Theoretical (object) design in non-interventional causal epidemiological research, a critical appraisal : issues in studies on the causal role of perinatal factors and the occurrence of asthma in children
Background: Results of epidemiologic etiologic studies on the same exposure-outcome relationship are often diverging or even contradicting. Theoretical design has hardly been considered in the discussion on issues with study design and the possible impact on study results. Aim: The aim was to gain insight into the reporting, use and knowledgeability of researchers with theoretical design and to apply the presented concepts for epidemiologic etiologic research in two incidence-density studies. Methods: Sixty-three articles were critically appraised on the presence of (seven key elements of) theoretical design (chapter 2). Reporting was also compared between articles published before and after the publication of STROBE (2007). In order to gain insight into the use and perceived knowledgeability of theoretical design (chapter 3), an informal survey was sent out to the authors of a selection of the 63 articles reviewed in chapter 2. Two incidence-density studies (chapter 4 and 5) were conducted and the presented concepts in chapter 2 and 3 were applied. Findings: In none of the articles a theoretical design was reported. Only 13 out of the 63 articles reported all key elements assessed. No marked differences in reporting were observed pre- vs. post-STROBE. How authors perceived themselves to be knowledgeable with the concepts of theoretical design was diverse. Only one author was able to formulate an occurrence function (part of theoretical design). The vast majority of the authors selected ‘current occurrence as a function of past or current exposure’ as the occurrence function for their study. However, half conducted their study as if the occurrence function is ‘future occurrence as a function of current exposure’. The incidence-density study in chapter 4 revealed that children exposed to four or more courses of systemic antibiotics during the first year of life had almost twice the incidence-density for asthma occurrence than children exposed to less than four courses This association was much stronger in children reporting lower respiratory tract infections in the first year of life. In chapter 5, an association was observed between the occurrence of a first doctor’s diagnosis of asthma and recent exposure to ETS (1 year prior to diagnosis). Discussion: Theoretical design is underreported, even though it is the backbone for the design of data collection, the design of data processing and the interpretation of the study results. Epidemiologists should critically discuss the importance of the use and explicit reporting of theoretical design in research practice and training.
Antwerp : University of Antwerp, Faculty of Medicine and Health Sciences , 2023
166 p.
Supervisor: Weyler, Joost [Supervisor]
Supervisor: Casas, Lidia [Supervisor]
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Creation 09.11.2023
Last edited 17.11.2023
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