Escolar Documentos
Profissional Documentos
Cultura Documentos
Epidemiologic Studies
Part (I)
UNIVERSITY OF TABUK, FACULTY OF MEDICINE
COMMUNITY MEDICINE MODULE
(MED 402)
November, 2016
Learning Outcomes
2
Used to:
Target population:
The target population is the total group
of individuals from which the sample
might be drawn.
Generalizability:
Refers to the extent to which we can
apply the findings of our research to the
target population we are interested in.
Study Population & Subjects
(Definition)
6
Study population:
The group of individuals in a study.
In a clinical trial, the participants make up the study
population.
Example: all children under 2 years of age in a community.
Subjects:
It can either be a person, a place, a thing, or an idea.
A human subject is defined as a living individual about whom
an investigator conducting research obtains.
Human subject is an individual who participates in research,
either as a recipient of the test article or as a control, and is
either a healthy human or a patient.
Other Definitions
7
Census:
Sampling of the entire population.
Population sampling:
Is the process of taking a subset of subjects that is
representative of the entire population.
Sampling frame:
Is the list of people forming a population from which a sample
is taken.
Sample:
Is a set of data collected and/or selected from a statistical
population by a defined procedure.
It is a subset of population.
Epidemiological Studies
(Types)
8
Interventional studies:
They include:
Lab experiments
Animal studies
Community interventions
Epidemiological Studies
(Types)
9
Non-interventional studies:
Descriptive study
Ecologic study
Cross sectional study
Case control study
Cohort study
Epidemiological Studies
(Types)
Observational Interventional
Descriptive
Lab experiment
Ecologic
analytic
Clinical trials
analytic
Cross-sectional
Community
Case-control interventions
Cohort
Sampling
11
Why sampling:
Sampling method/technique:
Sampling method refers to the rules and procedures by which some
elements of the population are included in the sample.
Estimator:
The estimation process for calculating sample statistics is called the
estimator.
Sampling
(Definition)
13
Sampling technique:
It is the name or identification of the specific process by
which the entities of the sample have been selected.
Sampling method:
It is a procedure for selecting sample members from a
population.
Sampling
(Types)
14
o Probability samples:
Allow the sampling error to be calculated and hence
allow inferences to be made regarding the population.
Sampling error is the difference between population
parameter & sample statistics.
o Non-probability samples:
Do not permit such inferences.
Probability Sampling
(Types)
15
Introduction:
Description:
Start with a sampling frame.
Sampling frames include:
Postcode address files.
The electoral register.
GP practice list.
Etc.,
Draw a random sample from the sampling frame.
Methods:
Lottery.
Pick number from a hat.
Computer programs.
Advantages:
Purest form of probability sampling.
Allows the sampling error to be calculated.
Disadvantages:
Relatively inconvenient in practice.
Inefficient for rare outcomes.
A sample frame is not always available.
Probability Sampling
(Systematic Random Sampling)
18
Description:
Starting number & constant interval.
Sampling frame.
Calculate the sampling interval (n):
= no. of population / no. of sample
Draw every nth person from the sampling frame.
Advantages:
More convenient than simple random sampling.
Allows the sampling error to be calculated.
Disadvantages:
Potential for bias if there are underlying patterns in the sampling
frame.
Modified systematic random sampling:
Total population/Sample size = Sampling fraction = Constant
=Interval
Probability Sampling
(Stratified Random Sampling)
19
Description:
Assign members of the population into relatively homogeneous subgroups
strata before sampling:
The most common strata used in stratified random sampling are age, gender,
socioeconomic status, religion, nationality and educational attainment.
Draw a random sample of subjects from each stratum.
Types:
Proportionate stratified random sampling: same fraction ,
Disproportionate stratified random sampling: different fraction ,
Advantages:
Improves the accuracy of estimation.
Efficient.
Allows the sampling error to be calculated.
Disadvantages:
Requires accurate information about the population.
Choice of relevant stratification variables can be difficult.
Not useful if there are no homogeneous subgroups.
Probability Sampling
(Cluster Random Sampling)
20
Description:
Used when there are natural clusters in the population (e.g. GP practices
within a borough)
A random sampling technique is used to choose which clusters to include in
the study.
Single/One-stage cluster sample:
pure cluster sampling (all the elements from each of the selected clusters are used
i.e. all patients in selected practices).
Two-stage cluster sample:
simple cluster sampling (elements from each of the selected clusters are selected
at random i.e. a sample of patients from within the selected practices)
Advantages:
Convenient for fieldwork.
Cost-efficient.
Allows calculation of the sampling error.
Disadvantages:
Increased sampling error.
Probability Sampling
(Complex, Mixed, Multi-stage)
21
Description:
Introduction:
Types of tools:
Data entry:
To computer software (excel, SPSS, WORD, ETC.,)
Storing of data:
Backup, backup & backup some more and more!
Data Management
(Categorization)
26
Categorical variables:
Dichotomous
Polynomial
Ordinal
Numerical variables:
Continuous
Discrete
Data Management
(Coding & Labeling)
27
Race:
Malay =1
Chinese =2
Indian =3
Others =4
Level of education:
Primary =1
Secondary =2
Tertiary =3
Data Management
(Verification/validation & Screening)
28
Descriptive analysis:
Categorical variables:
Counts/frequency.
Percentages.
Pie chart & bar chart.
Numerical variables:
Minimum & maximum.
Mean, median & mode.
Range, standard deviation & Inter-quartile range.
Histogram, plots, line.
Data Management
(Analysis)
30
Bivariate analysis:
Multivariable analysis:
E.g.:
Smoking cigarette (as outcome) & age, gender, race,
income & level of education (as associated factors).
Data Management
(Analysis)
32
Multivariate analysis:
E.g.:
Smoking cigarette & alcohol consumption (as outcomes)
& age, gender, race, income & level of education (as
associated factors)
Data Management
(Interpretation)
33
Similar
Different why?
Data Management
(Conclusion)
35
Research presentation:
Conference
Forum
Journal clubs
Colleagues
Health authorities
Your respondents
Research publication:
Abstract
Full article
High impact journal
End
Question
37
Textbooks:
1. K. Park's (2015): Textbook of Preventive and Social Medicine. Banarsidas Bhanot-Jabalpur. 23rd edition.
2. Text Book of Public Health and Community Medicine. RajVir Bhalwar, Department of Community
Medicine, Armed Forces Medical College, Pune, in collaboration with WHO, India Office, New Delhi
(2009).
3. Lucas, A. and Gilles, H. (2003): Short Textbook of Public Health Medicine for the tropic, 4th edition, Oxford
University Press Inc., New York, USA.
4. Portney, L. G. and Watkins, M. P. (2008): Foundation of Clinical Research. Applications to Practice. 3rd
edition.
5. Kumar, R.(1996): Research methodology. A step by step guide for beginners. 3rd edition.
6. Miller, D. C. (1991): Handbook of Research Design and Social Measurement. 5th edition.
7. Altman, D. G. (1991):Practical statistics for medical research. Boca Ratn, Chapman & Hall/ CRC;
Websites:
1. World Health Organization (WHO): http://www.who.ch
2. Centers for Disease Control and Prevention (CDC), USA: http://www.cdc.gov
3. The Johns Hopkins Bloomberg School of Public Health, OPENCOURSEWARE (OCW) project:
http://ocw.jhsph.edu
4. The WWW Virtual Library (Medicine and Health): Epidemiology
(http://www.epibiostat.ucsf.edu/epidem/epidem.html).
THANK YOU
39