Question: A research team is conducting a study to investigate whether consumption of fish can prevent heart disease. The team random digit dials approximately 12,000 adults asking how often they consume fish and whether they have ever been diagnosed with heart disease. The team finds that among 990 high fish consumers, 94 have heart disease, among 4120 medium fish consumers, 389 have heart disease, and among 6890 respondents with low or no fish consumption 703 have heart disease.

1. What type of study design is this?
2. What is the best measure to calculate for to evaluate the association between fish and heart disease given the type of study design?
3. Calculate the measure of association comparing high fish consumers and to low or no consumers and interpret.
4. What is at least 1 primary limitation of this study? (Hint: think about Hill considerations).

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