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Deborah Cragun, PhD, MS, CGC

How coincidence analysis leads to a desired health outcome

Researchers use a variety of techniques to find the best solution in health care, including something known as coincidence analysis, the study of how a combination of different factors leads to a desired outcome.

It’s like having a hundred pieces of a puzzle that fit together to form a picture, and knows a lot about the puzzles of health care. An associate professor in the and program director of at ľ¹ÏÊÓÆµâ€™s(COPH), Cragun recently shared her ideas at the International Conference for Coincidence Analysis (CNA) in Denmark.

“The goals are to bring people who developed and continue to improve upon this research method together with people who use the method to study and solve real world concerns,’’ she said of the annual conference, which provides a platform for exchange between CNA methodologists and applied researchers. “When we come together, we show what we’ve done, what we’re working on, and any challenges or new ways we’ve applied CNA.’’

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Researchers and educators from around the world met to share ideas on coincidence analysis at a recent conference in Copenhagen. In attendance was ľ¹ÏÊÓÆµ's Dr. Deborah Cragun, far left (wearing sunglasses).

Cragun focuses on the impact of CNA in health care. A cross-case mathematical tool, it helps researchers understand how different conditions, when combined, lead to specific results and can reveal multiple pathways to the same outcome.

For example, individuals who come to genetic counseling with a high level of knowledge may benefit from different care than that needed to achieve the same benefits for those who come with less pre-existing knowledge. In essence, CNA shows how outcomes are often the result of complex interactions between various factors, rather than a single, isolated cause. This approach allows for more nuanced and effective interventions and strategies. 

Specific to her research at ľ¹ÏÊÓÆµ, Cragun applied CNA to figure out why some women have unnecessary surgery while others don't.

"Success sometimes takes multiple factors coming together, and CNA helps uncover complex combinations of factors that make a difference for the outcome," she said.

“Many of these women were fearful of getting cancer (or getting cancer again),’’ she said. “But the difference was that those who were fearful and who did not trust their health care provider and the cancer screening were the ones who got the unnecessary surgery to remove their ovaries or breasts. So, it was the combination of factors together that were important.’’

CNA can be applied as a stand-alone method or with other approaches such as implementation science. Together, they can reveal new empirical findings that might otherwise have gone undetected. (See related ľ¹ÏÊÓÆµ stories and this additional related story)

These innovative methods can help medical experts better hone the tools and techniques in hospitals and clinics, and enhance patient health.

“We need to understand the complex issues in making health programs work better,’’ Cragun said. “Usually there are many contributing factors that impact how well something works in health care. For some people, they may benefit most from one type of service, but others may benefit from doing something different. CNA allows us to find multiple paths to achieving better outcomes.’’

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