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Noel R.

Juban, MD, MSc


Department of Clinical Epidemiology
College of Medicine
University of the Philippines - Manila
5/28/14

Case Reports
Most common type of study published
Unusual medical occurrences
First clues in a new disease or adverse

effects of exposure

Case Series
Collection of individual case reports
Used as an early means to identify the

beginning or presence of an epidemic


relatively easy and economical to conduct

Look at new and old cases at the same

time
Can get prevalence of a disease or

condition
Another name is _________ study

Cross sectional Study


With Disease
With Exposure
Without Disease

With Disease

Without Exposure
Without Disease

Cross-Sectional Studies
Measurement of exposure and effect are

made at the same time


Well defined-population
Snapshot of the health experience of the
population at a particular time
relatively easy and economical to
conduct

Case-Control Study
Used to investigate potential causes or etiologic

exposures of diseases

1st step is identifying cases


next is the selection of controls
ex. Thalidomide in FRG

*Odds Ratio (OR)

ratio of the odds of exposure among cases to the


odds in favor of exposure among controls

Case-Control Study
With Exposure
With Disease
Time

Without Exposure

With Exposure

Time

Without Disease
Without Exposure

Case-control studies
Useful especially with
Rare cases
Diseases with long latency period

Cancers

Cohort Study
Best information regarding causation
Most direct measurement of risk of

developing disease

In some cases, may require long follow-ups

*historical cohort study

*nested case-control design

Cohort Study
With Disease
Time
With Exposure
Without Disease

Time

With Disease

Without Exposure
Without Disease

Cohort Study
New cases can be monitored over time
Can measure incidence rates
Also known as ___________ study

Randomized Controlled Trials


Epidemiologic experiment
Study of new intervention or new

therapeutic regimen
Subjects are randomized

to ensure comparability of groups at the

start

Random allocation of treatment


Relative Risk (RR)

Randomized Controlled Trial


Time

With Disease

With Exposure
Without Disease
Sample
popn

Randomization

Time

With Disease

Without Exposure
Without Disease

Field Trials
Subjects are disease-free but at risk
Data collection done in the field
Involves major logistics and financial

considerations

purpose is to prevent occurrence of

disease

Ex. Salk vaccine for Polio (>1 Million)

Community Trials
Treatment groups are communities
Individual/group behavior
Appropriate for disease that have social

condition in their origins and


interventions directed at group behavior

Ecological Studies
Unit of analysis: populations
Easy to conduct but difficult to

interpret
Rely on data collected for another

purpose

Ecological Study
individual link between exposure and
effect cannot be made
Ecological Fallacy
association at group level # association
at individual level

Summary:

Types of Epidemiological Study

Observational
Experimental

Types of Epidemiological Study


Types of Study

Alternative Name
Study

Unit of

Observational Studies
Descriptive Studies
Case reports

Individuals

Case series

Individuals

Analytical Studies
Ecological

Correlational

Populations

Cross-sectional

Prevalence

Individuals

Case-control

Case-reference

Individuals

Cohort

Follow-up/Incidence

Individuals

Types of Epidemiological Study


Types of Study

Alternative Name

Unit of Study

Experimental Studies
Randomized
Controlled Trials

Clinical Trials

Field Trials
Community Trials

Patients

Healthy
people
Community
Intervention
Studies

Communities

Types of Epidemiological Study


Observational
Descriptive Studies
Case reports, Case series
Analytical Studies
Ecological Study
Cross-sectional Study
Case-control Study
Cohort Study

Types of Epidemiological Study


Experimental
Randomized Control Trials
Field Trials
Community Trials

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