Type of Research Design II Flashcards
What type of study starts with the Exposure and inquires the outcome
case control study
What type of study starts with the outcome and inquires the exposure (present to future)
prospective cohort study
What type of study starts with the outcome and inquires the exposure (past to present)
retrospective case control study
What type of study asks the exposure and outcome at the same time
cross sectional
What are the advantages of cohort studies? 4
Temporal relationship (what comes first) between exposure & disease can be established
Can examine relationship between a single exposure & one or more
conditions
Useful when the exposure is rare
Minimal selection & recall bias as compared to case-control studies
What are disadvantages to cohort studies? 6
Not very useful to study very rare diseases
Lossesto follow-up
Requires large sample
Long time to complete
Expensive & difficult to manage
Exposure status can change with long follow-up
When do you use odds ratio?
Case control study
When do you use risk ratio?
Cohort and clinical trials
Which epidemiological study uses incidence as a measure of frequency?
cohort and clinical trials
What is incidence?
Number of people with the disease over number of people at risk
Why are odds ratio less reliable than relative risk?
When outcome is common, odds ratio tend to overestimate the odds of the disease
When are odds ratio and relative ratio the same?
When outcome is rare
What is a baseline risk?
the common risk of getting a certain disease without any exposures
what is the name of the risks that are due to the presence of exposures?
excess risk
What is attributable risk?
the portion of the incidence of a given disease in the exposed that is due to the exposure
What are the advantages of randomized control trials? 5
Gold standard design for examining treatment’s efficacy
Clear eligibility criteria & exposure
Minimal bias if conducted appropriately
Selection bias & confounding are minimized by randomization & allocation concealment
Measurement bias (performance & detection) is minimized by blinding participants & investigators to group allocation
What is the disadvantages of randomized controlled trials
Expensive
Volunteering bias
Loss to follow-up bias (can be minimized by intention to treat analysis)
What is the intention to treat analysis?
all subjects randomized are included in the primary outcome analysis at the end of the study, even if they have dropped out
How to interpret NNT?
for every (no.) patient undergoing (exposure) treatment, 1 fall will be prevented as compared with (none exposure group)
Advantages of NNT and NNH?
Clinically meaningful way of expressing the benefit of an intervention over another
Take the absolute risk of the event into account
Assist in clinical decision making
What is the name of experiments that are not randomized?
Quasi-expirements
What is the advantages of Quasi experiments?
Less expensive (require fewer resources)
Useful in evaluation of rapid responses to outbreaks & patient safety
problems
What are the disadvantages of Quasi experiments? 5
Participants are not assigned randomly intervention & comparison group
Non-equivalent groups design: confounding & internal validity issues
(uncertainty of causal inference)
• Participants are not assigned randomly intervention & comparison group
• Participants in intervention & control groups may differ in known &
unknown confounders (non-equivalent groups design)
• Non-equivalent groups design threatens internal validity (the degree of confidence that the intervention was responsible for the outcome in the intervention group
What are systematic reviews?
Are studies of studies that offer a systematic approach to reviewing & summarizing evidence a bout a particular research question
What are the key characteristics of a systematic review? 5
• A set of objectives with pre-defined inclusion criteria
• Comprehensive searches to identify all relevant studies
• Assessment of the quality of included studies (risk of bias assessment)
• A standardized presentation & synthesis of the characteristics & findings of the included studies
• At least two reviewers are involved
What are the key roles & importance of systematic reviews? 6
• Keep up to date with constantly expanding number of studies
• Critically appraise primary studies addressing the same research question
Investigate possible reasons for conflicting results
• Provide more precise & reliable effect estimates than is possible from individual studies
• Identify gaps in the evidence base
• Make evidence-based decisions & to inform the development of clinical guidelines
What are the advantages of systematic reviews? 3
Less costly than RCTs
Stronger external validity
Considered an evidence-based resource
What are the disadvantages of systematic reviews? 4
Time-consuming
Heterogeneity of studies
May not be easy to combine studies results
Reporting (publication & language) bias