Question 1
Inadequacy of vitamin B-12, iron, and folate intake is common among this population. This is likely linked to reduced appetite, poor dentition, decreased tolerance of milk products, and even loss of intrinsic factor. Do you think the researchers should have included questions about appetite (e.g. any recent changes) oral health (dentures, partials, etc.), tolerance of milk products? If so why or why not? Do you think the Schilling test should have been performed to determine if the participants' anemia was related to lack of intrinsic factor? Why or why not?
posted by MelanieP @ 10:37 AM
29 comments
29 Comments:
I don’t believe it was necessary for this study to include questions about appetite, oral health, tolerance of milk products, or even perform the Schilling test. I think this study was a good baseline for researching nutrient intake and anemia risk in postmenopausal women and possibly future studies could focus on the other variables mentioned with a smaller sample size.
I do think that those would be some good questions to ask to help find some answers as to why this populations has inadequate nutrient intake of B12, iron and folate and to possibly help increase those nutrients. With that said, it would be a lot to include in this study and does not really fit into the objective of this study. You could expand the objective and include some of those questions but I think it would almost be better to stand alone in another study.
Considering this was one of the first longitudinal studies of its size to examine this association; it does not seem necessary to include questions regarding appetite, oral health, etc. However, now that they have achieved baseline data, further examining with these factors would be valuable for prevention and treatment information. The Schilling test would be a great measure for those who showed persistent anemia. It would not be efficient to perform the Schilling test for all participants prior to no knowledge of present anemias.
Liz, I definitely agree. Studies with smaller sample sizes may find it easier to focus on these additional variables.
I think that because this study’s purpose is more to simply observe if there was a relationship between the nutrient intakes and the prevalence of anemia, that more detailed questions about appetite would be best left to a whole different study. I also think that adding those extra factors would be making the study too complicated with too many variables. I also believe the same goes for the Schilling test, that it would be better to test the relationship in a different, more specific study.
I think those questions would be important to examine in any follow-up studies. For this study, I think the questions were appropriate and do not think a Schilling Test was needed. The sample size limits the data collection methods. Will a smaller, more specific sample population, these questions and additional testing may be warranted.
This is an interesting point that is certainly valid with this population group. However, the addition of several more questions and variables may result in exponentially increased work for researchers. Because these variables likely impact this group, testing and exploring these variables would be reasonable in a much smaller stratified random sample of the study population.
I think that all of these points would be great questions for follow-up studies to this one but I think the researchers asked the right questions to get the answers they were looking for. The purpose of the study was to look at the relationship between anemia among different ethnicities, etc and compare that to what this population is eating. If you were to add more variables then this study would have been too complex and difficult to do. However, I think this study definitely paved the way for future studies and that appetite, oral health, intrinsic factor are all variables that should be looked at through qualitative studies such as focus groups, etc.
No I do not belive that these questions should have been asked in this study. Since this study was one of the first longitudinal study to look at postmenopausal, aging, multi ethnic women and anemia, I think it was important to keep the amount of variables low and concentrate on the basics. These more specific questions would be great follow up research studies as people continue to research the same topic.
Everyone seems to be in agreement so far on the board about this answer, Sarah brings up a good point that additional variables would have given the reaserchers a lot more work and I wonder if taking on so many variables could actually harm a study because with a specific time line and time crunch, researchers may have to rush and data could be less accurately collected.
Considering the impressive population sample size, I'd say additional questions would have been unnecessary for this type of initial study. Instead, the results offer an overall view of risk factors for anemia instead of focusing on risk factors for causes of anemia. Additional research may investigate this area further.
Sarah, Bethany, and Michela, I agree that additional variables could potentially complicate the results and add unnecessary work for the researchers considering this is an initial study. If I have learned one thing from writing a thesis, it's to not add in too many details and to remember to look at the big picture if you are among the first to attempt to answer a question through research.
I would be interested in seeing the results from studies that examined these additional factors but I don't think they were needed for this study. Like others have said, the aim of this study was to produce baseline data. Future studies can build off of this by examining the specific causes of anemia. Also, I'd expect there to be problems with conducting the Schilling test on this large of a sample... expensive maybe?
Not every study can cover every base. For the study to be of any use it must have limitation to someday be published. Both of the questions are good one and avenues that researchers should look into in the future.
Kathy I agree. Even though I am sure the budget for a research study like this one must have been impressive, the population of this size would have been too time consuming and costly
I agree with the consensus on the use of this research on a follow-up study. A great proportion of the elderly suffer from atrophic gastritis which decreases their production of gastric acid and IF. For cost-efficiency, the sample size may need to be greatly reduced; if I am correct, isn't a B12 blood test more expensive? Since this was the first study of its kind, there are many opportunities to expand on these findings and narrow down future research objectives.
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I do not think asking the questions about appetite, dentition, and lactose intolerance were appropriate for this study. They were able to collect the data the set out to collect and I think further (smaller) studies should be done to address other points. As for the Schilling test, I do think that should have been done on each participant. It would make the study more accurate and valid to know if the participant faced anemia due to a dietary cause or lack of intrinsic factor.
Kathy you do make a good point about a schillings test being expensive but I do think in a future study that is a little smaller it would be beneficial to the study to do it for every participant.
For this study, I don't think it was necessary to include these variables. It would be interesting to see a future study include these variables among the populations that were at greater risk for anemia and compare the populations.
I agree with Sarah that adding these variables may increase time commitment of researchers and may result in less quality of data analysis if the researchers were working on a deadline.
I agree with everyone, this study was utilized to produce a baseline for future research. Additional studies that are more focused may include specific questions such as those. I do not think these questions would have been appropriate for this study considering the large sample size.
Great point Amanda in regards to the costs associated with getting certain tests results. Any lab tests done looking at levels of vitamins/minerals in the body are going to be more expensive and with this size of a population the researchers would need some serious funding to be able to pay for all of it. Which goes back to the point that many other people made about doing different studies looking at these specific variables in a much more condensed sample size.
Questions on appetite would have been beneficial to the study and understanding the state of the patient. I do not think the schilling test would be necessary, however it also would not be of any detriment since vitamin B12 is often lacking in these individuals.
I do not think it was necessary for this study to go that in depth. This study provided a base line for research and has now opened many new avenues for other studies. Those would be interesting questions for future studies. I would be very interested in reading the results of a study that measured the relationship between these findings and dairy consumption.
I agree with stephanie that those are interesting question but is it really feasible to include this data as well with such as large sample size? I think these questions would make a better follow up study.
I don't think the researchers should have necessarily included questions such as those. That would have taken away from the simplicity of a FFQ. I also think administering the Schilling test would have complicated the study for the researchers and participants. I think that if another longitudinal study is conducted, one of those factors could be measured, or even if a smaller sample-size was to be studied in-depth.
Yes, I do think they should have asked questions about appetite, oral health, and tolerance of milk products. I think it is important to see what the possible causes of anemia are in these women. They could then see if certain demographic characteristics were linked to the various causes of anemia. I also believe they should have used the Schilling test on these women, however, that would be a greater expense. But for the sake of the research and to better treat these individuals, it is important to see what the primary cause of their anemia is.
I think that Liz and Amy have made an important point, that now a baseline has been established further research can ask these various questions and delve into more detail. It is true that there was such a large sample size, which would have made it more complicated to ask these additional things and in particular, do the Schilling test.
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