I'm currently running a research project attempt to identify novel risk factors for a psychiatric disease. While I understand that risk can be quantified through methods like Odds Ratio, I am wondering how they are originally identified beyond anecdotes. My current assumption is that they are identified qualitatively, perhaps? If anyone has insight that would be fantastic.
Hi Max,
I am wondering: do you have a diagnosis for the "psychiatric disease"? Statistically that would then be seen as your "outcome variable". You are then interested in the risk factors relating to that particular diagnosis.
The questions I then have are: 1) do you mean that you are interested in "exposures" of particular matters (say, smoking which is a risk factor to lung cancer)? Then, matters to consider to explore through review of literature would be e.g. how common the diagnosis is (prevalence), does it exist in ICD/DSM manuals (i.e. some international acceptance), has it changed in name and/or meaning over time? Have symptom loads contributing to the diagnosis changed over time? To then, finally, explore: what is known about risk factors to that diagnosis; have some been excluded over time (as more knowledge has evolved)? Have new risk factors been established? Are some risk factors present in some contexts but not others (incident rate variations by countries etc)?
2) Or do you mean that you really are interested in various symptom clusters that in the way they are clustered, may form risks of a illness/disease diagnosis/various diagnoses? As well as the way the symptom clusters (risks) are talked about, say in lay discourse (or non-medical settings)? If so, there are symptom questionnaires (such as quality of life, well-being) that can cover some illnesses (look at WHO for example, they might have some questionnaires that are relevant, or national statistics institutes that do regular population level surveys).
3) Finally, if the disease is not established/recognised but seems to be present in lay discourse, focus groups could be a good way to start: you could ask questions to the group about symptoms, thoughts on disease and risk factors. And then perhaps follow that up with individual semi-structured interviews where you could try out some of the symptoms that came out from the focus groups and/or that you are thinking about, in order to gather a list of symptoms that may describe what could be the disease. And then do the the same with risk factors/exposures.
WHO's description about how they created the ICD- manuals may be of help to this. The focus is on the development of diagnosis but the actual process is relevant to the identification of risk factors too (to know the risk factors to disease/illness, an awareness of some form of disease/illness must exist): "History of the development of the ICD", https://cdn.who.int/media/docs/default-source/classification/icd/historyoficd.pdf?sfvrsn=b9e617af_3. They may also have published peer-reviewed articles. The same with DSM: "DSM History", https://psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm. The CDC document: "Assessing Risk Factors for Severe COVID-19 Illness", https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/assessing-risk-factors.html, could also be helpful (one heading is for example: "How We Learn about Risk Factors for Severe Disease").
Note: all of the above are suggestions, and may or may not be appropriate to your study.
All the best,
Karin
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