Epidemiological Methods: Prabha Krishnan, Year MSC Nursing, CNC, KKD

EPIDEMIOLOGICAL
METHODS
PRABHA KRISHNAN,
1ST YEAR MSc NURSING,
CNC, KKD
Epidemiologic methods
Epidemiologic methods are used for;
the identification of risk factors for disease
and determination of optimal treatment
approaches used in clinical practice.
Observational studies
Researcher observes association between exposure
and disease, estimates and tests it
DESCRIPTIVE STUDIES
 Descriptive studies are usually the first phase of an
epidemiological investigation
 Observing the distribution of disease or health related
characteristics in human population
 In Descriptive studies questions should be asked such
as;
o When is the disease occurring----time distribution
o Where it is occurring------place distribution
o Who is getting the disease----persons distribution
Procedures in Descriptive studies
1. Define the population to be studied
2. Defines the disease
3. Describe the disease by: Time, place and person
4. Measurement of disease
5. Comparing with known indices
6. Formulation of hypothesis
Defining the population to be studied
Descriptive study are investigation of population not
individual; include total number
o Sex
o Age
o Occupation
o cultural
Defining disease under study
Specified the disease to be investigated
The main objective to obtain accurate estimate of
disease in a population
Describing the disease by
The main primary objective of descriptive
epidemiology is to describe the occurrence and
distribution of disease by
Time
Place
person
Measurement of disease
The information should be available in terms of
Mortality
Morbidity (incidence and prevalence)
distribution
Comparing with known indices
Making comparisons between different population,
this is to ; identify groups who are at risk for certain
diseases
Formulation of an aetiological hypothesis
Hypothesis should formulated in a manner that it can
be tested.
Hypothesis should specify the following
• -the population- the characteristics of the persons to
whom the hypothesis to be applied
• -the specific cause being considered
• -the expected outcome
• -the dose-response relationship
• -the time-response relationship (time between
exposure to the cause observed)
Analytical studies
Analytical studies are the second major type of
epidemiological studies
In contrast to descriptive studies which look for the
whole population the analytical studies look for
individual within the population
Main types of observational studies are;
Case control study
Cohort study
Case – control study
I. A group of ‘cases’ of a disease is assembled.
II. Another group of matched ‘controls’ (free from
disease) is assembled.
III. The history of exposure to the suspected risk factor
is ascertained in all the members of both the groups
IV. The prevalence of the exposure among the cases is
compared with that in the controls.
Case – control study…cont..
V. Factors which are significantly more in the cases
group as compared to the control are reaffirmed as the
risk factors
-By same argument, factors which are significantly
higher in the controls are noted as the possible
protective factors.
VI. Odd’s ratio (OR) is calculated in case – control
studies to estimate the risk associated with each risk
factor
Cohort study
I. One group of people exposed to the suspected RF is
identified.This is the ‘Exposure cohort’
II. Another group of people similar to the exposure cohort,
but DEFINITELY NOT EXPOSED are identified.
– This is the ‘Control or Non-exposed cohort’.
III. The groups are similar except for the ‘exposure’ to the
risk factor.
• It is made sure that none of the members in both the
groups have the disease under investigation
Cohort … cont….
IV. Both the cohorts are regularly followed up for a
definite period and examined for development of
the disease at regular intervals
V. If the incidence of the disease is significantly higher in
the exposed cohort, the association is confirmed
VI. Relative Risk (RR) is calculated in cohort studies to
estimate the risk associated with each risk factor
RCT
Cases of the disease are identified.
If eligible, are included in the study after informed
consent
 Randomized to allot each case to either the ‘study’
group or the ‘control’ group
The ‘Control’ group is deliberately exposed to the
therapy, vaccine or the suspected RF (study group)
while the other is not (control group).
Both the groups are followed up for under identical
circumstances
RCT ..CONT..
The cure rate or the incidence (for therapy or
vaccine/RF respectively) in the study group is
compared with that in the control group which did not
receive the intervention.
If the difference is significant, the therapy is better or
an association is confirmed.
If not, the drug is considered ineffective
'Blinding' is an instrument to minimize bias in
experimental studies
Field Study
 Mainly for vaccines or preventive agents
 Hence units of study are HEALTHY individuals or
those without disease
The incidence among vaccinated is compared with the
incidence among non vaccinated
The two groups i.e. vaccinated and non vaccinated can
not usually be decided by randomization
Hence they may not be exactly comparable
Community Trial
Some communities e.g. districts may have the public
health intervention like a new method of water
purification
Other districts continue with the older methods
The incidence of water-borne disease can be
compared among these districts

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EPIDEMIOLOGICAL

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