Likely to Smoke
Aggression
Snacks Key to Kids’ TV- Linked Obesity: China Study
Breakfast Each Day May Keep Colds Away
Pollution Linked with Birth Defects in US Study
Kids Who Watch R-Rated Movies More Likely to Drink, Smoke
Detectives in the Classroom – Investigation 3-1: In the News
 Review

p i Tal k
E Epidemiology

The study of how and why

diseases or other health-
related conditions are
distributed in a population the
way they are, in other words,
why some people get sick
and others do not.

Detectives in the Classroom – Investigation 3-1: In the News

 Review

p i Tal k
E Epidemiology

The study of how and why

diseases or other health-
related conditions are
distributed in a population the
way they are, in other words,
why some people get sick
and others do not.

Detectives in the Classroom – Investigation 3-1: In the News

 Review
Study Design: Trial Study Design: Cohort Study

DZ DZ

E E
DZ DZ
Healthy Random Healthy
People Assignment People
DZ DZ
E E

- -
DZ DZ

tween
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

i ati on be
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

a s s o c
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Is there an the hypothesized

Time Time

Study Design: Case-Control Study

se a n d t he d ise ase?
Study Design: Cross-Sectional Study

E ca u E

DZ -

E E

E -
DZ
DZ

E DZ

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Time Time

Detectives in the Classroom – Investigation 3-1: In the News

 Association
Things that are associated are linked in some way
that makes them turn up
together.

Is there an association between

the hypothesized cause and the disease?
Detectives in the Classroom – Investigation 3-1: In the News
 In the News
Suicide Higher in Smoking Linked to YouthFamily Meals Are
Areas with Guns Eating Disorders Good for Mental Health

Study Links Study Concludes:

Iron Movies Influence
Deficiency Youth
to Math Smoking
Lack of High School Study Links
Scores
Diploma Tied to
US Death Spanking
Rate to
Depressed Teens More Likely to Smoke
Aggression
Snacks Key to Kids’ TV- Linked Obesity: China Study
Breakfast Each Day May Keep Colds Away
Pollution Linked with Birth Defects in US Study
Kids Who Watch R-Rated Movies More Likely to Drink, Smoke
Detectives in the Classroom – Investigation 3-1: In the News
In the News: The New York Times, 1 / 22 / 02

Detectives in the Classroom – Investigation 3-1: In the News

 In the News

Mother of Teenage
Suicide Pilot Sues
Maker of
Acne Drug She Says
He Used

Detectives in the Classroom – Investigation 3-1: In the News

 In the News
Charles Bishop, age 15, killed himself in
January 2002 by crashing a small plane into
a Tampa high rise office building.
His mother believes his suicide was caused
by the prescription drug, Accutane,
manufactured by Hoffman-LaRoche (HLR).
The charge is that HLR has been aware of the medication
causing depression, psychosis, and suicidal tendencies.
HLR claims that 13 million people have safely used
Accutane since 1982.
The company has investigated “minor and rare” reports of
adverse psychological effects but found “no scientific basis
to link to either depression or suicide.”
Detectives in the Classroom – Investigation 3-1: In the News
 In the News

The Accutane packaging warns against

possible psychological effects.
Toxicologists found no traces of Accutane
in the boy’s system.
The suicide note stated that he was acting
alone but supported efforts of Al Qaeda.
Suicide is one of the leading causes of death in teenagers and
young adults.
Since 1992, more than 500 adverse reactions to Accutane have
been recorded by national and international agencies.

Detectives in the Classroom – Investigation 3-1: In the News

 Epi Teams

Detectives in the Classroom – Investigation 3-1: In the News

 Always Remember
Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Detectives in the Classroom – Investigation 3-1: In the News
 Do Not Ever Forget
Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Association is not necessarily causation.

Detectives in the Classroom – Investigation 3-1: In the News
 Cause

Detectives in the Classroom – Investigation 3-1: In the News

 Epi Talk

i Ta lk
Ep Cause

Anything that produces an

effect.

Detectives in the Classroom – Investigation 3-1: In the News

 Epi Talk

i Ta lk
Ep Risk Factor

An exposure that increases

the likelihood of a specific
outcome.

Detectives in the Classroom – Investigation 3-1: In the News

 Essential Question 3
Is the
association
causal?

RR = 7

In the News
Detectives in the Classroom – Investigation 3-1: In the News
 Epi Talk

i Ta lk
Ep Interpret

To give the meaning of,

explain, or make clear.

Detectives in the Classroom – Investigation 3-1: In the News

Possible Explanations for Finding an Association

Investigations Explanations
3-2 Cause

3-3 Chance

3-4 Confounding

3-5 Reverse Time Order

3-6 Bias

Detectives in the Classroom – Investigation 3-1: In the News

 In the News

Investigation
3-1
has ended.

CDC

Detectives in the Classroom – Investigation 3-1: In the News