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. Introduction a. Explain in one sentence the aim of the present study?

1. Introduction

a. Explain in one sentence the aim of the present study?

b. What study design was used

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2. Methods

a. Specify the outcome variables

b. Specify the exposure variables

c. What statistical method was used? Explain why?

d. What method was used to guide the analysis for confounder definition?

e. Explain at least two confounders, in figure 1, which are adjusted for in the model, and discuss whether you consider these variables for confounding or not.

f. For which variable did the authors consider misclassification? Please describe their considerations regarding this misclassification.

3. Remarks to the results:

a. Please look at Table 2 and explain the results obtained for the variables and their adjustment

b. Please look at Table 3: What is the main relationship of interest and presented in the Table.

c. Please look at Table 4: For the cohort, please explain the different results generated by the models.

i. Compare the unadjusted results and results generated in the adjusted, traditional logistic regression model.

ii. What are the reasons for the different results?

iii. Which of these two models is the best choice

d. Calculate the different OR and intrepid the results

4. Finally, what is your opinion about the article

a. Explain the following causality criteria from Hill, and evaluate the article according to all of the 9 criteria

b. Please read the fourth paragraph in the discussion chapter: What Kind of recommendations do the authors recommend and why?

c. After answering all these questions. Do you believe the author provide the answers to the research question? Why and why not?


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Analysis of an Epidemiological Research Article

Identity of the article

Zambrana, I. M., Vollrath, M. E., Sengpiel, V., Jacobsson, B., & Ystrom, E. (2016).
Preterm delivery and risk for early language delays: A sibling-control cohort study. International Journal of Epidemiology, 151–159.


At the time of the study, the authors were leading researchers and professionals in various health institutions in Norway and Sweden.
The purpose of the study was to examine the relationship between early gestational age and language outcomes. To achieve this objective, the researchers used a control cohort study design, which they called “sibling-cohort” control design.

The researchers measured the outcomes of language comprehension and language production as the latent variables based on Confirmatory Factor Analysis (CFA).
The CFA model was chosen as it fits with high non-overlapping factor loadings for the descriptions of language construction, validation as well as the specific items included.

In addition, the researchers were measuring the outcome variables to determine the impact of early gestational age, which means that gestational age was the chief exposure that was being tested.
Nevertheless, gestational age as an exposure variable consists of a set of many variables, including gestational age at birth, malformations at birth, unplanned pregnancy, preeclampsia, urinary tract infections, alcohol intake by the mother during pregnancy, smoking by the mother during pregnancy and others.

The researchers used the Mplus version 7.2 as the statistical tool for data analysis. In addition, the statistical analysis was based on the item response theory approach, that is, the multi-level CFA for categorical data based on link function.

Although the researchers have not indicated he importance of using the Mplus statistical tool, it is evident that it was chosen because the system has features that relate to mediation analysis, latent class modeling and factor analysis…

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