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Research Evaluation > Lecture 3 - Analytical Study Design (Part 1) > Flashcards

Lecture 3 - Analytical Study Design (Part 1) Flashcards

1
Q

attempt to provide insight into etiology or find/ determine better patient outcomes

A

explanatory studies

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2
Q

has an active intervention from the investigator

A

experimental explanatory study

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3
Q

investigator observes nature

A

observational explanatory study

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4
Q

examples of experimental explanatory studies

A 
controlled trial
clinical trial
educational intervention
healthcare trial
intervention trial
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5
Q

ex’s of observational explanatory studies

A

case-control
follow up
cross -sectional
cohort (fancy way of saying follow-up)

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6
Q

observational studies

A

case-control
follow up
cross -sectional
cohort (fancy way of saying follow-up)

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7
Q

snapshot in time that doesn’t show causality

A

cross-sectional study

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8
Q

examines the relationship outcomes and other variables of interest as they exist in a defined population at one particular time

A

cross-sectional study

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9
Q

determines prevalence (% of population) not incidence (rate)

A

cross-sectional study

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10
Q

prevalence

A

(% of population)

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11
Q

not incidence

A

rate

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12
Q

can a cross-sectional study show causality?

A

No

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13
Q

Do cross-sectional studies separate cause/ effect?

A

No

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14
Q

T or F:

The cross sectional study establishes a temporal relationship between risk factors and disease

A

FALSE:

They do not because they are measured at the same time

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15
Q

another name for cross sectional study?

A

prevalence studies

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16
Q

gives the disease burden right now

A

prevalence study (cross sectional study)

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17
Q

What are the strengths of cross-sectional studies?

A

can assess MULTIPLE outcomes and exposures simultaneously

can be completed QUICKLY

data generated can LEAD TO FURTHER STUDIES

can generate PREVALENCE

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18
Q

What are the limitations of cross-sectional studies?

A

No time reference “snap shot in time” - like looking at a photograph

only useful for COMMON CONDITIONS

cannot calculate incidence, it is a PREVALENCE study

Results are dependent on the study population

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19
Q

What are observational studies?

A

case-control studies

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20
Q

retrospective study that looks back at causes

A

case-control study

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21
Q

study in which patients who already have a specific condition (cases) are compared with people who do no have the condition (controls)

A

case-control study

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22
Q

the researcher LOOKS BACK to identify factors or exposures that might be associated with the illness

A

Case-control study

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23
Q

this type of study design may follow a case-series (as a retrospective look at causes)

A

case-control study

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24
Q

tries to capture the cause and effect relationship by comparing frequency of a risk factor among those who are exposed and not-exposed

A

case-control study

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25
Q

case think

A

specific condition

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26
Q

control think

A

no condition

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27
Q

strengths of case-control studies

A

good for studying RARE OUTCOMES

can evaluate many exposures

ideal for initial, explanatory idea

Simple & fast - we already know the outcomes (efficient due to no waiting for account to occur)

INEXPENSIVE

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28
Q

T or F: case control studies are very expensive

A

FALSE

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29
Q

limitations of case-control studies

A

single outcome

high risk for BIAS

high risk for CONFOUNDING VARIABLES

other factors may exist that influence outcomes

no prevalence nor incidence

can’t make casual interpretations

can’t determine incidence

can’t calculate Relative risk

30
Q

Potential Biases in Case-Control Studies

A

Selection Bias

Information Bias

Researcher Bias

Voluntary Responses Bias

31
Q

Selection bias

A

an inappropriate selection of cases or controls

32
Q

What are the strengths of cross-sectional studies?

A

Selection bias

33
Q

Information Bias

A

recall bias (Subject Bias) is the main form of information bias in case-control studies. Occurs when there is a DIFFERENTIAL RECALL of exposure between cases and controls

34
Q

Researcher Bias

A

occurs when the researcher / observer evaluates cases vs controls differentially

35
Q

Voluntary Responses Bias

A

arises when case subjects who think they have been exposed to responds at a higher rate of controls

36
Q

can be selected from a variety of sources like hospitals, clinics, registries etc. IF selected from single source, risk factors from that facility may not be generalizable to all patients with that disease

A

Cases with selection bias due to inappropriate selection

37
Q

ideally, you want controls to come from the same reference population that cases are derived from. An inappropriate control group can have the opposite effect and obscure an important link between the disease and its cause

A

Controls with selection bias due to inappropriate selection

38
Q

to ensure you don’t have selection bias due to controls…. how do we choose our control group?

A

from the same reference population that cases are derived from

39
Q

what is selective recall, reporting, or recall bias?

A

when subjects hold beliefs about the cause of their disease

40
Q

what is the process of selection the controls so they are similar to the cases in certain characteristics, such as age, race, sex, socioeconomic status, and occupation

A

matching

41
Q

for each case selected for the study, a control is selected who is similar to the case in terms of the specific variable

A

individual

42
Q

select controls with a certain characteristic that is identical to the proportion of cases with the same characterstic

A

group-based

43
Q

what are the problems with matching?

A

1) if you select too many matching characteristics it is difficulty to find an appropriate control
2) you lose the ability to study a matched variable

44
Q

employing multiple control groups can do what?

A

offers independent estimates of exposure among different samples of non-cases. Increases strength of the study

45
Q

a variant of a case-control study

A

case-crossover

46
Q

each case becomes their own individual control

A

case-crossover

47
Q

used for transient exposures during a discrete occurence

A

case-crossover

48
Q

a cast control study within a large cohort

A

nested case-control

49
Q

typically seen with large enrollment studies

controls are samples of individuals who are at risk for the disease / outcome at the time each case of the disease develops

A

nested case-control

50
Q

same as nested case-control design, expect controls are randomly chosen from the cohort with which the study began

A

case-cohort

51
Q

a group of people who share a common characteristic or experience and all remain in the group for a period of time

A

cohort

52
Q

an epidemiologic investigation that follows groups with common characteristics,

A

cohort study

53
Q

which is the strongest observational study

A

cohort study

54
Q

which cohort study looks forward over time?

A

prospective

55
Q

which cohort study goes back in time?

A

retrospective

56
Q

identify a group of patients who are already taking a particular treatment or have an exposure, follow them forward over time, and then compare their outcomes with a similar group that has not been affected by the treatment or exposure being studies

A

prospective

57
Q

start with a cohort and go back in time to evaluate past exposure to risk factors

A

retrospective

58
Q

what are types of potential biases in cohort studies?

A

selection bias or “lost to follow up” where people with disease are selectively lost to follow-up, and those lost to follow-up differ from those not lost to follow-up

information bias

quality and info different for exposed & non-exposed
OBSERVER BIAS - when observer decides the disease has developed in each subject also knows whether that subject was exposed

59
Q

What are the strengths of cohort studies?

A

may study multiple effects of a single exposure

can identify a TEMPORAL RELATIONSHIP between the exposure and disease (outcome)

help CONFIRM CAUSE AND EFFECT of disease and the MAGNITUDE of the effect

can measure INCIDENCE (rate) of disease

can calculate RELATIVE RISK

HIGHEST VALIDITY OF OBSERVATIONAL STUDY DESIGN

60
Q

what is the highest validity of the observational study design?

A

cohort studies

61
Q

what are limitations to cohort studies?

A

Expensive and time consuming

INEFFECIENT for studying rare diseases

LOSE PARTCIPANTS to follow-up

Risk of CONFOUNDING VARIABLES

Retrospective studies require PRESENCE OF RECORDS or recall

62
Q

T or F: cohort studies are cheap

A

False! they are expensive and time consuming

63
Q

starts with exposure and looks for disease

A

cohort studies

64
Q

study that can be prospective or retrospective

A

cohort studies

65
Q

common diseases; high risk for drop out; Expensive

A

cohort studies

66
Q

start with disease, look for exposure

A

case-control studies

67
Q

retrospective always

A

case-control studies

68
Q

rare disease; has recall and selection bias; inexpensive

A

case-control studies

69
Q

is bias always there?

A

yes

70
Q

a good research study will acknowledge bias and also take steps to address bias or reduce it… when is this done?

A

Study Design Phase or

Analysis Phase

71
Q

top to bottom what is the “pyramid” for quality of evidence

A 
Meta-Analyses
Systematic Reviews
Critically Appraised Literature or Evidence-Based Practice Guidelines
Randomized Controlled Trials
Non-Randomized Controlled Trials
Cohort Studies
Case Series or Studies
Individual Case Reports
Background Information, Expert Opinion, Non-EBM Guidelines

Research Evaluation (12 decks)

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