Methods for Identification and Evaluation, Coursework Example

Introduction

This paper addresses the subject matter of sickle cell disease related to the African American ethic group. The analysis builds upon the mortality in sickle cell disease, together with the life expectancy and risk factors for early death. In particular the research findings of Orah. S. Platt et al, as published in the New England Medical Journal. (Platt, 1994).

Background

It was Sir John Dacie that first described Sickle Cell disease as one occurring in childhood. He described the disease as having a high rate of mortality and very few patients reached adult life. Life in the USA, particularly among the African/American community illustrated that those with Sickle Cell anaemia had a reduced adult life. The averages in Males being 42 and Females 48. Further this is often complicated as the disease can lead to other illnesses like Cancer thereby questioning the precise cause of death. (Platt, 1994).

Summary of case study and conclusions

The study revealed a number of important findings. Amongst these they discovered that the cause of mortality was mainly discovered at the time of autopsy. Findings stated that acute chest syndrome resulted in the main cause of death for those older than 10 years of age. This often resulted in heart failure, chronic renal disease or organ damage. The findings also produced evidence of the clinical conditions resulting in morbidity. The importance of these findings is considered to be of paramount importance in advising and counselling patients. The findings illustrated a median survival rate of 14.3 years with 20% of deaths occurring in the first 2 years of diagnosis. (Mayo Clinic, 2013)

Methods Used

The methods used in this research covered an examination of approximately 3,764 patients covering 23 clinical centres. The statistical techniques covered the use of proportional-hazards regression, use of the 2L program of BMDP and the Caan and Ryan approach for the analysis of data and studies. The use of qualitative research methods was used in the use of interviews, observations and investigation of specific data sets.  (Harper, 2004). Multiple regression analysis was used to determine redundancy in results and variations in the risk factors of death.

Discussion

The African/American population in the USA seem particularly vulnerable to this disease. This leads towards research in genetic markers, although this seems somewhat complex and there is not a lot of evidence that points towards conclusive evidence in this area. (Braun, 2013). The key towards a more prolonged life hinges on early detection and treatment before excessive cardiovascular disease gets a hold of the patient.

Risk Factors involved

Evidence indicated that male patients were at far higher risk for early death than that of female patients.  Early detection was key in prescribing treatment for reducing early morbidity. Early death was strongly linked to that of renal insufficiency, acute chest syndrome, acute anemic episodes and low levels of fetal hemoglobin. The study produced a number of comparative tables from the different distribution of clinics where the data was analysed in greater depth. (Darleen R. Powars, et al., 1994).

Conclusions

This was a large study over a wide geographical distribution and the research worked together in order to harvest all of the required data and results. This was published in a highly regarded reputable Medical Journal. The findings made a significant contribution to knowledge in this area. Useful databases for more information on this subject matter can be located at The Centers for Disease Control and Prevention (CDC). They offer a wide degree of information on the subject matter including links to other useful sites.  (Centre for disease control and prevention, 2013).

The complications that can occur from Sickle Cell disease (SCD) are huge. The collection of sickle cells in the bloodstream can manifest themselves in a wide range of other serious health problems. This can include swelling of the hands and feet, acute levels of pain and blocking blood flow that can result in strokes or heart attacks. This is particularly worse for those diagnosed at a very young age. There are treatments available via various drug administrations but equally these can produce serious side effects owing to absorbing high levels of toxicity. The concept of Anemia is one of the most difficult areas to deal with in SCD. This often results in the need for blood transfusions.

Another key factor is the risk of infection, this particularly prevalent amongst the infants and children. Pneumonia being one of the leading causes of death in this area. The use of vaccines and anti-biotics can help in the protection against harmful infections. Fevers are the early indication of a potential infection. The use of Penicillin is often used to treat infants between 2-5 years of age.  (Centre for disease control and prevention, 2013).

References

Braun, L. (2013). Race, Ethnicity, and Health: Can Genetics Explain Disparities? Perspectives in Biology and Medicine Vol 56(10, 159-174.

Centre for disease control and prevention. (2013, 7 21). Sickle Cell disease. Retrieved from Centre for disease control and prevention: http://www.cdc.gov/ncbddd/sicklecell/about.html

Darleen R. Powars, M., Donna D. Elliott-Mills, M., Linda Chan, P., Joyce Niland, P., Alan L. Hiti, M. P., Lawrence M. Opas, M., & and Cage Johnson, M. (1994). Chronic Renal Failure in Sickle Cell Disease: Risk Factors, Clinical Course, and Mortality . Anals of Internal Medicine Vol 15(8), 614-620.

Harper, P. S. (2004). Landmarks in Medical Genetics: Classic Papers with Commentaries. Oxford, UK: Oxford University Press.

Mayo Clinic. (2013, 7 21). Sickle cell anemia. Retrieved from Msyo Clinic: http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324

Platt, O. B. (1994). Mortality in Sickle Cell disease- Life expectancy and risk factors for early death. New England Medical Journal Vol 330, 1639-1644.