What exactly is the hypothesis (or hypotheses) being tested in this study?

INSTRUCTIONS TO CANDIDATES

ANSWER ALL QUESTIONS

 1. What exactly is the hypothesis (or hypotheses) being tested in this study?

2. What are the arguments for and against the biological plausibility of an association between thimerosal and autism?

3. What would be the design of a randomized clinical trial to test the hypothesis and do you believe it can it be carried out? Why or why not?

4. What are the advantages of constructing a cohort by record linkage?

5. Could this study be done in the US?

6. From the table, which numbers tell you that there is no association between thimerosal and autism?

7. From the table, explain in a sentence what this means: “Trend (increase in RR per 25 μg eHg) 0.98 (0.90-1.06)”

8. From the table, calculate the incidence rate of autism for children who received thimerosal and for children who did not. What is the unadjusted relative risk of autism for children who received thimerosal? Write a sentence describing what that RR means. Compare that to the relative risk in the table: Is there evidence of confounding by age and calendar period?

9. What confounders do they include and why do they include them?

10. What are the most important limitations of this study?

11. Why do the authors use such cautious language in their final conclusions, rather than just saying autism is not caused by thimerosal? “In conclusion, our results are not compatible with the hypothesis of a causal association between thimerosal and autism-spectrum disorders.”

12. Is this a good cohort study? Do you believe the findings? need two page paper

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