Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in a defined population.
The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study will have overarching similarities.
A cohort study is a particular form of longitudinal study that samples a cohort, performing a cross-section at intervals through time. It is a type of panel study where the individuals in the panel share a common characteristic.
The British Doctors' Study was a prospective cohort study which ran from 1951 to 2001, and in 1956 provided convincing statistical proof that tobacco smoking increased the risk of lung cancer.
A case–control study is a type of observational study in which two existing groups differing in outcome are identified and compared on the basis of some supposed causal attribute. Case–control studies are often used to identify factors that may contribute to a medical condition by comparing subjects who have that condition/disease with patients who do not have the condition/disease but are otherwise similar. They require fewer resources but provide less evidence for causal inference than a randomized controlled trial. A case–control study is often used to produce an odds ratio, which is an inferior measure of strength of association compared to relative risk, but new statistical methods make it possible to use a case-control study to estimate relative risk, risk differences, and other quantities.
The Women's Health Initiative (WHI) was a series of clinical studies initiated by the U.S. National Institutes of Health (NIH) in 1991, to address major health issues causing morbidity and mortality in postmenopausal women. It consisted of three clinical trials (CT) and an observational study (OS). In particular, randomized controlled trials were designed and funded that addressed cardiovascular disease, cancer, and osteoporosis.
The Framingham Heart Study is a long-term, ongoing cardiovascular cohort study of residents of the city of Framingham, Massachusetts. The study began in 1948 with 5,209 adult subjects from Framingham, and is now on its third generation of participants. Prior to the study almost nothing was known about the epidemiology of hypertensive or arteriosclerotic cardiovascular disease. Much of the now-common knowledge concerning heart disease, such as the effects of diet, exercise, and common medications such as aspirin, is based on this longitudinal study. It is a project of the National Heart, Lung, and Blood Institute, in collaboration with Boston University. Various health professionals from the hospitals and universities of Greater Boston staff the project.
In statistics, epidemiology, marketing and demography, a cohort is a group of subjects who share a defining characteristic.
Clinical study design is the formulation of trials and experiments, as well as observational studies in medical, clinical and other types of research involving human beings. The goal of a clinical study is to assess the safety, efficacy, and / or the mechanism of action of an investigational medicinal product (IMP) or procedure, or new drug or device that is in development, but potentially not yet approved by a health authority. It can also be to investigate a drug, device or procedure that has already been approved but is still in need of further investigation, typically with respect to long-term effects or cost-effectiveness.
A nested case–control (NCC) study is a variation of a case–control study in which cases and controls are drawn from the population in a fully enumerated cohort.
Tobacco products, especially when smoked or used orally, have negative effects on human health, and concerns about these effects have existed for a long time. Research has focused primarily on cigarette smoking.
In fields such as epidemiology, social sciences, psychology and statistics, an observational study draws inferences from a sample to a population where the independent variable is not under the control of the researcher because of ethical concerns or logistical constraints. One common observational study is about the possible effect of a treatment on subjects, where the assignment of subjects into a treated group versus a control group is outside the control of the investigator. This is in contrast with experiments, such as randomized controlled trials, where each subject is randomly assigned to a treated group or a control group. Observational studies, for lacking an assignment mechanism, naturally present difficulties for inferential analysis.
Molecular epidemiology is a branch of epidemiology and medical science that focuses on the contribution of potential genetic and environmental risk factors, identified at the molecular level, to the etiology, distribution and prevention of disease within families and across populations. This field has emerged from the integration of molecular biology into traditional epidemiological research. Molecular epidemiology improves our understanding of the pathogenesis of disease by identifying specific pathways, molecules and genes that influence the risk of developing disease. More broadly, it seeks to establish understanding of how the interactions between genetic traits and environmental exposures result in disease.
A retrospective cohort study, also called a historic cohort study, is a longitudinal cohort study used in medical and psychological research. A cohort of individuals that share a common exposure factor is compared with another group of equivalent individuals not exposed to that factor, to determine the factor's influence on the incidence of a condition such as disease or death. Retrospective cohort studies have existed for approximately as long as prospective cohort studies.
The following outline is provided as an overview of and topical guide to clinical research:
Nutritional epidemiology examines dietary and nutritional factors in relation to disease occurrence at a population level. Nutritional epidemiology is a relatively new field of medical research that studies the relationship between nutrition and health. It is a young discipline in epidemiology that is continuing to grow in relevance to present-day health concerns. Diet and physical activity are difficult to measure accurately, which may partly explain why nutrition has received less attention than other risk factors for disease in epidemiology. Nutritional epidemiology uses knowledge from nutritional science to aid in the understanding of human nutrition and the explanation of basic underlying mechanisms. Nutritional science information is also used in the development of nutritional epidemiological studies and interventions including clinical, case-control and cohort studies. Nutritional epidemiological methods have been developed to study the relationship between diet and disease. Findings from these studies impact public health as they guide the development of dietary recommendations including those tailored specifically for the prevention of certain diseases, conditions and cancers. It is argued by western researchers that nutritional epidemiology should be a core component in the training of all health and social service professions because of its increasing relevance and past successes in improving the health of the public worldwide. However, it is also argued that nutritional epidemiological studies yield unreliable findings as they rely on the role of diet in health and disease, which is known as an exposure that is susceptible to considerable measurement error.
The Caerphilly Heart Disease Study, also known as the Caerphilly Prospective Study (CaPS), is an epidemiological prospective cohort, set up in 1979 in a representative population sample drawn from Caerphilly, a typical small town in South Wales, UK.
Occupational epidemiology is a subdiscipline of epidemiology that focuses on investigations of workers and the workplace. Occupational epidemiologic studies examine health outcomes among workers, and their potential association with conditions in the workplace including noise, chemicals, heat, or radiation, or work organization such as schedules.
In epidemiology, attributable fraction for the population (AFp) is the proportion of incidents in the population that are attributable to the risk factor. The term attributable risk percent for the population is used if the fraction is expressed as a percentage. It is calculated as , where is the incidence in the population, and is the incidence in the unexposed group.
The Strong Heart Study is an ongoing cohort study of cardiovascular disease (CVD) and its risk factors among American Indian men and women. The original cohort began in 1984 with 4,549 participants ages 35–74 from 13 tribal nations and communities in Arizona, Oklahoma, North Dakota, and South Dakota. The need for specific ethnic and cultural understanding and sensitivities was recognized from the onset, so the study has a community-based participatory research (CBPR) model. Community members were involved in all stages of conception, design, and implementation of the research. Now in its seventh phase, the extensive research has led to many important findings about heart disease and unique risk factors in native populations. It is a project funded by the National Heart, Lung, and Blood Institute (NHLBI). The study maintains field centers in Oklahoma, North and South Dakota, and Arizona and a coordinating center at the University of Oklahoma Health Sciences Center.
