Dr. Omalu's Research of the Recurring CTE in NFL

Introduction:

The purpose of this paper is to identify and describe all applicable research designs applied in the CTE (Chronic Traumatic Encephalopathy) in a National Football League player. Identifying the research designs by analyzing the movie “Concussion”. Concussion released back in December 2015; the movie based on a true story that took place in Pittsburgh, Pennsylvania - September 2002. Dr. Omalu, a pathologist who is the first to discover the CTE in a National Football League player. Dr. Omalu involved in a battle with the NFL (National Football League) after his research findings, which concluded that a football profession might cause permanent brain damage. The movie takes you through the discovery of CTE and its research development.

It was an ordinary day Dr. Omalu got his task to carry out an autopsy on Mike Webster’s body; the legendary and well-known professional football player. Mike died at 50, his life after football retirement had been mysterious and heartbreaking. Mike was homeless, living in a truck, lost all his money, and even forgot how to feed himself; all of these triggered Dr. Omalu to have a special case study to further investigate Mike’s illness.

Case Study Design

Definition and Purpose:

“A case study is an in-depth study of a particular research problem rather than a sweeping statistical survey. It is often used to narrow down a very broad field of research into one or a few easily researchable examples. The case study research design is also useful for testing whether a specific theory and model applies to phenomena in the real world. It is a useful design when not much is known about a phenomenon.” We clearly see that how Dr. Omalu used a case study design to further narrow down his research problem with the fact that there is not much to know about the problem (How did Mike end up so crazy ?). Relevant movie scene (Dr. Omalu visually examined Mike’s brain. It appeared extremely normal. No signs of shrinkage like it would appear in Alzheimer’s disease. He reviewed the CT and MRI scans of Mike’s; which were taken years ago. He already had a cause of death. However, he would not let it go. He wanted to investigate in depth. There must be an answer. “People don’t go crazy for no reason”. He requested from his boss to run special tests on Mike’s brain. Where he might discover something hidden.

Cohort Design

Definition and Purpose

“Often used in the medical sciences, but also found in the applied social sciences, a cohort study generally refers to a study conducted over a period of time involving members of a population which the subject or representative member comes from, and who are united by some commonality or similarity. Using a quantitative framework, a cohort study makes note of statistical occurrence within a specialized subgroup, united by same or similar characteristics that are relevant to the research problem being investigated, rather than studying statistical occurrence within the general population. Using a qualitative framework, cohort studies generally gather data using methods of observation. Cohorts can be either 'open' or 'closed.'

• Open Cohort Studies [dynamic populations, such as the population of Los Angeles] involve a population that is defined just by the state of being a part of the study in question (and being monitored for the outcome). Date of entry and exit from the study is individually defined, therefore, the size of the study population is not constant. In open cohort studies, researchers can only calculate rate based data, such as, incidence rates and variants thereof.
• Closed Cohort Studies [static populations, such as patients entered into a clinical trial] involve participants who enter into the study at one defining point in time and where it is presumed that no new participants can enter the cohort. Given this, the number of study participants remains constant (or can only decrease).”

Dr. Omalu use a cohort design in his CTE research development; we clearly see that relevant scene where he was only focusing on the retired NFL football players, which they represent the cohort he is examining. “Cohort studies measure potential causes before the outcome has occurred, they can demonstrate that these “causes” preceded the outcome, thereby avoiding the debate as to which is the cause and which is the effect.”

Exploratory Design

Definition and Purpose

“An exploratory design is conducted about a research problem when there are few or no earlier studies to refer to. The focus is on gaining insights and familiarity for later investigation or undertaken when problems are in a preliminary stage of investigation.” According to the movie scene “Dr. Omalu watched Mike’s brain and kept thinking, How did this athletic man end up so crazy? He was thinking about the relationship between football and brain trauma. He thought about, Dementia pugilistica? 'Punch- drunk syndrome,' where its called in boxers. Symptoms are somewhat are identical: severe dementia—delusion, explosive behavior, fear, loss of memory all triggered by constant blows to the head. Dr. Omalu thought if chronic attacking of the head could destroy a boxer’s brain; it might also destroy a football player’s brain? May possibly; that what made Mike crazy?

Definition and Purpose

“This type of research design draws a conclusion by comparing subjects against a control group, in cases where the researcher has no control over the experiment. There are two general types of observational designs. In direct observations, people know that you are watching them. Unobtrusive measures involve any method for studying behavior where individuals do not know they are being observed. An observational study allows a useful insight into a phenomenon and avoids the ethical and practical difficulties of setting up a large and cumbersome research project.” According to the CTE research development and movie scene: Dr. Omalu drove up to a football field and watched a game where players do not know he is observing them. He collected a depth information pertaining particular behavior and actions were taken by players throughout the game.

Conclusion

This case highlights potential long-term neurodegenerative outcomes in retired professional National Football League players subjected to repeated mild traumatic brain injury. The prevalence and pathoetiological mechanisms of these possible adverse long-term outcomes and their relation to duration of years of playing football have not been sufficiently studied. We recommend comprehensive clinical and forensic approaches to understand and further elucidate this emergent professional sport hazard.