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Sequence of human studies |
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Clinical observations Available data: Cross Sectional Study Case-Control studies Cohort Studies Randomized Clinical Trial |
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snap shot in time of population |
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doll&hill on smoking and lung cancer |
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follows a cohort over time; Framingham |
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Randomized Clinical Trial |
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ratio of the measure of the disease frequency in the exposed and unexposed populations |
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Estimates the magnitude and direction of an association between exposure and a disease |
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Main Features of a Cohort |
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Comparing outcomes of exposed to unexposed groups TIME |
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Good for studies of rare exposures |
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Can yield information on multiple exposures |
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Clear temporal relationship between exposure and disease |
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Time consuming and expensive, especially if prospective |
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Observational study in which two existing groups with different outcomes are compared based on hypothesized causal attribute |
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Used to identify factors that may contribute to the disease but comparing cases with controls |
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Main Features of a Case Control Study |
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Identify a group of people with disease Compare to a group without disease Determine who were exposed to risk factors out of case Determine who were exposed to risk factors out of controls |
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estimate of the relative risk obtained by calculating the ratio of the odds of exposure among cases compared to controls |
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the ratio of the adds of exposure are identical in the case and control groups (no association) |
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an increased odds of exposure among cases as compared to controls (harmful exposure effect) |
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a decreased odds of exposure among cases as compared to controls (protective exposure effect) |
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Particularly well-suited to the evaluation of diseases with long latent periods |
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A confounding variable is |
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an extraneous variable in a statistical model that correlates (positively or negatively) with both the dependent variable and the independent variable. |
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the ability to predict who has the disease and who does not. |
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the ability of a screen/test to correctly identify those who have the disease. |
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the ability of a screen/test to correctly identify those who do not have the disease. |
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100% sensitive and 100% specific |
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A test with HIGH specificity will have FEW ______ |
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A test with HIGH sensitivity will have FEW ________ |
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Interaction, aka effect modification |
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When the incidence rate of a disease is different in the presence of two or more risk factors |
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