Critical Appraisal Of A Journal Article: Determinants Of Bre

Critical Appraisal of a Journal Article: Determinants of breast cancer in Saudi women from Makkah region

Critically appraise the journal article titled “Determinants of breast cancer in Saudi women from Makkah region: a case-control study” using the provided checklist. Write a comprehensive review of approximately two pages that evaluates the study's methodology, findings, and relevance, filling out the checklist accordingly.

Paper For Above instruction

Breast cancer remains a leading cause of morbidity and mortality among women worldwide, and understanding its risk factors is vital for developing targeted preventive strategies. The study titled “Determinants of breast cancer in Saudi women from Makkah region: a case-control study” aims to identify potential risk factors specific to Saudi women in Makkah. This critical appraisal evaluates the study’s methodological rigor and reliability, using a structured checklist to assess key aspects like participant selection, exposure measurement, confounding factors, and statistical analysis.

Firstly, the comparability of case and control groups is fundamental to reducing bias. The article reports that cases and controls were recruited from the same hospitals in the Makkah region, which helps ensure their source population was similar. However, the study does not explicitly state whether the control group was representative of the same population that produced the cases outside the hospital setting. Additionally, it remains unclear whether the groups were comparable in all respects aside from their disease status, which affects the internal validity.

Regarding matching, the study employed frequency matching based on age groups, which is appropriate to control confounding by age—a significant risk factor in breast cancer. Yet, other potential confounders like socioeconomic status or reproductive history were not explicitly matched, raising questions about residual confounding. The criteria used for the identification of cases (histologically confirmed breast cancer diagnosis) were appropriate and standardized. Controls were also selected based on absence of cancer diagnosis, fulfilling the eligibility requirements. These measures support the validity of case and control identification.

Exposure measurement is critical in case-control studies, and the authors collected data via structured interviews and validated questionnaires. The measurement of risk factors such as family history, reproductive history, and lifestyle habits was conducted using standard tools, ensuring validity. Furthermore, the study employed the same data collection procedures for both cases and controls, which minimizes information bias. Nonetheless, the retrospective nature of data collection means recall bias remains a concern, potentially affecting the accuracy of exposure assessments.

Confounding factors are a prominent concern in epidemiological research. The authors recognized several confounders, including age, reproductive factors, and immunohistological subtypes. They used multivariate logistic regression analyses to account for these potential confounders, providing adjusted odds ratios. However, it is uncertain whether all relevant confounders, such as dietary factors and environmental exposures, were adequately measured or included in the analysis, which could impact the overall interpretation of risk estimates.

Outcome assessment in this study was based on histopathologically confirmed breast cancer diagnoses, ensuring a high standard of validity and reliability. For controls, the absence of cancer was confirmed through medical records, further supporting consistent assessment criteria. The exposure period considered was appropriate, focusing on risk factors in the five years prior to diagnosis, which is relevant for identifying etiological factors.

Lastly, the statistical analysis was comprehensive, utilizing logistic regression models that adjusted for confounders. This approach is suitable for case-control studies and allows for estimation of the strength of associations. The authors provided detailed descriptions of their analytical methods, justified their choices, and checked model assumptions, endorsing the robustness of their findings.

In conclusion, the study demonstrates several strengths, including standardized diagnosis criteria, appropriate matching, and rigorous statistical analysis. Nonetheless, limitations such as potential recall bias, incomplete adjustment for confounders, and uncertain representativeness of controls highlight areas for cautious interpretation. Overall, this article offers valuable Insights into breast cancer determinants among Saudi women in Makkah and underscores the importance of tailored public health approaches in this population.

References

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• Karim, R., & et al. (2014). Risk factors for breast cancer in women in Saudi Arabia: a case-control study. Journal of Obstetrics and Gynaecology, 34(1), 69–75.
• World Health Organization. (2020). Breast cancer. WHO Reports. https://www.who.int/cancer/prevention/diagnosis-staging/breast-cancer/en/
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