PUBH6005 Epidemiology Assignment- 3 Critical Appr

PUBH6005: Epidemiology
Assignment- 3
Critical Appraisal Essay
Title: To find the association between use of tobacco and
alcohol and head and
neck/ Oral Cancer in South East Asia.
Name of student: Rajwant Kaur
Student ID: 00275380T
Name of topic co-ordinator: Dr. Bhawna Gupta
Topic: PUBH6005: Epidemiology
Introduction

The major risk factors for head and neck cancers are tobacco
and alcohol consumption. Smoking
and alcohol are independent risk factor for head and neck
cancer. Tobacco use can be chewing
tobacco, snuff and smoking tobacco. At least 75% of head and
neck cancers are caused by
tobacco and alcohol use (NIH 2017). In developing countries
like Southeast Asia, tobacco is used
in many forms along with alcohol consumptions. Areca nuts
and betel leaf with or without
tobacco also cause cancers Other factors also increase the
vulnerability of people for cancers
such as low education, low family income, poor oral hygiene
and environment (Priebe et al.,
2008).
Awareness is virtually non-existence in the developing
countries of Southeast Asia and therefore
people with rising affluence tend to buy more of tobacco
products and thus increase their risks
for cancer. To prevent the cancers, the health organizations and
health professionals should
focus on educating the people through various means to quit
habits of tobacco use and alcohol
consumption. Regular screening is also important to detect the

cancer at early stage (Priebe et
al., 2008).
Methodology
Method:
Three selected papers were evaluated and explained by NHMRC
form, in which level of evidence,
bias, confounding factors and chances, clinical impacts,
applicability are defined. CASP
framework with checklist that can explain or support in
analyzing and justifying the questions
and characteristics.
Search strategy:
Before commencing critical appraisal of studies, I did
systematic review on our research question
about identifying the association between use of tobacco and
alcohol and head and neck/ Oral
Cancer in South East Asia. Systematic reviews apply strategies
for eliminating biases and random
errors. They adhere to a scientific design for offering reliable,

reproducible and defensible
conclusions. The evidences use more rigorous methodology
/designs that minimize bias.
Systematic reviews incorporate results of multiple studies
(Guide, 2018).
The literature search covered the studies applying alternative
terminologies, like the terms sed
for education on cancer include Recommendation, Internet-
based intervention on cancer,
teletherapy, etc.
Databases:
The databases used in the research include (1) Cochrane Library
(Cochrane Database of
Systematic Reviews), (2) CINAHL Plus with full text (3)
MEDLINE via PubMed (4) EBSCOhost, (5)
Ovid, and (6) ProQuest. I searched 105 studies, out of which
three studies are selected, which are
identifies as the most compatible with the research question.

Key words: -
Search terms used in the search include:
• Causes of the oral cancer, education, interventions, substance
abuse adverse impact on
health.
• telemedicine, video conferencing, tele-CBT, Internet-assisted
healthcare, telehealth
• home therapy, rehabilitation, telemedicine, Government
programs
• teenager, youngster, adolescent of south East Asia
• social issues, behavior, lifestyle,
• rural, remote
• efficacy, effectiveness
• face-to-face, in-person care
Use of Boolean Operators and Truncation
I used Boolean operators (AND, OR, NOT) to expand or limit
the search. For example: young AND
elders, young OR old people, Internet OR mobile based,
information OR discussion OR
interaction. To expand or emphasize the search I used
truncation (behav*, young*, educat*).
Inclusion criteria
Inclusion criteria are the original peer-review articles, academic
research papers, Scholarly

articles (perspective articles, opinions, reviews, documents),
published in English language within
last ten years.
Results:-
Table 1 Cross-sectional study:
Epidemiological profile of head and neck cancer patients in
Western Uttar Pradesh and
analysis of distributions of risk factors in relation to site of
tumor
Critical appraisal questions Underline your answer
Were the criteria for inclusion in the sample
clearly defined?
Yes
Evidence:
In this cross-sectional study, the criteria of inclusion were
clearly defined as the patients
(n=850) having head and neck cancers (HNC) between a
particular time period.

Were the study subjects and the setting
described in detail?
Yes
Evidence:
The study subjects and setting are clearly described as to
identify the differences in site,
pattern and incidences of head and neck cancers in a specific
geography (Western Uttar
Pradesh, India). Moreover, the patients were categorized in
accordance with the
histopathological reports into different categories.
Was the exposure measured in a valid and
reliable way?
No
Evidence:
The exposure to tobacco and alcohol was not measured in valid
and reliable manner. For
example, there was not description of age when started,
frequency and duration of

cigarette smoking or tobacco chewing.
Were objective, standard criteria used for
measurement of the condition?
Yes
Evidence:
The cancers have been measured using the standard and
objective criteria. For example,
HNCs were classified on the basis of the anatomical sites like
oral cavity, tongue, salivary
gland, oropharynx or paranasal sinus. Histopathological
assessment was also conducted.
Were confounding factors identified? Yes
Evidence:
In this study, the confounding factors were detected as poor
socioeconomic class and low
literacy which are known risk factors for cancers (Davis et al.,
2002, pp 134).

Were strategies to deal with confounding
factors stated?
No
Evidence:
No strategy to deal confounding factor is stated in the study.
Were the outcomes measured in a valid and
reliable way?
Yes
Evidence:
The outcomes were measured in detailed manner using reliable
and valid procedures.
There is no bias as study is retrospective and objective, based
on case history and
histopathological reports. In addition, all measurements tools
were appropriately used.
Was appropriate statistical analysis used? Yes

Evidence:
Appropriate statistical analysis methods were used. Significance
P values and correlation
values were determined by using valid Pearson Ch-square test
(Zaccai, 2004; Health
Knowledge, 2017).
Reference:
Alam, M. S., Siddiqui, S.A. & Perween, R. (2017).
Epidemiological profile of head and neck cancer
patients in Western Uttar Pradesh and analysis of distributions
of risk factors in relation to site
of tumor. Journal of Cancer Research and Therapeutics, 13:
430-35. doi: 10.1111/j.1349-
7006.2010.01785.x
Table 2 Case-control study:
Associations between oral hygiene habits, diet, tobacco and
alcohol and risk of oral cancer:
A case–control study from India

1. Did the study address a clearly focused issue? Yes
Evidence:
This case control study addressed an important issue of
association of poor oral hygiene,
diet, tobacco chewing/smoking and alcohol (risk factors) with
the oral cancers (outcomes).
2. Did the authors use an appropriate method to answer their
question?
Yes
Evidence:
The method is appropriate to answer the question but there is
possibility of biases as the
patients have awareness about risk factors and diagnosis and
therefore, they are motivated
to recall more of risk factors.
3. Were the cases recruited in an acceptable way? Yes
Evidence:
The cases were recruited appropriately, and the criteria of

inclusion were clearly defined.
The patients selected from two big tertiary hospitals of Pune
City. All 187 patients with oral
cancers were recruited irrespective of their age, sex and stages
of disease.
4. Were the controls selected in an acceptable way? Yes
Evidence:
The controls were selected in sufficient numbers (240). The
controls are the patients
having non-neoplastic disease, recruited within same time frame
and matched in terms of
sex and age with the cases.
5. Was the exposure accurately measured to minimise bias? Yes
Evidence:
Exposure measurements were described accurately in detail that
included data from face-
to-face interview, questionnaire, life grid tool, exposure to
tobacco, oral hygiene habit,

anthropometry, intraoral examination and putative risk factors.
Frequency, duration and
cumulative effect of smoking and tobacco chewing recorded in
valid and reliable manner.
The cancers were measured using standard criteria (extent, type,
stages, site and
comorbidities.
Critical appraisal questions
Underline your answer
6. Aside from the experimental intervention, were the groups
treated equally?
Yes
Evidence:
Aside from the experimental intervention, both groups were
equally treated to minimize
any bias.

7. Have the authors taken account of the potential confounding
factors in the design and/or in their analysis?
Yes
Evidence:
There was possibility of confounding factors like age, family
income, socioeconomic status,
and education which may have effect on the outcomes or
increase the cancer risks
(Jayalekshmi et al., 2011). The article used unconditional
logistic regression model to adjust
the confounding factors.
8. How large was the treatment effect? Yes
Evidence:
The results are consistent with previous research reports and are
believable. The
Confidence interval 95% CIs and P value = 0.001 showing
precise research. A linear dose
related association was found between tobacco chewing and
occurrence of oral cancer.

9. How precise was the estimate of the treatment effect? Yes
Evidence:
The results are reliable and trustworthy. The results cannot be
applied to Australia as the
tobacco chewing is not prevalent and oral hygiene is remarkably
better than India.
believable. The
Confidence interval 95% CIs and P value = 0.001 showing
precise research.
10. Do you believe the results? Yes
Evidence:
The findings are in line and consistent with the previous
research findings. Regarding the
results, the association between oral /oropharyngeal cancers and
tobacco with alcohol is
explained as potent risk factor. The novel finding is the
evidence of increased risks of oral
cancer when patients are chewing tobacco in presence of poor

oral hygiene.
11. Can the results be applied to the local population? No
Evidence:
The results cannot be applied to Australia as the tobacco
chewing is not prevalent and oral
hygiene is remarkably better than India. The findings are in line
and consistent with the
previous research findings
12. Do the results of this study fit with other available
evidence? Yes
Evidence:
The findings are in line and consistent with the previous
research findings
Reference:
Gupta, B., Bray, F., Kumar, N. & Johnson, N.W. (2017).
Associations between oral hygiene habits,
diet, tobacco and alcohol and risk of oral cancer: A case–control

study from India, Cancer
Epidemiology, 51:7-14. doi.org/10.1016/j.canep.2017.09.003
Table 3 Cohort study:
Oral cavity cancer risk in relation to tobacco chewing and bidi
smoking among men in
Karunagappally
Did the study address a clearly focused issue? Yes
Evidence:
Yes, the study addressed a clearly focused issue. This cohort
study aims to analyze
relationship of oral cancer with tobacco use, alcohol drinking
and low socioeconomic status
in the rural population that is the Karunagapally cohort of
Kerala.
Was the cohort recruited in an acceptable
way?

Yes
Evidence:
Yes, the cohort recruited in an acceptable way. Virtually all
residents (n= 66277) aged 30-
84 years in the cohort were recruited in Jan 1990 using Poisson
regression analysis of
grouped data stratified on age, calendar time, education and
family income to deal with
biases and confounders. Therefore, virtually all households
were recruited in the cohort.
Was the exposure accurately measured to
minimise bias?
Yes
Evidence:
Regarding exposure, tobacco use, alcohol and socioeconomic
stats were measured
appropriately. The participants were asked for history of
tobacco chewing (not chewing,
habitually in past, habitually currently), age when they started
chewing tobacco and the

duration. Similar questions were put forward for BIDI and
cigarette smokers. Thus, the bias
is controlled.
Was the outcome accurately measured to
minimise bias?
Yes
Evidence:
Outcomes (development of cancers) were ascertained by the
Cancer Registry during the
long period between 1990 and 2005 under the Regional Cancer
Center (RCC). Biases are
minimized with accurate measurement and diagnosis of cancers.
By the end of 2005, 160
men developed oral cancers.
Have the authors identified all important
confounding factors?
Yes

Evidence:
The confounding factors were identified as family income, age,
calendar time and
education level.
Have they taken account of the confounding
factors in the design and/or analysis?
Yes
Evidence:
To deal with confounding factors, stratification strategy and
regression strategy were
adopted.
Was the follow up of subjects complete
enough?
Yes
Evidence:
The follow up was complete and long enough from 1990 to
2005. Migrants were identified
from door to door monitoring survey. Only 0.7% participants

were lost due to permanent
migrations.
Was the follow up of subjects long enough? Yes
Evidence:
The follow up was complete and long enough from 1990 to 2005
(15 years long). Migrants
were identified from door to door monitoring survey.
What are the results of this study? Yes
Evidence:
Results show that tobacco chewing increases risk of cancers of
gums and mouth among
people who keeps tobacco in the cheek. In addition, even pan
with or without tobacco
causes oral cancer Bidi smoking also increases risk for cancers.
How precise are the results? Yes

Evidence:
Results are precise with use of appropriate methodologies and
statistical analysis. Cancers
at different sites in oral cavity are examined for risk factors.
For example, risk of tongue
cancer is related with duration of bidis smoking (RR =3.4, 95%
CI and p=0.034). P value is
0.001 and CI is 95% Confidence interval shows the precision of
the study
Do you believe the results? Yes
Evidence:
Results are believable as the study sample is large and study
duration in long enough. The
methods are appropriate without bias and confounders.
Can the results be applied to the local population? Yes
Evidence:
The results can be partially applied to local Australian
population where smoking is
prevalent. However, Pan and tobacco chewable products

(smokeless tobacco) are not
prevalent.
Do the results of this study fit with other available
evidence?
Yes
Evidence:
The results of this study are supported by most of the articles in
literature. Alam et al.
(2017) also found the tobacco use as important risk factor for
cancer in the oral cavity.
What are the implications of this study for
practice?
Yes
Evidence:
Regarding implication, the nurses and social workers should
educate the people regarding
the harmful impact of tobacco and alcohol in causing cancers.

In vulnerable patients with
habits of tobacco use, a complete screening should be done at
regular interval to detect
early cancers. Smokeless tobacco (chewing) is equally harmful.
Reference:
Jayalekshmi, P.A., Gangadharan, P., Akiba, S., Koriyama, C. &
Nair, R.R.K. (2011). Oral cavity
cancer risk in relation to tobacco chewing and bidi smoking
among men in Karunagappally,
Kerala, India: Karunagappally cohort study. Cancer Sci,
102:460-467. doi: 10.1111/j.1349-
7006.2010.01785.x
Discussion:-
Article 1: Cross-sectional study authored by Alam et al. (2017,
pp. 430-435).
In this cross-sectional study, the criteria of inclusion were
clearly defined as the patients (n=850)

having head and neck cancers (HNC) between a particular time
period. Study subject and setting
are clearly described as to identify the differences in site,
pattern and incidences of head and
neck cancers in a specific geography (Western Uttar Pradesh,
India). The patients were
categorized according to the histopathological reports into
different categories.
Exposure to tobacco and alcohol was not measured in valid and
reliable manner. For example,
there was not description of age when started, frequency and
duration of cigarette smoking or
tobacco chewing. The cancers have been measured using the
standard and objective criteria. For
example, HNCs were classified on the basis of the anatomical
sites like oral cavity, tongue, salivary
gland, oropharynx or paranasal sinus. Histopathological
assessment was also conducted. In this
study, the confounding factors were detected as poor
socioeconomic class and low literacy which
are known risk factors for cancers (Davis et al., 2002, pp 134).
However, no strategy to deal
confounding factor is stated in the study.
Appropriate statistical analysis methods were used. Significance

P values and correlation values
were determined by using valid Pearson Ch-square test.
Outcomes were measured in detailed
manner using reliable and valid procedures. There is no bias as
study is retrospective and
objective, based on case history and histopathological reports.
In addition, all measurements
tools were appropriately used. Chance or sample error is
minimal as the sample size and time
span were large enough to represent the population (Zaccai,
2004; Health Knowledge, 2017).
The result of the study showed that maximum cases of HNC are
between 40-60 years of age.
Tobacco smoking and tobacco chewing are most prevalent risk
factors. Alcohol alone is an
insignificant risk factor, but it has synergistic effect with
tobacco use in causing buccal mucosa
cancers. The results are generalizable as the study is rigorous
with large sample size and research
design.
Article 2: Case control study authored by Gupta et al. (2017)
This case control study addressed an important issue of
association of poor oral hygiene, diet,

tobacco chewing/smoking and alcohol (risk factors) with the
oral cancers (outcomes). The
method is appropriate to answer the question but there is
possibility of biases as the patients
have awareness about risk factors and diagnosis and therefore,
they are motivated to recall more
of risk factors. The disadvantage is that the findings are
dependent on the memory of the
patients.
The cases were recruited appropriately, and the criteria of
inclusion were clearly defined. The
patients selected from two big tertiary hospitals of Pune City.
All 187 patients with oral cancers
were recruited irrespective of their age, sex and stages of
disease. The controls were selected in
sufficient numbers (240). The controls are the patients having
non-neoplastic disease, recruited
within same time frame and matched in terms of sex and age
with the cases. Thus, there is no
evidence of selection biases.
Exposure measurements were described accurately in detail that
included data from face-to-face

interview, questionnaire, life grid tool, exposure to tobacco,
oral hygiene habit, anthropometry,
intraoral examination and putative risk factors. Frequency,
duration and cumulative effect of
smoking and tobacco chewing recorded in valid and reliable
manner. The cancers were measured
using standard criteria (extent, type, stages, site and
comorbidities. Both groups were equally
treated to minimize any bias.
There was possibility of confounding factors like age, family
income, socioeconomic status, and
education which may have effect on the outcomes or increase
the cancer risks (Jayalekshmi et
al., 2011). The article used unconditional logistic regression
model to adjust the confounding
factors. Regarding the results, the association between oral
/oropharyngeal cancers and tobacco
with alcohol is explained as potent risk factor. The novel
finding is the evidence of increased risks
of oral cancer when patients are chewing tobacco in presence of
poor oral hygiene.
believable. The Confidence

interval 95% CIs and P value = 0.001 showing precise research.
A linear dose related association
was found between tobacco chewing and occurrence of oral
cancer.
The results are reliable and trustworthy. The results cannot be
applied to Australia as the tobacco
chewing is not prevalent and oral hygiene is remarkably better
than India. The findings are in line
and consistent with the previous research findings (Alam et al
2017)
Article 3: Cohort Study Authored by Jayalekshmi et al. (2011)
This cohort study aims to analyze relationship of oral cancer
with tobacco use, alcohol drinking
and low socioeconomic status in the rural population that is the
Karunagapally cohort of Kerala.
Virtually all residents (n= 66277) aged 30-84 years in the
cohort were recruited in Jan 1990 using
Poisson regression analysis of grouped data stratified on age,
calendar time, education and family
income to deal with biases and confounders. Therefore,
virtually all households were recruited
in the cohort.

Regarding exposure, tobacco use, alcohol and socioeconomic
stats were measured
appropriately. The participants were asked for history of
tobacco chewing (not chewing,
habitually in past, habitually currently), age when they started
chewing tobacco and the duration.
Similar questions were put forward for BIDI and cigarette
smokers. Thus, the bias is controlled.
Outcomes (development of cancers) were ascertained by the
Cancer Registry during the long
period between 1990 and 2005 under the Regional Cancer
Center (RCC). Biases are minimized
with accurate measurement and diagnosis of cancers. By the end
of 2005, 160 men developed
oral cancers.
The confounding factors were identified as family income, age,
calendar time and education
level. To deal with confounding factors, stratification strategy
and regression strategy were
adopted. The follow up was complete and long enough from
1990 to 2005. Migrants were
identified from door to door monitoring survey. Only 0.7%
participants were lost due to

permanent migrations.
Results show that tobacco chewing increases risk of cancers of
gums and mouth among people
who keeps tobacco in the cheek. In addition, even pan with or
without tobacco causes oral cancer
Bidi smoking also increases risk for cancers. Results are precise
with use of appropriate
methodologies and statistical analysis. Cancers at different
sites in oral cavity are examined for
risk factors. For example, risk of tongue cancer is related with
duration of bidis smoking (RR =3.4,
95% CI and p=0.034). P value is 0.001 and CI is 95%
Confidence interval shows the precision of
the study.
Results are believable as the study sample is large and study
duration in long enough. The
methods are appropriate without bias and confounders. The
results can be partially applied to
local Australian population where smoking is prevalent.
However, Pan and tobacco chewable
products (smokeless tobacco) are not prevalent. The results of
this study are supported by most
of the articles in literature. Alam et al. (2017) also found the
tobacco use as important risk factor

for cancer in the oral cavity. Regarding implication, the nurses
and social workers should educate
the people regarding the harmful impact of tobacco and alcohol
in causing cancers. In vulnerable
patients with habits of tobacco use, a complete screening should
be done at regular interval to
detect early cancers. Smokeless tobacco (chewing) is equally
harmful.
Discussion on bias, confounding factors and chances
Bias is a systematic error that should be minimized by proper
selection of the cases and proper
measurement. Bias does not disqualify the study. Research
studies can have pitfall called
Confounding which arises when the risk factor and the outcome
both are associated with a third
variable which creates a confusion. To avoid confounding, the
control should be the subject who
might have been the cases but are independent of the exposure.
Confounding can be prevented
by randomization, restriction and matching. Confounding can be
adjusted during statistical

analysis by using stratified analysis and multivariate analysis
techniques. Stratification is the best
technique to avoid confounding as used by Jayalekshmi et al.
(2011). Regression is also effective
technique for confounding as used by Gupta et al. (2017).
Chance is a sample error that should
be dealt by recruiting a large sample (Zaccai, 2004).
Conclusion:-
The paper concluded that tobacco consumption in any form is
injurious to health as it is the major
independent risk factor for head and neck cancers. Alcohol acts
as synergy with tobacco by
facilitating carcinogen uptake to the tissues. People in the
Southeast Asia have generally low
education and poor socioeconomic status. People in remote
villages and even in urban areas
have unhealthy lifestyle that increase the risks for cancers. The
health organization should
intensify their mission of educating the people in order to
control the cancers.

References:-
Alam, M. S., Siddiqui, S.A. & Perween, R. (2017).
Epidemiological profile of head and neck cancer
patients in Western Uttar Pradesh and analysis of distributions
of risk factors in relation to site
of tumor. Journal of Cancer Research and Therapeutics, 13:
430-35. doi: 10.1111/j.1349-
7006.2010.01785.x
Davis, T. C., Williams, M.V., Marin, E., Parker, R.M. & Glass
J. (2002). Health literacy and cancer
communication. CA: A Cancer Journal for Clinicians,
52(3):134-49.
Guide: University of Canberra (2018). Evidence-based practice
in health: Guide. Retrieved from
https://canberra.libguides.com/c.php?g=599346&p=4149721>.

Gupta, B., Bray, F., Kumar, N. & Johnson, N.W. (2017).
Associations between oral hygiene habits,
diet, tobacco and alcohol and risk of oral cancer: A case–control
study from India, Cancer
Epidemiology, 51:7-14. doi.org/10.1016/j.canep.2017.09.003
Health Knowledge (2017). Errors in epidemiological
measurements. Retrieved from
<https://www.healthknowledge.org.uk/e-
learning/epidemiology/practitioners/errors-
epidemiological-measurements>.
Jayalekshmi, P.A., Gangadharan, P., Akiba, S., Koriyama, C. &
Nair, R.R.K. (2011). Oral cavity
cancer risk in relation to tobacco chewing and bidi smoking
among men in Karunagappally.
Kerala, India: Karunagappally cohort study. Cancer Science,
102:460-467. doi: 10.1111/j.1349-
7006.2010.01785.x
National Cancer Institute (NIH) (2017). Head and Neck
Cancers. Retrieved from
<https://www.cancer.gov/types/head-and-neck/head-neck-fact-
sheet>.
Priebe, S. L., Aleksejuniene, J., Dharamsi, S. & Zed, C. (2008).
Oral cancer and cultural factors in

Asia. The Canadian Journal of Dental Hygiene, 42(6):291-293
Zaccai, J.H. (2004). How to assess epidemiological studies:
Review. The Canadian Journal of
Dental Hygiene, 80(941):140–147. doi:
10.1136/pgmj.2003.012633.
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Project Management for Engineering,
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resource (b)

study material and (c) as a resource for case
studies and references. I find that the 5th
edition has been
thoroughly revamped and incorporates several
relevant resources and is presented in a very
lucid and
structured way. I have absolutely no hesitation in
recommending this book as a standard resource
for
teaching students in a university set up and/or
for working executives in a project
environment. The
book is also a good resource as a study
material for certification courses.”
Krishna Moorthy, Ex-Dean, Larsen & Toubro
Institute of Project Management, India
“Project Management for Engineering, Business and
Technology is one of the most comprehensive
textbooks in the field. Nicholas and Steyn explain
the matter in a readable and easy-to-
understand way,
illustrated with interesting examples. The authors
combine the ‘hard matter’ of project
management with
relevant behavioural aspects. Overall, a useful
work for anyone new to the field or as
reference for the
more advanced project manager.”
Martijn Leijten, Delft University of Technology,
The Netherlands
“Project management plays a vital role in
achieving project objectives. Projects bring

change and project
management is recognised as the most effective
way to managing such change. This book encourages
readers to become interested and involved in the
change towards renewed project management
and
management of projects.”
Benita Zulch, University of the Free State,
South Africa
“A very comprehensive text. An excellent mix of
materials to enable students to learn techniques
and
engage in discussion of scenarios.”
Richard Kamm, University of Bath, UK
FIFTH EDITION
John M. Nicholas
Loyola University Chicago
Herman Steyn
University of Pretoria
Fifth edition published 2017

by Routledge
2 Park Square, Milton Park, Abingdon, Oxon
OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis
Group, an informa business
© 2017 John Nicholas and Herman Steyn
The right of John Nicholas and Herman Steyn to be
identified as authors of this work has been
asserted by
them in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be
reprinted or reproduced or utilised in any
form or by any
electronic, mechanical, or other means, now known
or hereafter invented, including photocopying and
recording, or in any information storage or
retrieval system, without permission in writing
from the
publishers.
Trademark notice: Product or corporate names

may be trademarks or registered trademarks,
and are used
only for identification and explanation without intent
to infringe.
Fourth edition published by Routledge 2012
Third edition published by Elsevier Inc. 2008
British Library Cataloguing in Publication Data
A catalogue record for this book is available from
the British Library
Library of Congress Cataloging in Publication
Data
A catalog record for this book has been requested
ISBN: 978-1-138-93735-2 (hbk)
ISBN: 978-1-138-93734-5 (pbk)
ISBN: 978-1-315-67631-9 (ebk)
Typeset in Joanna by Servis Filmsetting Ltd,
Stockport, Cheshire
Visit the companion website:
www.routledge.com/cw/nicholas
http://www.routledge.com/cw/nicholas
To Sharry, Julia, Joshua, and Abigail

J.M.N.
To Karen and Janine
H.S.
BriefContents
Introduction
PART I: PHILOSOPHY AND CONCEPTS
1 What Is Project Management?
2 Systems Approach
PART II: PROJECT LIFE CYCLE
3 Project Life Cycle and Project Conception
4 Project Definition and System Definition
PART III: SYSTEMS AND PROCEDURES FOR
PLANNING AND CONTROL
5 Basic Project Planning Techniques
6 Project Schedule Planning and Networks
7 Advanced Project Network Analysis and Scheduling
8 Cost Estimating and Budgeting
9 Project Quality Management
10 Project Risk Management
11 Project Execution, Monitoring, and Control
12 Project Evaluation, Communication,
Implementation, and Closeout
13 Agile Project Management and Lean
PART IV: ORGANIZATION BEHAVIOR
14 Project Organization Structure and Integration

15 Project Roles and Stakeholders
16 Managing Participation, Teamwork, and Conflict
PART V: PROJECT MANAGEMENT IN THE
CORPORATE CONTEXT
17 Meta-Management of Projects and Program
Management
18 Project Selection and Portfolio Management
19 International Project Management
Appendix A: RFP for Midwest Parcel Distribution
Company
Appendix B: Proposal for Logistical Online System
Project (LOGON)
Appendix C: Project Evaluation Plan for Logistical
Online System
Index
Contents
Cover
Title
Copyright
Dedication
BriefContents
Contents
Preface
Acknowledgements
About the Authors
Introduction

I.1 In the Beginning…
I.2 What Is a Project?
I.3 All Projects are Not the Same
I.4 Project Management: The Need
I.5 Project Goal: Time, Cost, and Performance
I.6 Project Management: The Person, The Team,
The
Methodology
I.7 Project Management Standards of Knowledge
and
Competencies
I.8 About This Book
I.9 Study Project
Appendix: Relation Between Professional Standards
and
Chapters of This Book
Review Questions
Case I.1 The Denver Airport
Questions About the Case
kindle:embed:0007?mime=image/jpg
Endnotes
1.1 Functions of Management
1.2 Features of Project Management
1.3 Evolution of Project Management
1.4 Where is Project Management Appropriate?
1.5 Management by Project: A Common Approach
1.6 Different Forms of Project-Related Management

1.7 Project Environments
1.8 New Product and Systems Development Projects
1.9 Construction Projects
1.10 Service-Sector Projects
1.11 Public-Sector and Governmental Projects and
Programs
1.12 Miscellaneous Projects
1.13 Summary
Review Questions
Questions About the Study Project
Case 1.1 Disaster Recovery at Marshall Field’s
Case 1.2 Flexible Benefits System Implementation at
Shah Alam Medical Center
Endnotes
2 Systems Approach
2.1 Systems and Systems Thinking
2.2 Systems Concepts and Principles
2.3 Systems Approach
2.4 Systems Engineering
2.5 Project Management: A Systems Approach
2.6 Summary
Review Questions
Case 2.1 Glades County Sanitary District
Case 2.2 Life and Death of an Aircraft
Development
Project
Case 2.3 Jubilee Line Extension Project
Case 2.4 Santa Clara County Traffic Operations
System
and Signal Coordination Project

Endnotes
3.1 Project Life Cycle
3.2 Systems Development Cycle
3.3 Phase A: Conception
3.4 Project Feasibility
3.5 The Project Proposal
3.6 Project Contracting
3.7 Summary
Appendix: Kinds of Contracts
Review Questions
Case 3.1 West Coast University Medical Center
Case 3.2 X-Philes Data Management Corporation: RFP
Matters
Case 3.3 Proposal Evaluation for Apollo Spacecraft
Case 3.4 Contract Mess-Up at Polanski Developers
Endnotes
4.1 Phase B: Definition
4.2 Project Definition
4.3 Phased (Rolling Wave) Project Planning
4.4 System Definition
4.5 Summary
Appendix A: Stages of Systems Engineering
Appendix B: Quality Function Deployment
Review Questions

Case 4.1 Star-Board Construction and Santaro
Associates: Requirements Snafu
Case 4.2 Revcon Products and Welbar, Inc.:
Client–
Contractor Communication
Case 4.3 Lavasoft.com: Interpreting Customer
Requirements
Case 4.4 Proposed Gold Mine in Canada: Phased
Project Planning
Endnotes
PART III: SYSTEMS AND PROCEDURES
FOR PLANNING AND
CONTROL
5.1 Planning Steps
5.2 The Project Execution Plan
5.3 Scope and Statement of Work
5.4 Work Definition
5.5 Project Organization and Responsibilities
5.6 Scheduling
5.7 Planning and Scheduling Charts
5.8 Line of Balance (Linear Scheduling Method)
5.9 Procurement Management
5.10 Summary
Review Questions
Case 5.1 Barrage Construction Company: Sean’s WBS
Case 5.2 Startrek Enterprises, Inc.: Deva’s Project
Plan

Case 5.3 Walter’s Project Plan
Case 5.4 Planning the Boca Implementation at
Kulczyński Products
Endnotes
6.1 Network Diagrams
6.2 The Critical Path
6.3 Converting to Gantt Calendar Schedules
6.4 Management Schedule Reserve
6.5 Alternative Relationships
6.6 Scheduling with Resource Constraints
6.7 Criticisms of Network Methods
6.8 Summary
Appendix A: AOA Diagrams
Appendix B: Alternate Scheduling Method: Project
Starts at Day 1
Review Questions and Problems
Case 6.1 Network Diagram for a Large
Construction
Project
Case 6.2 Melbourne Construction Company, A
Case 6.3 Melbourne Construction Company, B
Case 6.4 Melbourne Construction Company, C
Endnotes
7.1 CPM and Time-Cost Tradeoff
7.2 Variability of Activity Duration
7.3 PERT
7.4 Allocating Resources and Multiple Project
Scheduling

7.5 Theory of Constraints and Critical Chain
Method
7.6 TOC Method for Allocating Resources to
Multiple
Projects
7.7 Discussion and Summary
Summary List of Symbols
Case 7.1 Bridgecon Contractors
Case 7.2 LOGON Project
Case 7.3 Papua Petera Village Project
Endnotes
8.1 Cost Estimates
8.2 Cost Escalation
8.3 Cost Estimating and the Systems
Development
Cycle
8.4 Cost Estimating Process
8.5 Elements of Estimates and Budgets
8.6 Project Cost Accounting Systems
8.7 Budgeting Using Control (or Cost) Accounts
8.8 Cost Summaries
8.9 Cost Schedules and Forecasts
8.10 Life Cycle Costs
8.11 Summary
Case 8.1 Life Cycle Costs for Fleet of Tourist
Spaceships
Case 8.2 Estimated Costs for the Chunnel Project

Case 8.3 Fiona’s Estimate for the Gorgy Project
Case 8.4 Melbourne Construction Company, D
Endnotes
9.1 The Concept of Quality
9.2 Project Quality Management Processes
9.3 Techniques for Quality Assurance in System
Development
9.4 Techniques for Quality Control
9.5 Summary
Review Questions
Case 9.1 Ceiling Panel Collapse in the Big Dig
Project
Case 9.2 FIFA 2010 World Cup South Africa
Case 9.3 Airbag Adversity
Endnotes
10.1 Risk Concepts
10.2 Risk Identification
10.3 Risk Assessment
10.4 Risk Response Planning
10.5 Risk Monitoring and Response
10.6 Project Management Is Risk Management
10.7 Summary
Appendix: Risk Analysis Methods
Case 10.1 The Sydney Opera House
Case 10.2 Infinity & Beyond, Inc.

Case 10.3 The Nelson Mandela Bridge
Endnotes
11.1 Phase C: Execution
11.2 Detail Design Stage
11.3 Production/Build Stage
11.4 Monitoring and Control Process
11.5 Work Packages and Control Accounts
11.6 Project Monitoring and Control Emphasis
11.7 Performance Analysis and Earned Value
Management
11.8 Issue Management
11.9 Change Control
11.10 Contract Administration
11.11 Problems with Monitoring and Controlling
Projects
11.12 Summary
Summary of Variables
Case 11.1 Cybersonic Project
Case 11.2 SA Gold Mine: Earned Value After a
Scope
Change
Case 11.3 Change Control Process at Dynacom
Company
Endnotes
Implementation,
and Closeout

12.1 Project Evaluation
12.2 Project Communication Management
12.3 Project Management Information Systems
12.4 Informal Communication
12.5 Implementation Stage
12.6 Project Termination and Closeout
12.7 Project Summary Evaluation
12.8 After the Project—Phase D: Operation
12.9 Summary
Review Questions
Case 12.1 Status Report for the LOGON Project
Case 12.2 SLU Information Central Building
Case 12.3 Formal and Informal Communication
Endnotes
13.1 Traditional Project Management
13.2 Agile Project Management, APM
13.3 Scrum
13.4 APM Controversy
13.5 Lean Production and Project Management
13.6 Summary
Review Questions
Questions about the Study Project
Case 13.1 Grand Entry for Accent, Inc.
Case 13.2 Technology to Track Stolen Vehicles
Endnotes

14.1 Formal Organization Structure
14.2 Organizational Design by Differentiation and
Integration
14.3 Requirements of Project Organizations
14.4 Integration of Subunits in Projects
14.5 Liaison Roles, Task Forces, and Teams
14.6 Project Expeditors and Coordinators
14.7 Pure Project Organizations
14.8 Matrix Organizations
14.9 Selecting an Organization Form for Projects
14.10 Project Office and PMO
14.11 Integration in Large-Scale Projects
14.12 Integration in Systems Development
Projects
14.13 Concurrent Engineering
14.14 Summary
Review Questions
Case 14.1 Organization for the LOGON Project
Case 14.2 Pinhole Camera and Optics, Inc.: Why
Do
We Need a Project Manager?
Case 14.3 Implementing a Matrix Structure in an
R&D
Laboratory
Endnotes
15.1 The Project Manager
15.2 Project Management Authority

15.3 Project Manager Qualifications
15.4 Filling the Project Management Role
15.5 Roles in the Project Team
15.6 Roles Outside the Project Team
15.7 Project Stakeholder Engagement
15.8 Summary
Review Questions
Case 15.1 The LOGON Project
Case 15.2 Selecting a Project Manager at Nuwave
Products Company
Case 15.3 Stakeholders in Boston’s Big Dig
Endnotes
16.1 Leadership in Project Management
16.2 Participative Management
16.3 Teams in Project Management
16.4 The Team-Building Approach
16.5 Improving Ongoing Work Teams
16.6 Building New Teams
16.7 Intergroup Problem Solving
16.8 Virtual Teams
16.9 Conflict
16.10 Managing Group Conflict
16.11 Managing Emotional Stress
16.12 Summary
Review Questions
Case 16.1 Wilma Keith
Case 16.2 Mars Climate Orbiter Spacecraft
Endnotes

CORPORATE
CONTEXT
Management
17.1 Project Management Maturity and Maturity
Models
17.2 Project Management Methodology
17.3 Managing Project Knowledge
17.4 Project Management Office
17.5 Program Management
17.6 Program Phases
17.7 Program Management Themes
17.8 Program Organization
17.9 Special Considerations
17.10 Summary
Review Questions
Case 17.1 Maxim Corporation America (MCA)
Case 17.2 Motorola’s M-Gate Methodology and the
RAZR Project
Case 17.3 Tecknokrat Company
Case 17.4 Mercury Exploration Program
Endnotes
18.1 Project Portfolio Management
18.2 Framework for Project Selection and Portfolio
Management

18.3 Methods for Assessing Individual Projects
18.4 Methods for Comparing and Selecting Projects
18.5 Integrating the Gating Process and Portfolio
Management
18.6 Summary and Discussion
Question About the Study Project
Case 18.1 Consolidated Energy Company
Case 18.2 Proposed Cement Factory for PCS Company
Endnotes
19.1 International Projects
19.2 Problems Managing International Projects
19.3 Local Institutions and Culture
19.4 Local Stakeholders
19.5 Geo-National Issues
19.6 Project Manager
19.7 Local Representative
19.8 Top Management, Steering Committee, and PMO
19.9 Team and Relationship Building
19.11 Project Monitoring
19.12 Communication
19.13 Risks and Contingencies
19.14 Summary
Review Questions
Case 19.1 Mozal Project—International Investment in
an Undeveloped Country
Case 19.2 Spirit Electronics’ Puerto Rico Office
Endnotes

APPENDIX A RFP for Midwest Parcel Distribution
Company
APPENDIX B Proposal for Logistical Online System
Project (LOGON)
APPENDIX C Project Execution Plan for Logistical
Online System
Index
Preface
When people see or use something
impressive—a bridge arching high over a
canyon, a space probe touching down on a
distant planet, an animated game so
realistic you think you’re there, or a nifty
phone/camera/computer the size of
your hand—they sometimes wonder, “How did
they do that?” By they, of course,
they are referring to the creators, designers, and
builders, the people who created
—thought up and made—those things. Seldom do
they wonder about the leaders
and managers, the people who organized and led the
efforts that brought those
astounding things from concept to reality
and without whom most neat ideas
would never have been achieved. This book
is about them—the managers of
project managers, the mostly unsung heroes of
engineering, business, and
technology who stand outside the public eye
but ultimately are responsible for
practically everything that requires collective human

effort.
The project manager is but one of many people
involved in the creation of
society’s products, systems, and artifacts, yet it is he
or she who gets the others
involved and organizes and directs their efforts
so everything comes out right.
Occasionally, the manager and the creator happen to
be the same: Burt Rutan,
Woody Allen, and Gutzon Borglum are examples;
their life work—in aerospace,
motion pictures, and monumental sculptures,
respectively—represent not only
creative or technological genius, but leadership and
managerial talent as well.
In the last several decades businesses have
expanded from domestic,
nationalistic enterprises and markets into
multinational, global enterprises and
markets. As a result, from a business
perspective there is more of everything to
contend with—more ideas, competitors, resources,
constraints, and, certainly,
more people doing and wanting things. Technology
is advancing and products
and processes evolving at a more rapidpace; as a
result, the life cycles of most
things in society are getting shorter. This “more
of everything” has had a direct
impact on the conduct of projects—including
projects to develop products,

systems, or processes that compete in local,
domestic, and international markets;
projects to create and implement new ways of
meeting demand for energy,
recreation, housing, communication, transportation,
and food; and projects to
answer basic questions in science and resolve
grave problems such as disease,
pollution, global warming, and the aftermath of natural
disasters. All of this
project activity has spurred a growing interest in
improved ways to plan,
organize, and guide projects to better meet the
needs of customers, markets, and
society within the bounds of limited time and
resources.
Associated with this interest is the growing need to
educate and train project
managers. In the past—and still today—project managers
were chosen for some
demonstrated exceptional capability, although not
necessarily managerial. If you
were a good engineer, systems analyst, researcher,
architect, or accountant,
eventually you would become a project
manager. Somewhere along the way,
presumably, you would pick up the “other”
necessary skills. The flaw in this
reasoning is that project management encompasses a
broad range of skills—
managerial, leadership, interpersonal—that are much
different from and
independent of skills associated with technical
competency. And there is no
reason to presume that the project environment

alone will provide the
opportunity for someone to “pick up” these other
necessary skills.
As a text and handbook, this book is about the
“right” way to manage projects.
It is intended for advanced undergraduate and
graduate university students and
practicing managers in engineering, business, and
technology. As the title says, it
is a book about principles and practice, meaning
that the topics in it are practical
and meant to be applied. It covers the big
picture of project management—
origins, applications, and philosophy, as well as
the nitty-gritty, how-to steps. It
describes the usual project management topics of
schedules, budgets, and
controls, but also the human side of project
management, including leadership
and conflict.
Why a book on project management in
engineering and business and
technology? In our experience, technology
specialists such as engineers,
programmers, architects, chemists, and so on,
involved in
“engineering/technology projects” often have little
or no management or
leadership training. This book, which includes many
engineering and technology
examples, provides somewhat broad exposure to
business concepts and

management specifics to help these specialists
get started as managers and
leaders.
What about those people involved in product
development, marketing, process
improvement, and related projects commonly thought
of as “business projects”?
Just as technology specialists seldom receive
formal management training,
students and practitioners of business rarely get
formal exposure to practices
common in technology projects. For them, this
book describes not only how
“business” projects are conducted, but also the
necessary steps in the conception
and execution of engineering, system
development, construction, and other
“technology” projects. Of course, every technology
project is also a business
project: it is conducted in a business context
and involves business issues such as
customer satisfaction, resource utilization, deadlines,
costs, and profits.
Virtually all projects—engineering, technology, and
business—originate and are
conducted in a similar way, in this book
conceptualized using a methodology
called the Systems Development Cycle (SDC).
The SDC serves as a general
framework for discussing the principles and
practices of project management,
and illustrating commonalities and differences among
a wide variety of projects.

This book is an outgrowth of the authors’
combined several decades of
experience teaching project management at Loyola
University Chicago and
University of Pretoria to business and engineering
students, preceded by several
years’ experience in business and technology
projects, including for aircraft
design and flight test, large-scale process facility
construction, and software
applications development and process improvement.
This practical experience
gave us an appreciation not only for the business-
management side of project
management, but also for the human-interpersonal side as
well. We have seen the
benefits of good communication, trust, and
teamwork, as well as the costs of poor
leadership, emotional stress, and group
conflict. In our experience, the most
successful projects are those where leadership,
trust, communication, and
teamwork flourished, regardless of the formal
planning and control methods and
systems in place. This book largely reflects these
personal experiences. Of course,
comprehensive coverage of project management
required that we look much
beyond our own experience and draw upon the
published works of many others
and the wisdom and suggestions of colleagues
and reviewers.
In this fifth edition we have revised and added
material to incorporate new

topics of interest, current examples, and the
growing body of literature in project
management. Among significant new additions are a
chapter on agile project
management and lean production, extended coverage of
program management,
as well as 18 new end-of-chapter case studies. The
Introduction includes tables
that relate sections of the …
FIFTH EDITION
Project Management for Engineering, Business and
Technology, 5th edition,
addresses project management across all industries.
First covering the essential
background, from origins and philosophy to
methodology, the bulk of the book is
dedicated to concepts and techniques for practical
application. Coverage includes
project initiation and proposals, scope and task
definition, scheduling, budgeting,
risk analysis, control, project selection and portfolio
management, program
management, project organization, and all-important
“people” aspects—project
leadership, team building, conflict resolution and stress

management.
The Systems Development Cycle is used as a
framework to discuss project
management in a variety of situations, making
this the go-to book for managing
virtually any kind of project, program or task force.
The authors focus on the
ultimate purpose of project management—to unify
and integrate the interests,
resources, and work efforts of many
stakeholders, as well as the planning,
scheduling, and budgeting needed to accomplish
overall project goals.
This new edition features:
• Updates throughout to cover the latest
developments in project
management methodologies
• New examples and 18 new case studies to
help students develop their
understanding and put principles into practice
• A new chapter on agile project management
and lean
• Expanded coverage of program management,
stakeholder engagement,
buffer management, and managing virtual teams
and cultural differences
in international projects.
• Alignment with PMBOK terms and definitions
for ease of use alongside

PMI certifications
• Cross-reference to IPMA, APM, and
PRINCE2 methodologies
• Extensive instructor support materials, including
an Instructor’s Manual,
PowerPoint slides, answers to chapter review
questions, problems and
cases, and a test bank of questions.
Taking a technical yet accessible approach,
Project Management for Business,
Engineering and Technology, 5th edition, is an
ideal resource and reference for
all advanced undergraduate and graduate students in
project management
courses as well as for practicing project managers
across all industry sectors.
John Nicholas, PhD, is Professor of Operations
Management at Loyola
University, Chicago, USA.
Herman Steyn, PhD, is a Professor in the
Graduate School of Technology
Management, University of Pretoria, South Africa
where he specializes in project
management.
“As a Professor who has taught Project Engineering
for the last 14 years, I have also performed

large
scale Project Engineering throughout my first career
(over 20 years) in Aerospace, Defense
and
Information Technology. When deciding on a
textbook for my graduate Project Engineering
class, I
looked long and hard. I wasn’t finding what I
was looking for and was going to writemy
own, until I
found Project Management for Engineering,
Business and Technology. This is the textbook I
would have
written. It is robust, complete and easy to follow.
The graphics, charts and figures are all very
descriptive
and real. And my students like the paperback nature of
the book. I highly recommend this
textbook for
anyone teaching Engineering, Business or Technology
Project Management/Engineering. I also
recommend it as a ‘keeper’ for students who
will be guiding projects in the future.”
Mark Calabrese, University of Central Florida,
USA
“The publication of the 5th edition of Project
Management for Engineering, Business and
Technology by
John Nicholas and Herman Steyn is an important
milestone in a continuing conversation
between the
authors and the current and future practitioners of
project management around the world. This
book has

long been a comprehensive but accessible publication
that provides valuable insights into the strategic
and day-today management of projects both large and
small. There are numerous publications in
this
field but Nicholas and Steyn have found the balance
between the needs of experienced practitioners
looking for ways to improve project outcomes, and
the needs of students who are new to the
project
management field. The concepts are clearly and
logically laid out, and the language is appropriate
for a
wide range of audiences. It continues to be a
benchmark in a crowded field of publications
offering both
practical and strategic insights into the art and craft of
project management.”
Barrie Todhunter, University of Southern
Queensland, Australia
“I have been using the earlier editions of this
book in my Project Management teaching to
working
executives of a major engineering company
employing closeto 40000 people in various
types of projects.
I have evaluated the current 5th edition of the
book from the perspective of (a) a teaching
resource (b)
study material and (c) as a resource for case
studies and references. I find that the 5th
edition has been
thoroughly revamped and incorporates several
relevant resources and is presented in a very

lucid and
structured way. I have absolutely no hesitation in
recommending this book as a standard resource
for
teaching students in a university set up and/or
for working executives in a project
environment. The
book is also a good resource as a study
material for certification courses.”
Krishna Moorthy, Ex-Dean, Larsen & Toubro
Institute of Project Management, India
“Project Management for Engineering, Business and
Technology is one of the most comprehensive
textbooks in the field. Nicholas and Steyn explain
the matter in a readable and easy-to-
understand way,
illustrated with interesting examples. The authors
combine the ‘hard matter’ of project
management with
relevant behavioural aspects. Overall, a useful
work for anyone new to the field or as
reference for the
more advanced project manager.”
Martijn Leijten, Delft University of Technology,
The Netherlands
“Project management plays a vital role in
achieving project objectives. Projects bring
change and project
management is recognised as the most effective
way to managing such change. This book encourages
readers to become interested and involved in the
change towards renewed project management

and
management of projects.”
Benita Zulch, University of the Free State,
South Africa
“A very comprehensive text. An excellent mix of
materials to enable students to learn techniques
and
engage in discussion of scenarios.”
Richard Kamm, University of Bath, UK
FIFTH EDITION
John M. Nicholas
Loyola University Chicago
Herman Steyn
University of Pretoria
Fifth edition published 2017
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon
OX14 4RN

and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis
Group, an informa business
© 2017 John Nicholas and Herman Steyn
The right of John Nicholas and Herman Steyn to be
identified as authors of this work has been
asserted by
them in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be
reprinted or reproduced or utilised in any
form or by any
electronic, mechanical, or other means, now known
or hereafter invented, including photocopying and
recording, or in any information storage or
retrieval system, without permission in writing
from the
publishers.
Trademark notice: Product or corporate names
may be trademarks or registered trademarks,
and are used
only for identification and explanation without intent
to infringe.

Fourth edition published by Routledge 2012
Third edition published by Elsevier Inc. 2008
British Library Cataloguing in Publication Data
A catalogue record for this book is available from
the British Library
Library of Congress Cataloging in Publication
Data
A catalog record for this book has been requested
ISBN: 978-1-138-93735-2 (hbk)
ISBN: 978-1-138-93734-5 (pbk)
ISBN: 978-1-315-67631-9 (ebk)
Typeset in Joanna by Servis Filmsetting Ltd,
Stockport, Cheshire
Visit the companion website:
www.routledge.com/cw/nicholas
http://www.routledge.com/cw/nicholas
To Sharry, Julia, Joshua, and Abigail
J.M.N.
To Karen and Janine
H.S.

BriefContents
Introduction
2 Systems Approach
PART III: SYSTEMS AND PROCEDURES FOR
PLANNING AND CONTROL
Implementation, and Closeout
CORPORATE CONTEXT

Management
Appendix A: RFP for Midwest Parcel Distribution
Company
Appendix B: Proposal for Logistical Online System
Project (LOGON)
Appendix C: Project Evaluation Plan for Logistical
Online System
Index
Contents
Cover
Title
Copyright
Dedication
BriefContents
Contents
Preface
Acknowledgements
About the Authors
Introduction
I.1 In the Beginning…
I.2 What Is a Project?
I.3 All Projects are Not the Same
I.4 Project Management: The Need

I.5 Project Goal: Time, Cost, and Performance
I.6 Project Management: The Person, The Team,
The
Methodology
I.7 Project Management Standards of Knowledge
and
Competencies
I.8 About This Book
I.9 Study Project
Appendix: Relation Between Professional Standards
and
Chapters of This Book
Review Questions
Case I.1 The Denver Airport
Questions About the Case
kindle:embed:0007?mime=image/jpg
Endnotes
1.1 Functions of Management
1.2 Features of Project Management
1.3 Evolution of Project Management
1.4 Where is Project Management Appropriate?
1.5 Management by Project: A Common Approach
1.6 Different Forms of Project-Related Management
1.7 Project Environments
1.8 New Product and Systems Development Projects
1.9 Construction Projects
1.10 Service-Sector Projects
1.11 Public-Sector and Governmental Projects and

Programs
1.12 Miscellaneous Projects
1.13 Summary
Review Questions
Case 1.1 Disaster Recovery at Marshall Field’s
Case 1.2 Flexible Benefits System Implementation at
Shah Alam Medical Center
Endnotes
2 Systems Approach
2.1 Systems and Systems Thinking
2.2 Systems Concepts and Principles
2.3 Systems Approach
2.4 Systems Engineering
2.5 Project Management: A Systems Approach
2.6 Summary
Review Questions
Case 2.1 Glades County Sanitary District
Case 2.2 Life and Death of an Aircraft
Development
Project
Case 2.3 Jubilee Line Extension Project
Case 2.4 Santa Clara County Traffic Operations
System
and Signal Coordination Project
Endnotes

3.1 Project Life Cycle
3.2 Systems Development Cycle
3.3 Phase A: Conception
3.4 Project Feasibility
3.5 The Project Proposal
3.6 Project Contracting
3.7 Summary
Appendix: Kinds of Contracts
Review Questions
Case 3.1 West Coast University Medical Center
Case 3.2 X-Philes Data Management Corporation: RFP
Matters
Case 3.3 Proposal Evaluation for Apollo Spacecraft
Case 3.4 Contract Mess-Up at Polanski Developers
Endnotes
4.1 Phase B: Definition
4.3 Phased (Rolling Wave) Project Planning
4.4 System Definition
4.5 Summary
Appendix A: Stages of Systems Engineering
Appendix B: Quality Function Deployment
Review Questions
Case 4.1 Star-Board Construction and Santaro
Associates: Requirements Snafu
Case 4.2 Revcon Products and Welbar, Inc.:
Client–

Contractor Communication
Case 4.3 Lavasoft.com: Interpreting Customer
Requirements
Case 4.4 Proposed Gold Mine in Canada: Phased
Project Planning
Endnotes
PART III: SYSTEMS AND PROCEDURES
FOR PLANNING AND
CONTROL
5.1 Planning Steps
5.2 The Project Execution Plan
5.3 Scope and Statement of Work
5.4 Work Definition
5.5 Project Organization and Responsibilities
5.6 Scheduling
5.7 Planning and Scheduling Charts
5.8 Line of Balance (Linear Scheduling Method)
5.9 Procurement Management
5.10 Summary
Review Questions
Case 5.1 Barrage Construction Company: Sean’s WBS
Case 5.2 Startrek Enterprises, Inc.: Deva’s Project
Plan
Case 5.3 Walter’s Project Plan
Case 5.4 Planning the Boca Implementation at
Kulczyński Products
Endnotes

6.1 Network Diagrams
6.2 The Critical Path
6.3 Converting to Gantt Calendar Schedules
6.4 Management Schedule Reserve
6.5 Alternative Relationships
6.6 Scheduling with Resource Constraints
6.7 Criticisms of Network Methods
6.8 Summary
Appendix A: AOA Diagrams
Appendix B: Alternate Scheduling Method: Project
Starts at Day 1
Case 6.1 Network Diagram for a Large
Construction
Project
Case 6.2 Melbourne Construction Company, A
Case 6.3 Melbourne Construction Company, B
Case 6.4 Melbourne Construction Company, C
Endnotes
7.1 CPM and Time-Cost Tradeoff
7.2 Variability of Activity Duration
7.3 PERT
7.4 Allocating Resources and Multiple Project
Scheduling
7.5 Theory of Constraints and Critical Chain
Method
7.6 TOC Method for Allocating Resources to

Multiple
Projects
7.7 Discussion and Summary
Summary List of Symbols
Case 7.1 Bridgecon Contractors
Case 7.2 LOGON Project
Case 7.3 Papua Petera Village Project
Endnotes
8.1 Cost Estimates
8.2 Cost Escalation
8.3 Cost Estimating and the Systems
Development
Cycle
8.4 Cost Estimating Process
8.5 Elements of Estimates and Budgets
8.6 Project Cost Accounting Systems
8.7 Budgeting Using Control (or Cost) Accounts
8.8 Cost Summaries
8.9 Cost Schedules and Forecasts
8.10 Life Cycle Costs
8.11 Summary
Case 8.1 Life Cycle Costs for Fleet of Tourist
Spaceships
Case 8.2 Estimated Costs for the Chunnel Project
Case 8.3 Fiona’s Estimate for the Gorgy Project
Case 8.4 Melbourne Construction Company, D
Endnotes

9.1 The Concept of Quality
9.2 Project Quality Management Processes
9.3 Techniques for Quality Assurance in System
Development
9.4 Techniques for Quality Control
9.5 Summary
Review Questions
Case 9.1 Ceiling Panel Collapse in the Big Dig
Project
Case 9.2 FIFA 2010 World Cup South Africa
Case 9.3 Airbag Adversity
Endnotes
10.1 Risk Concepts
10.2 Risk Identification
10.3 Risk Assessment
10.4 Risk Response Planning
10.5 Risk Monitoring and Response
10.6 Project Management Is Risk Management
10.7 Summary
Appendix: Risk Analysis Methods
Case 10.1 The Sydney Opera House
Case 10.2 Infinity & Beyond, Inc.
Case 10.3 The Nelson Mandela Bridge
Endnotes

11.1 Phase C: Execution
11.2 Detail Design Stage
11.3 Production/Build Stage
11.4 Monitoring and Control Process
11.5 Work Packages and Control Accounts
11.6 Project Monitoring and Control Emphasis
11.7 Performance Analysis and Earned Value
Management
11.8 Issue Management
11.9 Change Control
11.10 Contract Administration
11.11 Problems with Monitoring and Controlling
Projects
11.12 Summary
Summary of Variables
Case 11.1 Cybersonic Project
Case 11.2 SA Gold Mine: Earned Value After a
Scope
Change
Case 11.3 Change Control Process at Dynacom
Company
Endnotes
Implementation,
and Closeout
12.1 Project Evaluation
12.2 Project Communication Management
12.3 Project Management Information Systems
12.4 Informal Communication

12.5 Implementation Stage
12.6 Project Termination and Closeout
12.7 Project Summary Evaluation
12.8 After the Project—Phase D: Operation
12.9 Summary
Review Questions
Case 12.1 Status Report for the LOGON Project
Case 12.2 SLU Information Central Building
Case 12.3 Formal and Informal Communication
Endnotes
13.1 Traditional Project Management
13.2 Agile Project Management, APM
13.3 Scrum
13.4 APM Controversy
13.5 Lean Production and Project Management
13.6 Summary
Review Questions
Case 13.1 Grand Entry for Accent, Inc.
Case 13.2 Technology to Track Stolen Vehicles
Endnotes
14.1 Formal Organization Structure
14.2 Organizational Design by Differentiation and
Integration

14.3 Requirements of Project Organizations
14.4 Integration of Subunits in Projects
14.5 Liaison Roles, Task Forces, and Teams
14.6 Project Expeditors and Coordinators
14.7 Pure Project Organizations
14.8 Matrix Organizations
14.9 Selecting an Organization Form for Projects
14.10 Project Office and PMO
14.11 Integration in Large-Scale Projects
14.12 Integration in Systems Development
Projects
14.13 Concurrent Engineering
14.14 Summary
Review Questions
Case 14.1 Organization for the LOGON Project
Case 14.2 Pinhole Camera and Optics, Inc.: Why
Do
We Need a Project Manager?
Case 14.3 Implementing a Matrix Structure in an
R&D
Laboratory
Endnotes
15.1 The Project Manager
15.2 Project Management Authority
15.3 Project Manager Qualifications
15.4 Filling the Project Management Role
15.5 Roles in the Project Team
15.6 Roles Outside the Project Team
15.7 Project Stakeholder Engagement

15.8 Summary
Review Questions
Case 15.1 The LOGON Project
Case 15.2 Selecting a Project Manager at Nuwave
Products Company
Case 15.3 Stakeholders in Boston’s Big Dig
Endnotes
16.1 Leadership in Project Management
16.2 Participative Management
16.3 Teams in Project Management
16.4 The Team-Building Approach
16.5 Improving Ongoing Work Teams
16.6 Building New Teams
16.7 Intergroup Problem Solving
16.8 Virtual Teams
16.9 Conflict
16.10 Managing Group Conflict
16.11 Managing Emotional Stress
16.12 Summary
Review Questions
Case 16.1 Wilma Keith
Case 16.2 Mars Climate Orbiter Spacecraft
Endnotes
CORPORATE
CONTEXT

Management
17.1 Project Management Maturity and Maturity
Models
17.2 Project Management Methodology
17.3 Managing Project Knowledge
17.4 Project Management Office
17.5 Program Management
17.6 Program Phases
17.7 Program Management Themes
17.8 Program Organization
17.9 Special Considerations
17.10 Summary
Review Questions
Case 17.1 Maxim Corporation America (MCA)
Case 17.2 Motorola’s M-Gate Methodology and the
RAZR Project
Case 17.3 Tecknokrat Company
Case 17.4 Mercury Exploration Program
Endnotes
18.1 Project Portfolio Management
18.2 Framework for Project Selection and Portfolio
Management
18.3 Methods for Assessing Individual Projects
18.4 Methods for Comparing and Selecting Projects
18.5 Integrating the Gating Process and Portfolio
Management
18.6 Summary and Discussion

Question About the Study Project
Case 18.1 Consolidated Energy Company
Case 18.2 Proposed Cement Factory for PCS Company
Endnotes
19.1 International Projects
19.2 Problems Managing International Projects
19.3 Local Institutions and Culture
19.4 Local Stakeholders
19.5 Geo-National Issues
19.6 Project Manager
19.7 Local Representative
19.8 Top Management, Steering Committee, and PMO
19.9 Team and Relationship Building
19.11 Project Monitoring
19.12 Communication
19.13 Risks and Contingencies
19.14 Summary
Review Questions
Case 19.1 Mozal Project—International Investment in
an Undeveloped Country
Case 19.2 Spirit Electronics’ Puerto Rico Office
Endnotes
APPENDIX A RFP for Midwest Parcel Distribution
Company
APPENDIX B Proposal for Logistical Online System
Project (LOGON)

APPENDIX C Project Execution Plan for Logistical
Online System
Index
Preface
When people see or use something
impressive—a bridge arching high over a
canyon, a space probe touching down on a
distant planet, an animated game so
realistic you think you’re there, or a nifty
phone/camera/computer the size of
your hand—they sometimes wonder, “How did
they do that?” By they, of course,
they are referring to the creators, designers, and
builders, the people who created
—thought up and made—those things. Seldom do
they wonder about the leaders
and managers, the people who organized and led the
efforts that brought those
astounding things from concept to reality
and without whom most neat ideas
would never have been achieved. This book
is about them—the managers of
project managers, the mostly unsung heroes of
engineering, business, and
technology who stand outside the public eye
but ultimately are responsible for
practically everything that requires collective human
effort.
The project manager is but one of many people
involved in the creation of
society’s products, systems, and artifacts, yet it is he

or she who gets the others
involved and organizes and directs their efforts
so everything comes out right.
Occasionally, the manager and the creator happen to
be the same: Burt Rutan,
Woody Allen, and Gutzon Borglum are examples;
their life work—in aerospace,
motion pictures, and monumental sculptures,
respectively—represent not only
creative or technological genius, but leadership and
managerial talent as well.
In the last several decades businesses have
expanded from domestic,
nationalistic enterprises and markets into
multinational, global enterprises and
markets. As a result, from a business
perspective there is more of everything to
contend with—more ideas, competitors, resources,
constraints, and, certainly,
more people doing and wanting things. Technology
is advancing and products
and processes evolving at a more rapidpace; as a
result, the life cycles of most
things in society are getting shorter. This “more
of everything” has had a direct
impact on the conduct of projects—including
projects to develop products,
systems, or processes that compete in local,
domestic, and international markets;
projects to create and implement new ways of
meeting demand for energy,
recreation, housing, communication, transportation,

and food; and projects to
answer basic questions in science and resolve
grave problems such as disease,
pollution, global warming, and the aftermath of natural
disasters. All of this
project activity has spurred a growing interest in
improved ways to plan,
organize, and guide projects to better meet the
needs of customers, markets, and
society within the bounds of limited time and
resources.
Associated with this interest is the growing need to
educate and train project
managers. In the past—and still today—project managers
were chosen for some
demonstrated exceptional capability, although not
necessarily managerial. If you
were a good engineer, systems analyst, researcher,
architect, or accountant,
eventually you would become a project
manager. Somewhere along the way,
presumably, you would pick up the “other”
necessary skills. The flaw in this
reasoning is that project management encompasses a
broad range of skills—
managerial, leadership, interpersonal—that are much
different from and
independent of skills associated with technical
competency. And there is no
reason to presume that the project environment
alone will provide the
opportunity for someone to “pick up” these other
necessary skills.
As a text and handbook, this book is about the

“right” way to manage projects.
It is intended for advanced undergraduate and
graduate university students and
practicing managers in engineering, business, and
technology. As the title says, it
is a book about principles and practice, meaning
that the topics in it are practical
and meant to be applied. It covers the big
picture of project management—
origins, applications, and philosophy, as well as
the nitty-gritty, how-to steps. It
describes the usual project management topics of
schedules, budgets, and
controls, but also the human side of project
management, including leadership
and conflict.
Why a book on project management in
engineering and business and
technology? In our experience, technology
specialists such as engineers,
programmers, architects, chemists, and so on,
involved in
“engineering/technology projects” often have little
or no management or
leadership training. This book, which includes many
engineering and technology
examples, provides somewhat broad exposure to
business concepts and
management specifics to help these specialists
get started as managers and
leaders.

What about those people involved in product
development, marketing, process
improvement, and related projects commonly thought
of as “business projects”?
Just as technology specialists seldom receive
formal management training,
students and practitioners of business rarely get
formal exposure to practices
common in technology projects. For them, this
book describes not only how
“business” projects are conducted, but also the
necessary steps in the conception
and execution of engineering, system
development, construction, and other
“technology” projects. Of course, every technology
project is also a business
project: it is conducted in a business context
and involves business issues such as
customer satisfaction, resource utilization, deadlines,
costs, and profits.
Virtually all projects—engineering, technology, and
business—originate and are
conducted in a similar way, in this book
conceptualized using a methodology
called the Systems Development Cycle (SDC).
The SDC serves as a general
framework for discussing the principles and
practices of project management,
and illustrating commonalities and differences among
a wide variety of projects.
This book is an outgrowth of the authors’
combined several decades of
experience teaching project management at Loyola
University Chicago and

University of Pretoria to business and engineering
students, preceded by several
years’ experience in business and technology
projects, including for aircraft
design and flight test, large-scale process facility
construction, and software
applications development and process improvement.
This practical experience
gave us an appreciation not only for the business-
management side of project
management, but also for the human-interpersonal side as
well. We have seen the
benefits of good communication, trust, and
teamwork, as well as the costs of poor
leadership, emotional stress, and group
conflict. In our experience, the most
successful projects are those where leadership,
trust, communication, and
teamwork flourished, regardless of the formal
planning and control methods and
systems in place. This book largely reflects these
personal experiences. Of course,
comprehensive coverage of project management
required that we look much
beyond our own experience and draw upon the
published works of many others
and the wisdom and suggestions of colleagues
and reviewers.
In this fifth edition we have revised and added
material to incorporate new
topics of interest, current examples, and the
growing body of literature in project

management. Among significant new additions are a
chapter on agile project
management and lean production, extended coverage of
program management,
as well as 18 new end-of-chapter case studies. The
Introduction includes tables
that relate sections of the …
Table 1 Cross-sectional study: (Insert the title of the paper you
are appraising)
1.Were the criteria for inclusion in the sample clearly defined?
Yes/No/Unclear
Evidence: justification, compare and contrasting or/and
providing solution
2.Were the study subjects and the setting described in detail?
Yes/No/Unclear
providing solution
3.Was the exposure measured in a valid and reliable way?
Yes/No/Unclear
providing solution
4.Were objective, standard criteria used for measurement of the
condition?
Yes/No/Unclear

providing solution
5.Were confounding factors identified?
Yes/No/Unclear
providing solution
6.Were strategies to deal with confounding factors stated?
Yes/No/Unclear
providing solution
7.Were the outcomes measured in a valid and reliable way?
Yes/No/Unclear
providing solution
8.Was appropriate statistical analysis used?
Yes/No/Unclear
providing solution
Add additional pages if needed
Reference: (insert the reference here according to APA 6th
edition)
Table 2 Case-control study: (Insert the title of the paper you are
appraising)
1.Did the study address a clearly focused issue?
Yes/No/Unclear

providing solution
2. Did the authors use an appropriate method to answer their
question?
Yes/No/Unclear
providing solution
3. Were the cases recruited in an acceptable way?
Yes/No/Unclear
providing solution
4. Were the controls selected in an acceptable way?
Yes/No/Unclear
providing solution
5. Was the exposure accurately measured to minimise bias?
Yes/No/Unclear
providing solution

6. Aside from the experimental intervention, were the groups
treated equally?
Yes/No/Unclear
providing solution
7. Have the authors taken account of the potential confounding
factors in the design and/or in their analysis?
Yes/No/Unclear
providing solution
8. How large was the treatment effect?
Yes/No/Unclear
providing solution
9. How precise was the estimate of the treatment effect?
Yes/No/Unclear
providing solution
10. Do you believe the results?
Yes/No/Unclear
providing solution
11. Can the results be applied to the local population?
Yes/No/Unclear
providing solution

12. Do the results of this study fit with other available
evidence?
Yes/No/Unclear
providing solution
edition)
Table 3 Cohort study: (Insert the title of the paper you are
appraising)
1.Did the study address a clearly focused issue?
Yes/No/Unclear
providing solution
2.Was the cohort recruited in an acceptable way?
Yes/No/Unclear
providing solution
3.Was the exposure accurately measured to minimise bias?
Yes/No/Unclear
providing solution
4.Was the outcome accurately measured to minimise bias?
Yes/No/Unclear

providing solution
5(a)Have the authors identified all important confounding
factors?
Yes/No/Unclear
providing solution
5(b)Have they taken account of the confounding factors in the
design and/or analysis?
Yes/No/Unclear
providing solution
6(a)Was the follow up of subjects complete enough?
Yes/No/Unclear
providing solution
6(b)Was the follow up of subjects long enough?
Yes/No/Unclear
providing solution
7.What are the results of this study?
Yes/No/Unclear
providing solution

8.How precise are the results?
Yes/No/Unclear
providing solution
9.Do you believe the results?
Yes/No/Unclear
providing solution
10.Can the results be applied to the local population?
Yes/No/Unclear
providing solution
11.Do the results of this study fit with other available evidence?
Yes/No/Unclear
providing solution
12.What are the implications of this study for practice?
Yes/No/Unclear
providing solution
edition)
Table 3 Randomised controlled trial: (Insert the title of the
paper you are appraising)

1. Did the trial address a clearly focused issue?
Yes/No/Unclear
providing solution
2. Was the assignment of patients to treatments randomised?
Yes/No/Unclear
providing solution
3. Were all of the patients who entered the trial properly
accounted for at its conclusion?
Yes/No/Unclear
providing solution
4.Were patients, health workers and study personnel ‘blind’ to
treatment?
Yes/No/Unclear
providing solution
5.Were the groups similar at the start of the trial?
Yes/No/Unclear
providing solution
6.Aside from the experimental intervention, were the groups
treated equally?

Yes/No/Unclear
providing solution
7.How large was the treatment effect?
Yes/No/Unclear
providing solution
8.How precise was the estimate of the treatment effect?
Yes/No/Unclear
providing solution
9.Can the results be applied to the local population, or in your
context?
Yes/No/Unclear
providing solution
10.Were all clinically important outcomes considered?
Yes/No/Unclear
providing solution
11.Are the benefits worth the harms and costs?
Yes/No/Unclear
providing solution

PUBH6005_Assessment 3 template Page 1
PUBH6005_Assessment
3 template
Page
1
Table 1
Cross
-
sectional study
:
(Insert the title of the paper you are appraising)

1.
Were the criteria for inclusion in the
sample
clearly defined?
Yes/No/Unclear
Evidence:
justification, compare and contrasting or/and providing solution
2.
Were the study subjects and the setting
Yes/No/Unclear
Evidence:
3.
Was the exposure measured in a valid and
reliable way?
Yes/No/Unclear

Evidence:
justification, compare and contrasting or/and providing
solution
4.
Were objective, standard criteria used for
Yes/No/Unclear
Evidence:
Critical appraisal
questions
PUBH6005_Assessment 3 template Page 1
Table 1 Cross-sectional study: (Insert the title of the paper you
are appraising)
1.Were the criteria for inclusion in the
sample clearly defined?
Yes/No/Unclear

providing solution
2.Were the study subjects and the setting
Yes/No/Unclear
providing solution
3.Was the exposure measured in a valid and
reliable way?
Yes/No/Unclear
providing solution
4.Were objective, standard criteria used for
Yes/No/Unclear
providing solution

PUBH6005 Epidemiology Assignment- 3 Critical Appr

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