1) The document provides instructions for a DNP student to critically appraise and summarize two epidemiological research articles on chronic pain by Oppenheimer (2010) and Elliott et al. (1999), identifying the strengths and weaknesses of each study's methods, analysis, and potential for bias. 2) Students are asked to consider possible sources of bias and strategies to minimize it in each study, as well as potential confounding variables that could influence the results. 3) By a deadline, students must submit a minimum 550-word response following the provided outline and citing at least three required readings.

1. Appraising the Literature
For the DNP-prepared nurse, it is important to hone skills
related to reviewing and evaluating research literature to
implement evidence-based practices. As you examine
epidemiological research, in particular, it is essential to ask,
“What are the strengths and weakness of the research
method(s)? Are the data analysis and interpretation sound? Is
there any evidence of bias?” This Discussion provides you and
your colleagues valuable practice in critically analyzing
research literature.
To prepare:
With this week’s Learning Resources in mind, reflect on the
importance of analyzing epidemiological research studies.
Critically appraise the Oppenheimer (2010) and Elliott,
Smith, Penny, Smith and Chambers (1999) articles presented
in the Learning Resources using Appendix A in
Epidemiology for Public Health Practice as a guide.
Determine the strengths and weaknesses of the research
methods and data analysis of each study.
Ask yourself, “Is any bias evident in either study? What did
the researchers do to control for potential bias?”
Finally, consider the importance of data interpretation in
epidemiologic literature and the issues that may arise if
potential confounding factors are not considered.

2. By tomorrow 04/05/2018 3pm, write a minimum of 550 words in
APA format with at least 3 scholarly references from the list of
required readings below. Include the level one headings as
numbered below”
Post
a cohesive scholarly response that addresses the following:
1) Appraise the Oppenheimer (2010) and Elliott et al. (1999)
articles, summarizing the strengths and weaknesses of each
study (see attached files for those articles).
2) Analyze potential sources of bias in each study and suggest
strategies for minimizing bias.
3) Suggest possible confounding variables that may have
influenced the results of each study.
Required Readings
Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public
health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
Chapter 10, “Data Interpretation Issues”
Chapter 15, “Social, Behavioral, and Psychosocial
Epidemiology”

3. Appendix A – Guide to the Critical Appraisal of an
Epidemiologic/Public Health Research Article
In Chapter 10, the authors describe issues related to data
interpretation and address the main types of research errors that
need to be considered when conducting epidemiologic research,
as well as when analyzing published results. It also presents
techniques for reducing bias. Chapter 15 features psychosocial,
behavioral, and social epidemiology. Appendix A includes
criteria to consider when reading an empirical journal article.
Elliott, A. M., Smith, B. H., Penny, K., Smith, W. C., &
Chambers, W. A. (1999). The epidemiology of chronic pain in
the community. The Lancet, 354(9186), 1248–1252.
This article describes an early epidemiologic study on chronic
pain. Carefully review this article noting the structure of the
research design, assessment and data collection, and analysis
strategies. You will refer to this article for Discussion 2. (see
attached file)
Oppenheimer, G. M. (2010). Framingham Heart Study: The first
20 years. Progress in Cardiovascular Diseases, 53(1), 55–61.
The Framingham Heart Study is a landmark epidemiologic study
that began in the 1940s. The author of this article reviews the
history of the Framingham Heart Study and its contribution to
population health. As you read this article, consider any sources
of bias or potential conflict of interest. You will refer to this

4. article for Discussion 2. (See attached file).
Phillips, C. V., & Goodman, K. J. (2004). The missed lessons of
Sir Austin Bradford Hill. Epidemiologic Perspectives &
Innovations, 1(3). Retrieved from
http://www.biomedcentral.com/1742-5573/1/3
In 1965, Austin Bradford Hill worked on a paper that has
become a standard in public health and epidemiologic study
about how to make decisions based on epidemiologic evidence.
Hill put forth strategies for inferring causation and stressed the
need for considering costs and benefits when planning health-
promoting interventions. Review this article, which examines
how Hill’s strategies are often misused or misinterpreted.
Centers for Disease Control and Prevention. (2011). CDC health
disparities and inequalities report—United States, 2011.
Morbidity and Mortality Weekly Report, Supplement, (60), 1–
114. Retrieved from
http://www.cdc.gov/mmwr/pdf/other/su6001.pdf. [Read pages
11–32]
This report consolidates national data on disparities in
mortality, morbidity, behavioral risk factors, health care access,
preventive health services, and social determinants of critical
health problems in the United States by using selected
indicators. The required section of reading introduces the social
determinants of health and environmental hazards.

5. World Health Organization. (2011). Social determinants of
health. Retrieved from
http://www.who.int/social_determinants/en/
According to the World Health Organization, “The social
determinants of health are mostly responsible for health
inequities—the unfair and avoidable differences in health status
seen within and between countries.” This article presents an
introduction to social determinants of health.
World Health Organization. (2011). Social determinants of
health: Key concepts. Retrieved from
http://www.who.int/social_determinants/thecommission/finalrep
ort/key_concepts/en/index.html
This article outlines key concepts related to the social
determinants of health.
Healthy People 2020. (2011). Social determinants of health.
Retrieved from
http://healthypeople.gov/2020/topicsobjectives2020/overview.as
px?topicid=39
This website presents an overview of the social determinants of
health and addresses how the information relates to Healthy
People 2020.
UCL Institute of Health Equity. (2012). ‘Fair society healthy
lives’ (The Marmot Review). Retrieved from
http://www.instituteofhealthequity.org/projects/fair-society-

6. healthy-lives-the-marmot-review
Optional Resources
Genaidy, A. M., Lemasters, G. K., Lockey, J., Succop, P.,
Deddens, J., Sobeih, & Dunning, K. (2007). An epidemiological
appraisal instrumental – a tool for evaluation of epidemiological
studies. Ergonomics, 50(6), 920–960.
Centers for Disease Control and Prevention. (2011). Social
determinants of health. Retrieved from
http://www.cdc.gov/socialdeterminants/