Caverly, T.J., Fagerlin, A, & Wiener, R.S. (2018, January 22). Comparison of observed harms and expected...

Caverly, T.J., Fagerlin, A, & Wiener, R.S. (2018, January 22). Comparison of observed harms and expected mortality benefit for persons in the Veterans Health Affairs Lung Cancer Screening Demonstration Project. JAMA Internal Medicine.

1. What research questions are addressed in this study and what is their purpose? 2. What type of research design was used (experimental, quasi-experimental, correlational) in this study and what led you to your decision? 3. Are the instruments in this study valid and reliable, why or why not? 4. Discuss the specific results of each of the ANCOVAs (analysis of covariance) done in this study. What was the purpose of"each" of the ANCOVAs? What was the covariate in each and why did they do an ANCOVA in each case (5 points)? 5. In the Tables, results are presented, Please explain the tables and summarize the results. 6. Explain, in simple language, any significant results of this study? 7. Identify and discuss any threats to internal and/or external validity in this study. 8. If you could redesign this study correcting anything you have found wrong with the research, what would you correct and how would you do it?

Expert Solution

1, The veterans Health Affairs(VHA) lung cancer screening(LCS) comparison of observed harms and expected mortality for persons with lung cancer..Lung cancer screening demonstration project findout much higher false-positive rate with initial low-dose computed tomographic screening..Real-world findings from a veterans reinforce the need for personalized decision-making validated risk-stratification models in lung cancer screening..purpose of this study to prevent lung cancer death..
2, Bach risk tool was used..Two large randomize trials..published decision analyses and the SEER(surveilance,Epidemiology and End Results)cancer registry..Design state-transition microstimulation model..
3, Instruments in this study model valid (LDCT)low-dose computed tomography screening influenced with eligible persons with annual lung cancer risk..LDCT screening over came even highly negative views about screening and its downsides..people in low-risk groups need to know the risk for harm and a low chance for benefits..
5,patient's in higher quintiles of lung cancer risk had significantly more lung cancer diagnosed(4.8lung cancer per 1,000 in quintile 1 versus 29.7 per 1000 in quintile 5)..The rates of false-positive results and downstream evaluations did not differ significantly across risk quintiles..over all 56.2% rate false-positive results 2.0% rate false-positive results need downstream diagnostic evaluations..totally there is high false-postive rates so patients at high lung cancer risk still surpasses those of most established cancer screening programs..

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