EPIDEMIOLOGY & RESEARCH METHODS I

2.02c EXERCISE 6: CROSS-SECTIONAL LE 2

STUDY
Dr. Remigio Butacan | February 15, 2017

I.
OUTLINE

Overview of Cross-sectional Study

B.

Classification
#
Analytical test hypothesis based on the coexistence of
both factor and outcome
a. Definition Observational meaning there is no manipulation of
b. Advantages and Disadvantages exposure
II. Case Objective
a. Background of the Case o To show that the proportion of those
b. Guide Questions individual with disease (prevalence) is
greater in exposed than the unexposed
OBJECTIVES:
At the end of the exercise, the student should be able to:
1. Describe the framework of a cross-sectional study
2. Analyze and interpret the results of cross-sectional study
3. Explain the advantages and disadvantages of cross-
sectional study design

Legend:
Remember Previous
Lecturer Book Trans Com
(Exams) Trans

Overview: Figure 1. Comparison between Cross-sectional, case-control and

cohort studies. Take note that in cross sectional, disease and exposure
Descriptive Analytic co-exist.
(hypothesis) (test hypothesis) C. Advantages
Short term, less time to conduct, cheap and easy to perform
Observational Provides information on disease rate and characteristics of
Case Report/ the population
Case Series Cross sectional
Cohort Useful for hypothesis generation
Case Control Fairly quick and easy to perform
Many outcomes and risk factors can be assessed
Prevalence
Study
Experimental C. Disadvantages
Community Trial Difficulty to separate cause and effect
Randomized Clinical Present exposure status may not be the relevant exposure
Trial
Ecologic Study Series of prevalent cases will have a higher proportion of
cases with long duration than as series of incident cases
Observer bias
CASE REP
Response bias
I. OVERVIEW OF CROSS-SECTIONAL STUDY No direct estimate of risk
Can be subject to late-look bias (only those with slowly
A. Cross-Sectional Study developing diseases can be detected as they are the only
1. Descriptive Cross-Sectional ones left alive).
- can help characterize the amount and distribution
of the health and disease II. CASE
- ends with computing the over-all prevalence and Comparing the Prevalence of Depression among Elderly
subgroup prevalence Individuals in a Nursing Home and the Community: A
2. Analytical Cross-Sectional Cross-Sectional Study
- can be used to test the hypothesis
- looks at not just the subgroup prevalence but A. Background of the Case
relating it to the frequency of exposure of Late life depression is the most common psychiatric
individuals disorder that does not show signs and symptoms of
It is a study that examines the occurrence of a disease in a depression
defined population at a particular (single) point in time This due to the masking of physical manifestations of co-
o Disease and exposure coexist morbid conditions
It is used to determine frequency and magnitude of the It is usually not physiologic and can be reversible with
disease or other health related characteristics prompt and appropriate treatment
Can only provide information about prevalence (not In the Philippines, screening for geriatric depression living
incidence) in the communities or in the nursing home are relatively few

TRANSCRIBERS Longanilla, Lorenzo, Lumabas, Luy, EDITOR Bautista, S. 09272529739 1of2

Macaraig, Malipol
 2.02c EXERCISE 6:
CROSS-SECTIONAL STUDY
B. Objectives
To determine the prevalence of depression among elderly
individuals residing in a nursing home and community and
compare the prevalence rates between these two settings,
using the Geriatric Depression Scale-Short Form
To determine whether residential status is a potential risk
factor for the development of geriatric depression in these
settings
C. Guide Questions
1. Describe the characteristics of the study subjects.
The subjects in the study are comprised mostly of
women. Majority of those in the nursing home are aged
70-79 years old while those in the community are aged
60-69 years old.
Table 1 is usually used for demographic profile of
subjects. When asked to describe the characteristics,
give a summary of the social demographic profile of the
study subjects.
2. Explain the technique used in the selection of the study
population, including its strengths and weaknesses. Is
the technique appropriate for the study?
Subjects in the nursing home and in the community
were selected using Simple Random Sampling
Main characteristic of simple random sampling is that
every element in the population has an equal chance
of being included in the sample
Six steps to create a simple random sample:
1. Define the population
2. Choose your sample size
3. List the population
4. Assign numbers to the units
5. Find random numbers
6. Select your sample
Strengths Weaknesses
Less human bias Carriers larger error from sample size
than found in stratified sampling
Simple to use sample becomes impossible if the
units/items are widely dispersed
Easy to asses lacks use of available knowledge
sampling error concerning the population
Free from errors
in classification
ADVANTAGES:
The aim of the simple random sample is to reduce the
potential for human bias in the selection of cases to be
included in the sample. As a result, simple random sample
provides us with a sample that is highly representative of
the population being studied, assuming that there is limited
missing data.
Since the units selected for the inclusion in the sample are
chosen using probabilistic methods, simple random
sampling allows us to make generalizations (i.e. statistical
interferences) from the sample population. This is a major
advantage because such generalizations are more likely to
be considered to have external validity.
LE2 TRANSCRIBERS Longanilla, Lorenzo, Lumabas, Luy,
Macaraig, Malipol
EPIDEMIOLOGY AND RESEARCH METHODS I 2020C
DISADVANTAGES:
A simple random sample can only be carried out if the list
of the population is available and complete. Attaining a
complete list of the population can be difficult for a number
of reasons. Even if a list is readily available, it may be
challenging to gain access to that list. The list may be
protected by privacy policies or require a lengthy process
to attain permission. There may be no single list detailing
the population you are interested in. As a result, it may be
difficult and time consuming to bring together numerous
sub-lists to create a final list from which you want to select
your sample.
3. Describe the methods used in the collection of data
relevant to the independent (i.e., community vs.
nursing home) and the dependent variables (i.e.,
depression) under study.
Mini Mental Status Exam (MMSE) - assess
participants mental capacity; those who scored less
than 15 were considered cognitively impaired and were
excluded from the study
Geriatric Depression Scale Short Form - subjects
answer yes or no items; a score of less than or equal
to 6 indicates depression
4. How should he results of the cross-sectional study be
analyzed? Show calculations of prevalence of odds
ratio (POR) of depression, using data presented in the
above tables.
The results of a cross-sectional study should be
analyzed using prevalence odd ratio (POR) since
hypothesis of the relationship between risk factor and
disease outcome may be generated.
Let nursing home be the exposure and depression
be the outcome/ disease
POR = AD/BC
= (15x100)/(20x39)
= 1.92 or 2
5. What are the conclusions of this study?
Elderly individuals who stay in a nursing home are 2
times more likely to be depressed compared to those
living in the community.
We dont say more likely to DEVELOP depression
because what we computed is PREVALENCE odd ratio
(POR) and we cant deduce the development of disease
based from prevalence
Remember:
POR = 1; NO ASSOCIATION
POR > 1; RISK FACTOR (those with factor/exposure are
MORE likely to have the disease
POR < 1; PROTECTIVE FACTOR (those with
factor/exposure are LESS likely to have the disease)
REFERENCES:
1.Dr. Butacans lecture and powerpoint
2. Tolabing, M.C. (2015). Cross-sectional Lecture. UPM-CPH
EDITOR Bautista, S. 09272529739 2of2