STUDY DESIGNS-for PPT Use Only

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Study designs of epidemiological studies

Main Types of Epidemiological Studies Essentials


1. Experimental
2. Observational
3. Cohort
4. Case–control
5. Cross-sectional
6. Ecological

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Epidemiologic Descriptive Study Designs Merill


 Ecological
 Case study
 Cross-sectional

Observational Analytic Study Designs


 Case-control
 Case-crossover
 Nested case-control
 Cohort

Experimental Study Designs

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Study Design Merill


-Guides the researchers in studies and systemic collection, analyzation, interpretation of data
- formal approach of scientific investigation
- manage and analyze epidemiologic data, interpret study results, and apply the results in preventing
and controlling disease and health-related events.

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Descriptive Study Designs in Epidemiology Merill


- Descriptive studies examine patterns of disease occurrence, with a focus on person, place, and time.
- provide a means for obtaining descriptive statistics
- include case reports and case series, cross-sectional surveys, and exploratory ecologic designs

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Ecological Study
- Examines the relationship between exposure and disease with population-level rather than individual-
level data Essentials
- involves making comparisons between variables where the unit of analysis is aggregated data on the
population level rather than on the individual level. Merill
- A limitation of ecologic data, however, is that they are often unable to control for potential
confounding factors that may explain some or all of the association. Merill
- ecologic fallacy Merill
- Ecologic studies are often appropriate in environmental settings. Merill

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Case Study
- profile of a single individual; it includes qualitative descriptive research of the facts in chronological
order. Merill
- case series involves a small group of patients with a similar diagnosis. Merill

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Cross-sectional
- Typically examines the relationship between exposure and disease prevalence in a defined population
at a single point in time Essentials
- Cross-sectional studies are carried out for public health planning and etiologic research.
- Cross-sectional studies are fairly common in occupational settings using data from preemployment
physical examinations and company health insurance plans.
- Cross-sectional studies are also used to establish the prevalence of knowledge and attitudes about
diseases and health-related states or events.

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Observational Analytic Studies


- These studies can be exploratory or analytic.
- study a variety of associations are examined.
- evaluation of associations between exposure and outcome variables

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Case-control GORDIS REFERENCE


- Comparison is an essential component of epidemiologic investigation and is well exemplified by the
case-control study design. Gordis
- Typically examines multiple exposures in relation to a disease; subjects are defined as cases and
controls, and exposure histories are compared. Essentials
- Selection of Cases Gordis and Merill
- Selection of Controls: criteria
- involves grouping people as cases (persons experiencing a health-related state or event) and controls
and investigating whether the cases are more or less likely than the controls Merill
- Methods for Sampling Controls
- are commonly used in epidemiologic research

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Case-crossover
- In a case-crossover study, each case serves as his or her own control, and the value of a time
dependent exposure in the period just before the outcome occurred is compared with its value at one or
more previous control periods of time.
- a variant of the case–control study that was developed for settings in which the risk of the outcome is
increased for only a brief time following the exposure.
-HAZARD PERIOD Essentials of EPI

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Nested case-control
-case-control study “nested” within a cohort study. Essentials of EPI
- cases and controls are drawn from the population in a fully enumerated cohort. Usually, the
exposure of interest is only measured among the cases and the selected controls. net
- Usually, the exposure of interest is only measured among the cases and the selected controls.
net

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Cohort Study
- Cohort as a general term means a group or body of people Merill
- Typically examines multiple health effects of an exposure; subjects are defined according to their
exposure levels and followed for disease occurrence. Essentials of EPI
- investigator selects a group of exposed individuals and a group of unexposed individuals and follows
both groups over time to compare the incidence of disease in the two groups Gordis
- Bias in Cohort Studies
- Study Design: Prospective cohort, Retrospective cohort, Double cohort Merill

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Experimental Study Designs Essentials


- Studies preventions and treatments for diseases; investigator actively manipulates which groups
receive the agent under study.
- Investigators conduct an experimental study when they wish to learn about a prevention or treatment
for a disease.
- The high degree of validity in an experimental study stems mainly from investigators’ ability to
randomize subjects to: treatment group or the comparison group
- makes use of a comparison group, which allows for testing of specific research hypotheses. Merill

CONCLUSIONS—refer to merril

1. RBCs suspended in saline can react ineffectively- can have a poorly or weak reaction.
2. There may be fewer RBCs to tested in patients that are anemic.
3. In the case of weak RBCs, reading the result in less than 2 minutes can give a false result
4. Improper reagent: – Expired reagent? – Storage temperature out of range? – Contaminated
reagent?

1. In the case of drying of the slide, it may mimic agglutination.


2. Inadequate amount of the anticoagulant
3. Rule out the presence of microclots, and these may mimic agglutination.

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