College aantekeningen
All lectures, elaborated, Nutrition in Health and Disease (AM_470841)
All lectures (elaborated) of the course Nutrition in Health and Disease, with notes and examples.
[Meer zien]Voorbeeld 4 van de 91 pagina's
Voorbeeld 4 van de 91 pagina's
In winkelwagengesponsord bericht van onze partner
Voorbeeld van de inhoud
1Nutrition in Health & Disease
HC1: Introduction
Clinical Nutrition: nutritional care for individual patients or patient groups.
Changes in nutritional requirements due to illness, treatment, malnutrition.
● Physiology, metabolism.
● Body composition.
● What is the most optimal nutrition for this patient?
Exam: open ended questions
HC2: Rules and Regulations in (Clinical nutrition) research
Writing a research proposal:
Background: broad context:
Start with writing broad, working to specific.
Background: Clinical relevance:
Consequences of muscle wasting: (observational studies)
↑ More severe toxicity of treatment.
↓ Reduced functional status.
↓ Reduces quality of life (QoL).
↓ Reduced survival.
, 2
● Clinical outcomes may be improved by interventions aiming at preserving muscle
mass.
● For inducing muscle protein anabolism, a sufficient protein intake, next to an
adequate physical activity, is of critical importance.
Background: Known/unknown:
● Dietary advice has a beneficial effect on body weight after one year.
● Gastrointestinal tract, non-small cell lung cancers or mesothelioma.
● Beneficial effect of PN on BMI, BCM, QoL, chemotherapy toxicity, survival.
○ No control group.
No clear guidelines for nutritional support.
Background: Scientific relevance
Research question/ aim:
Use PICO.
What's next, when you have a research question? Start with searching for a budget to move
on with your research proposal and fund your study.
Budget:
● ! Salary (researcher, research assistant, dietitian, date manager, statistician).
● Equipment (depending on measurements).
● Laboratory costs.
● Education (courses, conferences etc.).
● Office equipment (computer, paper, pencils etc.).
● Travel costs of participants.
To do before you can start:
1. Write protocol.
2. Present protocol to department(s) involved.
3. Prepare protocol and other files for Scientific Research Committee.
4. Prepare protocol and other files for the Medical Research Ethical Committee (MREC/
Dutch: METC).
5. Prepare logistics.
Useful website: ccmo: https://english.ccmo.nl/investigators/standard-research-file
Study population:
Inclusion criteria & exclusion criteria.
, 3
Study design:
- Randomized controlled trial?
- Blinding; single blind? double blind?
- Cohort study?
Make a Study Flowchart.
Intervention:
When RCT:
1. Arm A (intervention)
2. Arm B (control)
Study endpoints:
What is your primary outcome?
Sample size:
Why calculation?
n = too small → false negative conclusion.
n = too large → intervention effective: too many subjects have missed out on this
intervention.
→ intervention ineffective: too many have been exposed to this
ineffective intervention.
- Population too small?
- Budget.
- Sample represents the population you want to study.
What information do you need?
Desired power of the study (1 - ß)
How certain do you want to be of preventing a type II error?
80% - accepting a chance of 20% of failing to detect an effect that is indeed present in the
population (false negative).
Desired significance level (α)
How certain do you want to be of preventing a type I error?
, 4
5% accepting a chance of 0.05 to detect an effect in your study that is not present in the
whole population (false positive).
Desired test direction
One or two sided?
2-sided: treatment A better than treatment B // treatment B better than treatment A.
Type I error (α) - the probability of falsely rejecting H0.
Type II error (ß) - the probability of falsely accepting H0.
Clinically relevant (or expected) difference (v)
Which difference or which effect are you trying to find?
From literature.
Expected variance/ standard deviation (σ)
How much variation is expected in subjects belonging to the same study group?
From pilot data or literature.
Attrition rate
Anticipate on the number of included subjects who will not be available for the study
analysis.
Expected drop-out/ withdrawal from previous studies.
E.g. if 10% drop-out is expected: divided number needed by 0.9.
Differences in means
● Differences in body weight change between groups.
● Difference in survival time between groups.
Differences in proportions
● Difference in proportions (%) 1 year survival between groups.
● Difference in proportions (%) with a certain weight loss between groups.
Primary endpoint
What is your primary outcome measurement, and how many patients do you need?
- How
- When
- Who
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper janinevdhoorn. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €8,59. Je zit daarna nergens aan vast.
Is Stuvia te vertrouwen?
4,6 sterren op Google & Trustpilot (+1000 reviews)
Afgelopen 30 dagen zijn er 73918 samenvattingen verkocht
Opgericht in 2010, al 14 jaar dé plek om samenvattingen te kopen