Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Research Studies
Abdel-Hamid Serwah, MD
Professor of Internal Medicine
astroenterolo!y
"linical #pidemiolo!y $nit, %&M, S"$, #!ypt
'()* - )+*+
Objectives of the talk
'ase report
'ase series
Survey
Observational
Analytic
Observational
'orrelational
'ross sectional
'ase+control
'ohort studies
,-perimental
Randomi.ed
controlled trials
Strength of evidence for causality between a risk factor and outcome
Other Studies:
Systematic review
Meta analysis
Cross over
N of 1 trial
Descriptive studies
HP associated Maltoma
Surveys
'haracteristics0
escriptive
4enerally no controls
"ase Series . "ase Reports
Observational / Analytic Studies
'ross Sectional
'ase+'ontrol
'ohort
,-perimental
5o+o-perimental
Attempt to establish a causal link bet"een a
predictor6risk factor and an outcome.
Cross-sectional Study'
escriptive value0
Analytic value0
7nivariate
, Prevalent'
+ )is* factors may be more related to survival &ith
disease than development /incidence0 of disease
"on-32perimental
32perimental
Prospective1 longitudinal1 follo& up
Studies' Cohort
A cohort study is a0
'omparative
heart attacks
strokes
%ll Sub9ects &ere follo&ed for <= years to ascertain various health
outcomes'
>Heart attac*s
>Stro*es
>.reast cancer and so on.
/riting 4roup for the /omenJs *ealth !nitiative !nvestigators. 2CDDC3. Risks and benefits of estrogen plus
progestin in healthy postmenopausal "omen0 principal results from the /omenJs *ealth !nitiative
randomi.ed controlled trial. JAMA, 2882B3& BCE+BBB.
/omenHs *ealth !nitiative 2/*!3
,-perimental esign 2R'T3
Healt) outcomes8 )eart attacks' strokes' *reast cancer and so on/
'omparison of /*! and 5*S
Subgroup analysis
Smoking
'?
'a lung
'a esophagus
/eaknesses of cohort studies
,-pensive
9ramingham
Problems &ith cohort studies
Selection 2patients6control3 bias
Attrition 2rop out3
'o intervention
'ross over
8isclassification bias
'onfounders
!nformation bias
Recall bias
!ntervie"ers
#ublication bias
*o" to guard against and deal "ith problems?
)andomiBation in )C!s
.lindness in )C!s
Meta-analysis is a statistical
techniFue for combining the results
of independent1 but similar1 studies
to obtain an overall estimate of
treatment effect.
Margaliot1 Nvi1 Gevin C. Chung. Systematic )evie&s' % Primer for Plastic Surgery
)esearch. P)S Oournal. :;@#P /;@@P0 p.:QK@
Meta- %nalysis /cont.0
(hile all meta-analyses are based on
systematic revie& of literature1 not all
systematic revie&s necessarily include
meta-analysis.
Margaliot1 Nvi1 Gevin C. Chung. Systematic )evie&s' %
Primer for Plastic Surgery )esearch. P)S Oournal. :;@#P /;@@P0
p.:QK@
Junnel Plot
8A funnel "lot is used as a way to assess "u9lication
9ias in meta.analysis':
% Jorest Plot