1. Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? What's Wrong with This Picture?

2. 2 Is there an association? Did the exposure and the disease turn up together? 1 How is this disease distributed? Hypotheses 3 Is the association causal? 4 What should be done to prevent the disease? 5 Did the prevention strategy work? Where are we and where are we going? What’s my hypothesis? Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

3. Formulates Hypotheses Hypothesis Tests Hypotheses Review What is a hypothesis? An Educated Guess Descriptive Epidemiology What is descriptive epidemiology? Analytical Epidemiology What is analytical epidemiology? Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

4. What is a control group? People who participate in a trial but do not get the treatment. Their results are compared to results of the group that does get the treatment. No AcneMed “Not Exposed” Control Group AcneMed “Exposed” Experimental Group Review Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

5. Epidemiologist Board of Education Smoking marijuana causes memory loss. Scenario Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Poor Grades Drug Use

6. 200 High School Students No Marijuana 100 Students Control Group Marijuana 100 Students Experimental Group 4 Months Measure Memory Loss 2 x 2 Table, Calculate Risks, and Relative Risk What’s wrong with this picture? Measure Memory Scenario Detectives in the Classroom - Investigation 2-3: What’s Wrong With This Picture?

7. Epi Talk Ethical In accordance with the accepted principles of right and wrong governing the conduct of a group. Epi Talk Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

8. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

9. Nazi Human Experiments Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? What’s wrong with this picture?

10. Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Doctors Trial What happened after World War II was over?

11. Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Based on prior animal experiments Totally voluntary, informed consent Justification of benefit to individuals or society Highlights of the Nuremberg Code

12. Based on prior animal experiments Totally voluntary, informed consent Absolute avoidance of physical and mental suffering and injury Justification of benefit to individuals or society Highlights of the Nuremberg Code Conducted only by qualified scientists Ability of subjects to withdraw at any time Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

13. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

14. Tuskegee Syphilis Study Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Nothing Learned Will Prevent, Find, or Cure a Single Case. What’s wrong with this picture?

15. Tuskegee Syphilis Study Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

16. What happened? Senate hearings on human experiments Newspaper article and public outcry Belmont Report Affected wives and children given medical treatment National Commission for the Protection of Human Subjects Lifetime medical treatment guaranteed for survivors Study stopped Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? 1973: 1972: 1979: 1975: 1974:

17. Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Clinton Regrets “Clearly Racist” U.S. Study New York Times, May 17, 1997

18. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

19. Accepted Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? The Belmont Report Office of the Secretary Ethical Principles and Guidelines for the Protection of Human Subjects of Research The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research April 18, 1979

20. Accepted Principles Basic Ethical Principles Respect for Persons Beneficence Justice Belmont Report Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

21. Epi Talk Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Respect for Persons Respect individual autonomy (independence, freedom, capacity for self direction) Provides extra protection for those with less autonomy.

22. Rules for Ensuring “Respect for Persons” Complete information about study and potential risks Understand information Voluntary participation Withdraw at any time Informed Consent Basic Ethical Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

23. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

24. Epi Talk Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Beneficence An effort to secure people’s well-being. A decision about when it is justifiable to seek certain benefits despite the risks involved.

25. Rules for ensuring “Beneficence” Consider all types of potential harms Benefits to participants and / or to society Brutal or inhumane treatment is never justified Risk / Benefit Assessment Basic Ethical Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

26. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

27. Epi Talk Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Justice Fair distribution of the benefits of research and the burdens of being a research subject.

28. Rules for Ensuring “Justice” Selection process and outcome must be fair Avoid cultural, racial, social or other biases Avoid choosing convenient or easy to manipulate participants Subject Selection Basic Ethical Principles Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

29. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

30. Accepted Principles Need to let people know about study. RFP

31. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

32. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

33. Epi Log Worksheet Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture?

34. CDC What's Wrong with This Picture? Detectives in the Classroom - Investigation 2-3: What's Wrong with This Picture? Investigation 2-3 has ended.