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Epidemiology

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SaloniParekh12

This document provides an overview of epidemiological methods and study designs. It defines descriptive epidemiology as describing diseases in terms of time, place and person. Analytical epidemiology includes case-control and cohort studies. Case-control studies involve selecting cases and controls and measuring exposure using interviews, questionnaires or records. Cohort studies select study subjects, obtain exposure data, follow subjects over time, and compare incidence rates. Experimental epidemiology uses randomized controlled trials (RCTs) to randomly assign subjects to intervention or control groups and assess outcomes.

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EPIDEMIOLOGY By SALONI PAREKH
Epidemiology Classify epidemiological methods . Crude death rate Analytical write in detail about case control studies Cohort study Odd ratio Experimental RCT Descriptive epidemiology
Descriptive epidemiology 1. Defining the population to be studied 2. Defining disease under study 3. Describing diseases in terms of time, place and person 4. Measurement of disease 5. Comparing with known indices 6. Formulating an etiological hypothesis
Describing diseases in terms of time Short term-epidemics Common source epidemiology A. Point source/ single exposure B. Continuous / multiple exposure Propagated epidemiology A. Person person B. Arthropod vector C. Animal reservoir Slow/modern epidemiology Periodic A. Seasonal variations/ trends B. cyclic Long term/secular trends
Describing diseases in terms of place National International Rural- urban variations Local distribution migrant studies
Describing diseases in terms of person 1. Age 2. Gender 3. Ethnic grip/ ethnicity 4. Occupation 5. Socioeconomic status 6. Marital status 7. Behavior 8. bimodality
Measurement of disease Cross- sectional longitudinal
Case- control studies 1. Selection of cases and control 2. Matching 3. Measurement of exposure 4. Analysis and interpretation
Selection of cases and control-selection of cases Definition of case- 1. Diagnostic criteria 2. Eligibility criteria Source of case 1. Hospitals 2. General population
Selection of cases and control-selection of control Source of control 1. General population 2. Hospital controls 3. Relatives 4. neighborhood Number of control/ control groups
Matching Group matching Pair matching Unmatched
Measurement of exposure Interviews Questionnaires Clinical/ lab examination Obtaining past records of cases such as hospitals, employment records
Analysis and interpretation Exposure rates Estimation of risks- odds ratio
Bias in case control studies 1. Selection bias 2. Confounding bias 3. Information bias
Cohort study Selection of study subjects Obtaining data on exposure Selection of comparison groups Follow- up analysis
Selection of study subjects General population Special groups Select group Exposure group
Obtaining data on exposure Cohort members Review of records Medical examination/ special tests Environmental surveys
Selection of comparison groups 1. Internal 2. External 3. With general pop rates
Follow- up Periodic medical examination Reviewing physician and hospital records Routine surveillance of death records Mailed quaternaries, telephone calls, periodic home visits- preferable all 3 on annual basis
analysis Incidence rates of outcome among exposed and non-exp Estimation of risk 1. Relative risk/ risk ratio 2. Attributable risk/ risk difference 3. Population attributable risk
Bias in cohort studies 1. Selection bias 2. Confounding bias 3. Information bias 4. Post hoc bias
Experimental epidemiology Randomized control trials Non-randomized/ non-experimental trials
Randomized control trials(RCT) 1. Drawing up a protocol 2. Selecting reference and experimental pop 3. Randomization 4. Manipulation 5. Follow up 6. assessment
Bias in RCT 1. Observer bias 2. Bias in evaluation 3. Participant bias
Blinding Single Double triple
Types of RCT 1. Clinical trials 2. Preventive trials 3. Risk factor trials 4. Cessation experiments 5. Trial of etiological agents 6. Evaluation of health services 7. Community intervention trials (CITs)
Non randomized trials/ Quasi- experiments 1. Uncontrolled trials 2. Natural trials 3. Before and after comparison studies
Uses of epidemiology To study rise and fall of population in study Community diagnosis Planning and evaluation Evaluation of individuals risk and chances Syndrome identification Completing the natural history of disease Searching for cause/ risk factors

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Epidemiology

  • 2. Epidemiology Classify epidemiological methods . Crude death rate Analytical write in detail about case control studies Cohort study Odd ratio Experimental RCT Descriptive epidemiology
  • 3. Descriptive epidemiology 1. Defining the population to be studied 2. Defining disease under study 3. Describing diseases in terms of time, place and person 4. Measurement of disease 5. Comparing with known indices 6. Formulating an etiological hypothesis
  • 4. Describing diseases in terms of time Short term-epidemics Common source epidemiology A. Point source/ single exposure B. Continuous / multiple exposure Propagated epidemiology A. Person person B. Arthropod vector C. Animal reservoir Slow/modern epidemiology Periodic A. Seasonal variations/ trends B. cyclic Long term/secular trends
  • 5. Describing diseases in terms of place National International Rural- urban variations Local distribution migrant studies
  • 6. Describing diseases in terms of person 1. Age 2. Gender 3. Ethnic grip/ ethnicity 4. Occupation 5. Socioeconomic status 6. Marital status 7. Behavior 8. bimodality
  • 7. Measurement of disease Cross- sectional longitudinal
  • 8. Case- control studies 1. Selection of cases and control 2. Matching 3. Measurement of exposure 4. Analysis and interpretation
  • 9. Selection of cases and control-selection of cases Definition of case- 1. Diagnostic criteria 2. Eligibility criteria Source of case 1. Hospitals 2. General population
  • 10. Selection of cases and control-selection of control Source of control 1. General population 2. Hospital controls 3. Relatives 4. neighborhood Number of control/ control groups
  • 11. Matching Group matching Pair matching Unmatched
  • 12. Measurement of exposure Interviews Questionnaires Clinical/ lab examination Obtaining past records of cases such as hospitals, employment records
  • 13. Analysis and interpretation Exposure rates Estimation of risks- odds ratio
  • 14. Bias in case control studies 1. Selection bias 2. Confounding bias 3. Information bias
  • 15. Cohort study Selection of study subjects Obtaining data on exposure Selection of comparison groups Follow- up analysis
  • 16. Selection of study subjects General population Special groups Select group Exposure group
  • 17. Obtaining data on exposure Cohort members Review of records Medical examination/ special tests Environmental surveys
  • 18. Selection of comparison groups 1. Internal 2. External 3. With general pop rates
  • 19. Follow- up Periodic medical examination Reviewing physician and hospital records Routine surveillance of death records Mailed quaternaries, telephone calls, periodic home visits- preferable all 3 on annual basis
  • 20. analysis Incidence rates of outcome among exposed and non-exp Estimation of risk 1. Relative risk/ risk ratio 2. Attributable risk/ risk difference 3. Population attributable risk
  • 21. Bias in cohort studies 1. Selection bias 2. Confounding bias 3. Information bias 4. Post hoc bias
  • 22. Experimental epidemiology Randomized control trials Non-randomized/ non-experimental trials
  • 23. Randomized control trials(RCT) 1. Drawing up a protocol 2. Selecting reference and experimental pop 3. Randomization 4. Manipulation 5. Follow up 6. assessment
  • 24. Bias in RCT 1. Observer bias 2. Bias in evaluation 3. Participant bias
  • 26. Types of RCT 1. Clinical trials 2. Preventive trials 3. Risk factor trials 4. Cessation experiments 5. Trial of etiological agents 6. Evaluation of health services 7. Community intervention trials (CITs)
  • 27. Non randomized trials/ Quasi- experiments 1. Uncontrolled trials 2. Natural trials 3. Before and after comparison studies
  • 28. Uses of epidemiology To study rise and fall of population in study Community diagnosis Planning and evaluation Evaluation of individuals risk and chances Syndrome identification Completing the natural history of disease Searching for cause/ risk factors