A new article by Swedish researchers highlights the extent to which the results of epidemiological studies can be influenced by the choice of methodology. The researchers tested whether subtle differences – including questionnaire layout and wording – had a measurable impact on prevalence and risk estimates of asthma.

Their report, published in the Clinical Respiratory Journal, describes how questions with different set-up or differences in wording resulted in significantly different prevalence and risk estimates. In particular, the use of follow-up questions that excluded subjects answering no to the initial question, resulted in 2.9-6.7 percent-units lower prevalence.

These kinds of findings highlight some of the underestimated complexities of chronic disease epidemiology. But they also underscore how little attention developers of mobile and wireless health tools have put into understanding and incorporating previous research on the implications of different methodologies into their applications. Reports like these should motivate us to save ourselves a lot of unnecessary originality and admonish us to greater care and reflection in our work.

I had the fortune to meet Jim Crow during my first year as a postdoc on campus and remember well listening to him step us through connections between genetics and population health with energy and agility. At one point, I ordered a used copy of Crow’s Notes, which was out of print by then, but am embarrassed to say that I never made it through much of the book. Time to pull it off the shelf today and reflect on his striking and inspiring career as scientist and mentor.

Our Q&A – about Asthmapolis and the potential of mobile technology to improve the quality of care and public health – is published in their Quality Matters newsletter this month. Read more »

In addition, the newsletter has another article on apps for health care quality improvement that is well worth reading.

Providers have proven eager adopters of health care “apps,” the software applications used on cell phones and other mobile devices to perform specific tasks, such as charting data points or aggregating information. Apps can be easily integrated into providers’ workflow, delivering information when and where they need it. Disease management apps, in particular, can improve communication between patients and providers and promote adherence to recommended care. Still, for apps to achieve their potential, they will need to be factored into reimbursement models and meet clear clinical needs. Read more »

The press release announcing the closure of the program has some statistics on the reach and influence it achieved.

The April 2011 Young Epidemiology Scholars (YES) Competition in Washington, D.C., was the eighth and final YES Competition. YES was launched in 2003 by the Robert Wood Johnson Foundation and the College Board to encourage high school students nationwide to apply epidemiological methods to the investigation of public health issues and inspire the brightest young minds to enter the field of public health. Nearly 5,000 students from all 50 states have participated in the YES Competition, which has awarded $3.7 million in college scholarships to 976 students, including this year’s participants. YES has been successful in inspiring student interest in and understanding of public health and epidemiology: 75 percent of YES Regional Finalists who have declared an undergraduate major are pursuing a health and/or science related major.

For me, YES was also about an annual trip to DC, to meet with a fantastic group of scientists from universities and public health. We all brought high expectations but more often we sat together in respect and satisfaction at great work.

Kathleen Barnes (Johns Hopkins) presented research examining how allergic asthma may be a by-product of an evolved immunological defense against extracellular parasites. She showed some very interesting genetic epidemiological evidence that mutations associated with IgE (and the development of allergic disease, therefore) may be protective against schistosomiasis infestation. Her works is classic evidence for the hygiene hypothesis, to the extent that we focus only on allergic asthma. More importantly, though, it provides an all too rare view into what research into the primary determinants of asthma at the population level actually looks like. In other words, what changes (with some evolutionary probability) are occurring to shape the overall prevalence of asthma in a population. [Some great coverage of Kathleen's talk]

My talk weaved together research on asthma over the past 15 years in India, Wisconsin and among Native Americans in the US Southwest and Alaska, to highlight variability in the diagnosis of asthma among physicians and in the management of the disease day-to-day by local populations. The Univ of Wisconsin issued a press release on my talk here, and Rachael Rettner, of MyHealthNewsDaily, wrote one of the better articles on my presentation.

Anna Di Rienzo, from the University of Chicago, summarized her work scanning the human genome for genetic adaptations to environments and climates. Many alleles she discovered overlap with those identified by recent genome-wide association studies, including polymorphisms associated with pigmentation, autoimmune diseases, lipid levels and type 2 diabetes.

Pete Zimmerman, from Case Western Reserve University School of Medicine, reported some very interesting findings from Madagascar, where something important is happening with the malaria parasite, P. vivax, to permit it to infect Duffy blood group-negative people, who have formerly been resistant to P. vivax infection.

Margaret (Peggy) Bentley drew from her incredible trove of filmed infant feeding observations from around the world to talk about how to improve growth and nutrition in different cultural and economic settings.

Unfortunately, Marcia Inhorn, who was supposed to be on the panel was unable to make it. She was scheduled to give a talk on assisted reproduction in the Middle East.

I really enjoyed the meeting and the time we got to spend together as a group. I love seeing anthropologists like my colleagues on this panel working deep in complex, meaningful fields, and yielding great progress through cross-pollination, unending curiosity and observation.

The BBC summarizes: “Researchers at the University of Arizona believe there is a problem with the way the disease is managed.”

I think Dr. Martinez has framed lack of adherence in a different and potentially productive way.

I had recently seen an article about the growing number of hospitals publishing their wait times online, but since that information is scattered across multiple sites, I found it a challenge to quickly compare and evaluate wait times in a given geographic area.

In addition, I found that there was no mechanism for people to independently report how long they waited to be seen by a physician.

As an experiment, I built ERwaittimes.us to aggregate current wait times published by hospitals nationwide and to provide a way for people to add their own wait times for every emergency room and urgent care. So far, it’s just a simple site that needs a lot more development. Please let me know what you think of the idea and how it could be improved.