Please post to the forum by 1pm on the day of class
Hi everyone, homework this week has three parts (the first two parts are pretty straightforward though). You will find part 2 substantially easier after you read the Harper reading for this week:
Part 1:
1. Choose a paper describing the development or validation of a measure of relevance in health disparities research (please give the full citation and/or upload the paper if that's possible).
Validation of a youth acute pain function tool
https://www.sciencedirect.com/science/article/pii/S1526590014009353?via%3Dihub
2. What was the definition of the construct?
The authors developed and assessed the clinical utility and preliminary validity of the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) to assess the pain experience in children and adolescents with chronic disease.
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
Construct validity testing was hampered by the fact that there are no available measures of function in the inpatient setting for use in validation of the YAPFAQ. Construct validity was evaluated through Pearson correlations assessing the relationship between YAPFAQ scores and measures of pain burden, health-related quality of life, motor activity, and activity limitations. This was a shortcoming of the study.
4. How did the authors provide evidence on the reliability of the measure? Could you think of additional approaches to evaluating the reliability of the measure?
Participants with SCD who were admitted into the hospital for vaso-occlusive pain episode were approached within 72 hours of admission for possible study participation. After consent was obtained, the participant was asked to complete measures of physical activity, pain impact, pain location, and quality of life. All measures were administered between 3 pm and 5 pm on the day of study entry. A subset of participants (10%) was randomly assigned to complete the YAPFAQ 2 hours later to examine test-retest reliability. Given the nature of acute pain, this assessment strategy seems reasonable.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
Testing of the construct using the same population, using validated measures of chronic pain and function in adolescents (these only exist in the outpatient setting), to assess validity of the instrument.
Part 2:
1. Find a paper describing a health disparity (please give the full citation or, even better, upload the paper so everyone else can look at it too)
Effects of race/ SES on survival in childhood acute lymphoblastic leukemia
https://www.ncbi.nlm.nih.gov/pubmed/27177145
2. Summarize the construct and measurement of the dimension of disparity (e.g., racial inequalities?, SES inequalities?) and the outcome measured (e.g., self-rated health).
Hazard ratios (HRs) for overall survival were calculated using the Cox proportional hazards model. Variables included in the univariate analysis were race/ethnicity, sex, age at diagnosis, neighborhood-level SES, and treatment era. Variables were included in the multivariable model if statistically significant on univariate analysis. Interactions between race/ethnicity, neighborhood-level poverty rate, sex, age, and treatment era were tested and included if significant on multivariable analysis.
3. What is the evidence for the validity and reliability of the measures?
State cancer registry survival data (linked with National Death Index).
4. What is the reference category used for the disparity measure (ie, who is the comparison group)? Why does this reference category make sense (or not) for this research question?
Non-Hispanic whites, and <5% neighborhood poverty. This makes sense for research question studied.
5. How is the disparity quantified or measured? Is this an absolute or relative measure or are both provided? Describe which type of measure you would prefer for this research area, or, if both, why.
The disparity is quantified by assessing overall survival (time alive from diagnosis). The authors aim to understand which covariates affect the outcome (OS) most. Their use of a HR is appropriate.