1. Detectives in the Classroom – Investigation 3-1: In the News In the News RR = 7 In the News Is the association causal?

2. Detectives in the Classroom – Investigation 3-1: In the News Where are we and where are we going? 1. How is this disease distributed and what hypotheses might explain that distribution? 2. Is there an association between the hypothesized cause and the disease? 3. Is the association causal? 4. What should individuals and society do when preventable causes of disease are found? 5. Did the prevention strategy work?

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

4. Association Found Between Coffee and Diabetes Detectives in the Classroom – Investigation 3-1: In the News What does it mean? 1

5. What do we mean when we say that there is an association between two things? Associated TiedRelated Linked Things that are associated are linked in some way that makes them turn up together. Detectives in the Classroom – Investigation 3-1: In the News What does it mean?

6. Happy Birthday Why did Jennifer and Michael turn up together at the party? Detectives in the Classroom – Investigation 3-1: In the News Association Things that are associated are linked in some way that makes them turn up together.

7. Detectives in the Classroom – Investigation 3-1: In the News Things that Turn Up Together Things that are associated are linked in some way that makes them turn up together.

8. Epi Talk Things that are linked in some way that makes them turn up together. Association Detectives in the Classroom – Investigation 3-1: In the News Review

9. Detectives in the Classroom – Investigation 3-1: In the News In the News Suicide Higher in Areas with Guns Smoking Linked to Youth Eating Disorders Snacks Key to Kids’ TV- Linked Obesity: China Study Family Meals Are Good for Mental Health Lack of High School Diploma Tied to US Death Rate Study Links Spanking to Aggression Breakfast Each Day May Keep Colds Away Study Concludes: Movies Influence Youth Smoking Study Links Iron Deficiency to Math Scores Kids Who Watch R-Rated Movies More Likely to Drink, Smoke Pollution Linked with Birth Defects in US Study Depressed Teens More Likely to Smoke

10. Epi Talk The study of how and why diseases or other health- related conditions are distributed in a population the way they are, in other words, why some people get sick and others do not. Epidemiology Detectives in the Classroom – Investigation 3-1: In the News Review

11. Epi Talk The study of how and why diseases or other health- related conditions are distributed in a population the way they are, in other words, why some people get sick and others do not. Epidemiology Detectives in the Classroom – Investigation 3-1: In the News Review

12. Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Random Assignment - E E DZ Study Design: Trial Healthy People Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ - E E DZ Study Design: Cohort Study Healthy People Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ - DZ E E E E Study Design: Case-Control Study Time ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ - DZ E E Study Design: Cross-Sectional Study Detectives in the Classroom – Investigation 3-1: In the News Review Is there an association between the hypothesized cause and the disease?

13. Detectives in the Classroom – Investigation 3-1: In the News Association Things that are associated are linked in some way that makes them turn up together. - Is there an association between the hypothesized cause and the disease?

14. Detectives in the Classroom – Investigation 3-1: In the News In the News Suicide Higher in Areas with Guns Smoking Linked to Youth Eating Disorders Snacks Key to Kids’ TV- Linked Obesity: China Study Family Meals Are Good for Mental Health Lack of High School Diploma Tied to US Death Rate Study Links Spanking to Aggression Breakfast Each Day May Keep Colds Away Study Concludes: Movies Influence Youth Smoking Study Links Iron Deficiency to Math Scores Kids Who Watch R-Rated Movies More Likely to Drink, Smoke Pollution Linked with Birth Defects in US Study Depressed Teens More Likely to Smoke

15. Detectives in the Classroom – Investigation 3-1: In the News In the News: The New York Times, 1 / 22 / 02

16. Mother of Teenage Suicide Pilot Sues Maker of Acne Drug She Says He Used Detectives in the Classroom – Investigation 3-1: In the News In the News

17. Charles Bishop, age 15, killed himself in January 2002 by crashing a small plane into a Tampa high rise office building. His mother believes his suicide was caused by the prescription drug, Accutane, manufactured by Hoffman-LaRoche (HLR). The charge is that HLR has been aware of the medication causing depression, psychosis, and suicidal tendencies. HLR claims that 13 million people have safely used Accutane since 1982. The company has investigated “minor and rare” reports of adverse psychological effects but found “no scientific basis to link to either depression or suicide.” Detectives in the Classroom – Investigation 3-1: In the News In the News

18. The Accutane packaging warns against possible psychological effects. Toxicologists found no traces of Accutane in the boy’s system. The suicide note stated that he was acting alone but supported efforts of Al Qaeda. Suicide is one of the leading causes of death in teenagers and young adults. Since 1992, more than 500 adverse reactions to Accutane have been recorded by national and international agencies. Detectives in the Classroom – Investigation 3-1: In the News In the News

19. Epi Teams Detectives in the Classroom – Investigation 3-1: In the News

20. Association is not necessarily causation. Detectives in the Classroom – Investigation 3-1: In the News Always Remember

21. Association is not necessarily causation. Detectives in the Classroom – Investigation 3-1: In the News Do Not Ever Forget

22. Detectives in the Classroom – Investigation 3-1: In the News Cause

23. Epi Talk Anything that produces an effect. Cause Detectives in the Classroom – Investigation 3-1: In the News Epi Talk

24. An exposure that increases the likelihood of a specific outcome. Risk Factor Detectives in the Classroom – Investigation 3-1: In the News Epi Talk

25. Detectives in the Classroom – Investigation 3-1: In the News Essential Question 3 RR = 7 In the News Is the association causal?

26. Epi Talk To give the meaning of, explain, or make clear. Interpret Detectives in the Classroom – Investigation 3-1: In the News Epi Talk

27. Detectives in the Classroom – Investigation 3-1: In the News Possible Explanations for Finding an Association Explanations 3-2Cause 3-3Chance 3-4Confounding 3-5 Reverse Time Order 3-6Bias Investigations

28. Detectives in the Classroom – Investigation 3-1: In the News In the News CDC Investigation 3-1 has ended.