The assessment will assess your understanding of epidemiological principles and terminology, and your ability to apply these to interpret and critically appraise quantitative health research.

Assessment is by means of a 3,000-word essay divided into two equally weighted (50% each) sections – Sections A and Section B – of 1,500 words each. The assessment will assess your understanding of epidemiological principles and terminology, and your ability to apply these to interpret and critically appraise quantitative health research.
Section A will be a critical appraisal worksheet on a research paper and Section B will be the design of an epidemiology study to address an important public or environmental health problem. The assessment marking will be structured using the descriptors shown on page 12 of this handbook.
Please prepare your essay in a Word document and format it with 1.5 or 2 line spacing with normal margins. Please pay attention to the word count limit for each section as no words will be marked beyond the word count limit. Please do not include any further appendices.

SECTION A: (50% of the marks; 1,500 words maximum)
Critically appraise the seen paper on a systematic review with meta-analysis. Answer each numbered question with a ‘yes’, ‘no’, or ‘can’t tell’, but please note that marks are only awarded for explanations and arguments sustaining your summary answer, not for the answer itself.

1. Did the review address a clearly focused question?

HINT: An issue can be ‘focused’ in terms of the population studied, the intervention given or the outcome considered. 4 marks

2. Did the authors look for the right type of papers?

HINT: ‘The best sort of studies’ would address the review’s question and have an appropriate study design. 4 marks

3. Do you think all the important, relevant studies were included?

HINT: Look for which bibliographic databases were used, follow up from reference lists, personal contact with experts, unpublished as well as published studies, non-English language studies. 5 marks

4. Did the review’s authors do enough to assess quality of the included studies?

HINT: The authors need to consider the rigour of the studies they have identified. Lack of rigour may affect the studies’ results. 5 marks

5. Have the study results been properly quantitatively combined in a meta-analysis?

HINT: Consider whether results were similar from study to study, results of all the included studies are clearly displayed, results of different studies are similar, reasons for any variations in results are discussed. 4 marks

6. What are the overall results of the review? Are they clearly stated or illustrated and are relevant results included? How precise are the results?

HINT: Consider if you are clear about the review’s ‘bottom line’ results, what these are (numerically if appropriate), how were the results expressed (relative risk, odds ratio, etc). Look at the confidence intervals, if given. 10 marks

7. Can the results be applied to your local population?

HINT: State your local population (e.g., Bristol, New Delhi, Yaoundé, etc). Consider whether the participants covered by the review could be sufficiently different to your population to cause concern and whether your local setting is likely to differ much from that of the review. 3 marks

8. Were all important outcomes included in the analysis?

HINT: Consider whether there is other information you would like to have seen 5 marks

9. Are the authors’ conclusions justified by the results presented?

HINT: Consider whether the authors’ conclusions are appropriately informed by the results they have presented. 6 marks

10. Should practice or policy change because of this study?

HINT: Consider how convinced you are about the validity of the results of the review in informing practice or policy. 4 marks

General advice for completing Section A.

1. Read the questions very carefully and stick to the brief. e.g., do not use other guidelines. Number your answer by the question number.
2. It is permissible to discuss the paper beforehand in groups but be aware that errors in interpretation or approach can be magnified by this approach.
3. Read and understand the paper (you may need to read it several times) – this is critical.
4. Do not be overly critical – take a balanced view. Remember the objective is to determine what you can trust. One method is to read the paper as though it was written by a dear friend, and then again, as though it was written by someone you really do not like at all.
5. Avoid any tendency to pick on a shortcoming or weakness and flog it to death. You must objectively examine each shortcoming and consider what effect it has on the results or their interpretation.
6. Remember, you are appraising the research presented through the medium of the paper. If you cannot tell what the researchers have done, state this and examine the possible implications for the trustworthiness of the authors’ results and conclusions. But be sure they have not told you somewhere in the paper.
7. The implications you provide on the quality and interpretation of the research are judgement-based. These implications will be critically appraised by the marker of your script and marks awarded only where there are cogent arguments to support them.
8. Always provide evidence for your comments. If the subjects were not randomly selected, for example, explain why; do not just state that they were not.
9. Rigorously avoid…” the authors should have done this” sort of comments. You are not being asked to do the study yourself – that is another task.

Section B: (50% of the marks; 1,500 words maximum)
Use the Population Intervention/ Exposure Comparison Outcome (PICO) framework to frame a research question relating to an important public or environmental health issue. Choose a study design from those studied in this module (cross-sectional, ecological, case-control, cohort, randomised controlled trial or cluster randomised controlled trial) that could be used to answer this question and write a draft research proposal.
You will be awarded a maximum of 3 marks for a good structure and style of your proposal (title, formatting, spelling, grammar and coherence in presentation). The headings you should include in your proposal are:

1. Research question.

HINT: State your research question using PICO. 4 marks

2. Why is this an important question for public or environmental health?

HINT: Reference relevant literature to support the importance of your research question and provide a reference list at the end of the document. The reference list is not part of the word count. 6 marks

3. Why is this an appropriate study design to answer your research question?

HINT: Ensure discussions here are related to the context of your study or research. 7 marks

4. How would you select participants for your study?

HINT: Think about how you would select and approach the participants to take part in your study. 5 marks

5. What are your exposure and outcome measures? How would you collect data on these measures?

HINT: The exposure could be an intervention (in an RCT). Outcome refers to the health outcome of interest. 15 marks

6. Discuss the strengths and limitations of your approach.

HINT: Consider issues around bias, chance and confounding and other practical issues if relevant. 10 marks

General advice for completing Section B.

1. Your proposed research should be realistic and pragmatic. It should be able to be carried out within a 10-month period.
2. This a draft proposal and will not include all elements of a full proposal such as statistical data analysis method, etc. Including elements outside the suggested headings will not be marked.
3. Remember that this is a research yet to be carried out and therefore needs to be written in future tense.
4. Essay submissions will be subjected to checks for collusions and plagiarised material.
5. Ensure you use Harvard referencing not Vancouver, i.e., references in the text should be in (author surname, date) style where relevant and the references list should be alphabetical; references should not be numbered.