I appreciate the work you did in updating the case-patient reports and your recommendations about moving the investigation forward. At this point we need to design a case-control study to test the relevant exposure variables that are still under consideration in order to determine which of them is the real source of the outbreak. Your study design should include the following components, with a justification for each:

• Hypothesis (or hypotheses) you want to test
  
• Characteristics of your controls
  
• Size of your study

If we study the wrong variables, the wrong people, or don’t study enough people, then we’ll waste time and may have to repeat the study to get the right data. Use the information you’ve compiled in your previous reports and what you know about study design so we get it right the first time and are able to detect any differences that exist. I have attached a template to help guide you through this task.

I also need to you update the questionnaire so the wording is appropriate for controls instead of case-patients.

We’re getting close to finding the source and being able to contain the outbreak. I will look for your case-control study design ASAP so we can move our investigation forward.

Thanks,

Sam Lyons, MD

Thank you for all your work on the statistics team. Our regular team members are finished with their other projects and will have time to take care of any requests for assistance that come in. Hopefully you found the work you did for the NDCC Statistics Team interesting. Dr. Lyons tells me you're getting further into the cocci investigation; perhaps you'll be able to use the work you did with us on tasks you encounter there.

Best wishes in all your work,

Cecilia Young