EPIDEMIOLOGI

EPIDEMIOLOGI
Cabang ilmu ked. yang mempelajari
penyakit dan faktor-faktor yang
menentukan terjadinya penyakit
pada sekelompok (pop./komunitas)
manusia

OBSERVASIONAL
DESKRIPTIF ANALITIK
EKSPERIMENTAL
 PENELITIAN EPIDEMIOLOGIS
DESKRIPTIF
(Mengkaji penyebaran/distribusi penyakit menurut:
- orang (who?) tempat (where?)
- waktu (when?)
ANALITIK
(Mencari/merumuskan jawaban mengapa terjadi
pada epidemiologi deskriptif)
- OBSERVASIONAL : Ada hub. penyakit
faktor risiko? Ada Susun hipotesis)
- EKSPERIMENTAL : Pengujian hipotesis
(Manipulasi/intervensi faktor risiko/determinan
terhadap timbulnya penyakit)
 EPIDEMIOLOGI
FREKUENSI
(Menemukan masalah
Mengukur besar masalah) DESKRIPTIF
DISTRIBUSI
(Karakteristik/ciri-ciri: manusia (who?), tempat
(where?), waktu (when?)
FAKTOR-FAKTOR BERPENGARUH ANALITIK
Langkah-langkah pokok: Merumuskan HPT
Menguji HPT Kesimpulan (sebab-akibat)
 PENELITIAN EPIDEMIOLOGIS
Who/Where/When
1. STUDI DESKRIPTIF
2. PENYUSUNAN
4. ANALISIS HPT/MODEL
HASIL PENEL.
3. STUDI ANALITIK
 PENELITIAN EPIDEMIOLOGIS
(lanj.)
PENEL. EPIDEMIOL.

DESKRIPTIF ANALITIK
OBSERV. EKSP./INTERV.

MURNI KUASI
Identifikasi (HPT
agen-agen etiologi)
penyebab
Membedakan
penyebab dari
faktor2 lain

P P ? P
P PENYEBAB

(P: PENYAKIT)
 PENELITIAN EPID. (lanj.)
PEMBAGIAN LAIN
TIPE SUBTIPE
LABORATORIS
1. EKSPERMENTAL CLINICAL TRIAL
(Manipulasi artifisial COMMUNITY INTERVENSION
Randomisasi +)
CLINICAL
2. KUASI EKSP. LABORATORY
(Manipulasi artifisial PROGRAM
Randomisasi +) POLICY
DESKRIPTIF
3. OBSERVASIONAL CROSS-SECTIONAL
ANALITIK CASE-CONTROL
COHORT PROSPEKTIF
RETROSPEKTIF
 RANCANGAN PENEL.
CROSS-SECTIONAL DESIGN (What is happening?)
BEGIN MULTICARROT DIET
GOOD VISION
PATIENTS OLIGOCARROT DIET
INPATIENTS
PRACTICE MULTICARROT DIET
IN PRACTICE POOR VISION
OLIGOCARROT DIET
CASE-CONTROL DESIGN (What was happened?)
BEGIN
EAT MANY CARROTS CASES
EAT FEW CARROTS
PATIENTS WITH POOR VISION

EAT MANY CARROTS CONTROL

EAT FEW CARROTS
PATIENTS WITH GOOD VISION
 RANC.PENEL. (lanj.)
* FOLLOW-UP/COHORT DESIGN
(What will happen?) GOOD VISION
BEGIN EAT 4-6 CARROTS DAILY
FREE OF DISEASE POOR VISION
PATIENTS IN GOOD VISION
PRACTICE EAT < 1 CARROT DAILY
HAVE POOR VISION POOR VISION
ALREADY (excluded)
EXPERIMENTAL (CONTROLLED TRIAL) DESIGN
BEGIN ALLOCATE GOOD VISION
PAT. IN HIGH CARROT DIET POOR VISION
PRACTICE GOOD VISION
LOW CARROT DIET POOR VISION
 Research designs
BEGIN MEASURE/CLASSIFY
& COMPARE
RF (+)
FREQ. OF DISEASE/
OUTCOME RF (-)
STUDY POP.
HAVE NO DISEASE/ RF (+)
OUTCOME
RF (-)
(PRESENT)

RF: risk factor

1. CROSS-SECTIONAL DESIGN
Research design (cont.)
BEGIN

RF (+) CASES
(People with disease/
RF (-) outcome)
RF (+) CONTROL
(People withou disease/
RF (-) outcome)

PAST PRESENT

2. CASE-CONTROL DESIGN
 Research design (cont.)
BEGIN MEASURE/ CLASSIFY MEASURE OUTCOME/
COMPARE
D/O (+)
RF (+)
FREE OF DISEASE D/O (-)
STUDY RF (-) D/O (+)
POP. D/O (-)
HAVE OUTCOME
D: disease; O: outcome
ALREADY (excluded)

PRESENT FUTURE

3. FOLLOW-UP (COHORT) DESIGN

 Research design (cont.)
BEGIN ALLOCATE MEASURE OUTCOME/COMPARE

D/O (+)
EXPERIMENT/
INTERVENSION D/O (-)
STUDY
POP. D/O (+)
CONTROL
D/O (-)

PRESENT FUTURE

4. EXPERIMENTAL (CONTROLLED TRIAL) DESIGN

 COHORT - TROHOC
FEINSTEIN

SEBAB/AKIBAT PROSES KOLEKSI DATA

1. CAUSE-EFFECT: COHORT
2. EFFECT-CAUSE: TROHOC
COHORT
Menggambarkan: - Sistem cause effect
- Proses/jalannya: forward study
- Proses koleksi data:
prolektif/retrolektif
- Observasional (mis. survei)/
Eksperimental (mis. trial)
 Cohort (cont.)
Contoh
TROMBOEMBOLI ? PIL KONTRASEPSI
(TE) (PKS)
Jika titik tolak (PKS) Diamati TE
(wanita pemakai PKS
dibandingkan TE
wanita tidak memakai PKS)
CAUSE EFEECT

(COHORT)
 Trohoc
Jika titik tolak TE diamati PKS
(Wanita dengan TE
dibandingkan dengan PKS
wanita tanpa TE)
EFFECT CAUSE
COHORT TROHOC
TROMBOEMBOLI PEMAKAIAN PKS
PKS (+) PKS (-) TE (+) TE (-)
------- ------ ------ ------