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Task:
At the start of 2016, a study was conducted in the small country of Driscoville to investigate the relationship between excessive alcohol consumption (binge‐drinking) and stroke in young adults. Stroke is very uncommon in young adults, but can result in significant long‐term impacts in those who suffer them and the causes are not well‐established. For the purposes of this exercise, you can assume that the only known risk factors for stroke are smoking and age. It is also known that males are more likely to engage in risky health behaviours such as binge‐drinking and smoking than females.
Young adults who had experienced a stroke (18‐25 yrs old at time of stroke) between 1st January 2000 and 31st December 2015 were identified from the hospital records of all three hospitals in the country. All stroke victims are admitted to hospital, and hospital records in Driscoville are known to be 97% complete. Attempts were made to contact all 183 patients identified to invite them to be part of the study. Sixty‐three of them were either non‐contactable or refused to be part of the study. A further 11 of these patients had died either as a result of their stroke or ongoing complications. All other identified patients agreed to participate in the study and completed a survey about their health behaviours in the 10 years prior to having their stroke. Hospital records showed that those who were non‐contactable, refused to be part of the study or died were a similar age but more likely to be male than those who participated.
Young adults aged 18 to 25 years who were residents of Driscoville between 1st January 2000 and 31st December 2015 were eligible to act as comparisons. They were identified from all of the universities in the country (there are two of them). Approximately 80% of 18 to 25 years olds in Driscoville attend one of these Universities. Of the 1080 identified, a random sample of 430 students were selected to take part in the study. Of these, 312 agreed to participate, and completed a survey about their health behaviours in the 10 years prior. The remainder were either non‐contactable or refused to be part of the study. University records showed that those who were non‐contactable or refused to be part of the study were more likely tobe female and older than those who participated.
Of the stroke patients that participated, 23 stated that they were frequent binge drinkers in the ten years prior to having their stroke. Of the comparison persons who participated, 52 stated that they were frequent binge drinkers in the previous ten years.
Answer the following questions assuming that the results from the study are not biased:
1) Draw a 2×2 table that summarises the above information.2) Calculate the appropriate measure of association to describe the relationship between binge‐drinking and stroke in young adults. Show your working.3) Interpret the result you obtained in 2) in one sentence, and in words that someone who has not studied epidemiology would understand.4) What proportion of stroke patients who reported being a frequent binge drinker had their stroke because of their binge drinking? Show your working.5) How many of the 23 stroke patients who reported being a frequent binge drinker would not have had a stroke if they did not binge drink?6) Can you calculate the risk difference from this information? If so, calculate and interpret. If not, explain why you can’t.
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