Campaigns to lower smoking rates and advances in medical and surgical therapies have both helped bring about large declines in mortality from coronary heart disease
(CHD) in Canadian men.Which of the following study designs and epidemiological
Measures could contribute to assessing their relative contributions?

Question

Quizplus · Accepted Answer

None of these options can answer the question on its own but most central
are (A) because if treatments have improved (e.g.surgical stenting) then people should
now be less likely to die from their CHD (i.e.the case‐fatality ratio should be lower) and
(B) because if smoking cessation campaigns have had an effect there should be a
measurable decline in CHD incidence as a result (and this would be apparent much
more quickly than for lung cancer).Although, at a practical level, we must remember
that comparisons across different cohorts of patients challenge the assumptions we are
necessarily making about exchangeability, and CHD incidence data are mostly not
available.The other measures will confirm the extent to which smoking rates have
fallen (C) and/or that GPs are now identifying and treating more people with high blood
pressure (D) which, when combined with information about changing incidence rates,
can help demonstrate that the changes have occurred in parallel.

Campaigns to Lower Smoking Rates and Advances in Medical and Surgical