Design of the National Children's Study A Workshop Summary (2013) / Chapter Skim
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5 Moving Forward
5 Moving Forward
Pages 61-70
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From page 61... ...
. The panelists were Ana Diez Roux (Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor)
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From page 62... ...
specifically addressed the proposed measurements in light of their ability to learn about asthma, endocrine disruptors, and neurological problems, but this was the only discussion about public health impacts and how well the design supports understanding them. He said this raises the question of whether or not the design will support learning about the impact of specific environmental exposures on health.
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From page 63... ...
He expressed concern about the power of the study to determine relationships. He stated that he understands the reluctance to identify a single specific set of hypotheses, but one way to evaluate a sample design might be in terms of an exemplar set of hypotheses and consideration of the power that exists within the design to evaluate them.
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From page 64... ...
He praised the supplemental sample of 10,000 in the draft sample design and agreed with O'Muircheartaigh and Kalton that, for most of the sample, an equal probability sample design makes sense, particularly without clearly articulated hypotheses. On the other hand, he said getting good variability in exposures is important and suggested developing an index of environmental risk and oversampling areas that have high risk.
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From page 65... ...
She commented on the criteria for making design decisions, the process, and other points that came up during the workshop. Diez Roux said the study will continue to grapple with prioritizing study objectives in order to make design decisions, and there are tradeoffs in that the Main Study will not be able to properly address certain items.
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From page 66... ...
She argued less for a specific list of questions than a typology. She noted the typology might include rare outcomes, outcomes that have a public health impact, or common outcomes that are causing the United States to have much worse health than other high-income countries for unclear reasons.
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From page 67... ...
She concluded with two comments on ideas that came up during the workshop. Given differences in the biology of first pregnancies versus subsequent pregnancies, and also birth order effects on a number of social and health outcomes, she stated that it is very plausible that prenatal factors interact with birth order.
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From page 68... ...
He also agreed that hypotheses that reflect what this study could do and that demonstrate its value are important, noting a study's targeted health effects help communities decide to support a project, rather than just serve as a data platform. He agreed with Diez Roux in urging some speed in developing sentinel hypotheses and the value of reviewing previous work to determine whether hypotheses of current interest are included.
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From page 69... ...
Even though the household sample has been found to be too expensive, Duan noted that many at the workshop commented on the importance of early pregnancy and preconception measures. This suggests that recruitment costs are not the only costs to consider; total lifetime costs for the study are important as well.
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From page 70... ...
70 DESIGN OF THE NATIONAL CHILDREN'S STUDY Children's Study. He said its potential is well appreciated, and the goal of the NCS is to have that potential not only realized to meet current expectations but also to have a platform that would exceed expectations in the future so it becomes an ongoing resource for informing about the health and development and growth of children.
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