VIN NGHIN CU Y X HI HC

Tng quan v cc thit k

nghin cu nh lng
Nguyn Hng Phng
Hong Vn Minh, Nguyn Trng Nam

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hoc ton b bi ging ngh mi ngi trch dn: tn tc gi v
thongke.info. V d: Nguyn A Thongke.info
Mc tiu
Sau bui hc, hc vin c kh nng:
Phn bit c cc dng thit k nghin cu
nh lng c bn
Bit p dng chn cc thit k nghin
cu trong cc tnh hung c th
Phng php
Trnh by ngn
Tho lun
Cc thnh t ca thit k nghin cu
Thit k nghin cu cn tr li c cc cu hi sau:
Nghin cu v ci g?
Ti sao cn c nghin cu ny?
Nghin cu s tin hnh u?
Cn loi s liu g?
Thu thp cc s liu th no?
Nghin cu trong khong thi gian no?
C mu v cch tnh mu?
S liu s c phn tch th no?
Cc im cn ch trong thit k
nghin cu
Kinh ph v thi gian
Chun b trc k cng
Chn cng c ph hp
Loi tr cc yu t gy nhiu v cc sai st
khc
 Phn loi nghin cu

Theo bn Theo loi

cht NC thit k NC

Quan st Can thip

nh nh
l-ng tnh M Phn
t tch
Kt hp
Nghin cu nh lng v nh tnh
NC nh l-ng NC nh tnh
nh o l-ng kch th-c, Thm d mt s yu t gip ta
ngha ln, phn b, s kt hp hiu su sc v bn cht,
ca mt s yu t nguyn nhn ca vn

Cu hi Bao nhiu? Bng no? Ci g? Nh- th no? Ti sao?

T l suy dinh d-ng ca Ti sao ng-i dn t n

tr em < 5 tui khm bnh ti trm y t x?
Lin quan gia ht thuc Lm th no hn ch no
l v ung th- phi ph thai tr v thnh nin?
Cc loi nghin cu nh lng chnh

Experimental
Quasi-experimental Non-experimental
Nghin cu
Nghin cu bn can Nghin cu khng
can thip
thip can thip
l_____________l_____________l
 Cc thit k nghin cu nh lng chnh

Strongest Weakest
Design Non Experimental Designs Design

_______________________________________

9
Thit k nghin cu can thip
Cung cp tiu chun vng xc nh mi quan h nhn qu.
Gm cc loi sau:

Thit k c nhm chng, nh gi trc v sau can thip

Thit k c nhm chng, ch nh gi sau can thip
Thit k khng c nhm chng, nh gi trc v sau can thip
( ch c mt nhm)
Mt nghin cu tnh hung ngn
THIT K C NHM CHNG, NH GI TRC V
SAU KHI CAN THIP
Nhm th nghim

iu tr th nghim

nh gi trc can thip nh gi sau can thip

Nhm chng

nh gi trc can thip nh gi sau can thip

i tng nhm iu tr th nghim v nhm chng c chn ngu nhin

nh gi cc bin ph thuc trc v sau khi iu tr.

 Th nghim lm sng
Ngu nhin

M i

Kim chng c i chng

N
No CAD
g
Garlic Pill
u
n CAD
h
i tng i
nghin cu
n
No CAD
Control

CAD
u im v Nhc im
u im:
Phng php tt nht nh gi nguyn nhn-
hu qu
Thit k tt nht, kim sot c cc yu t nhiu
C th o c nhiu ch s u ra

Nhc im:
Chi ph cao
o c trong nghin cu
Khng tun th iu tr
 THIT K C NHM CHNG, CH NH GI
SAU CAN THIP

Nhm can thip

iu tr th nghim

nh gi sau can thip

Nhm kim chng

nh gi sau can thip

C 2 nhm c chn ngu nhin, nhng khng c nhm no c
kim tra trc th nghim.
Dng trong trng hp khng th thc hin kim tra i tng trc
iu tr
 THIT K KHNG C NHM CHNG,
NH GI TRC V SAU KHI CAN THIP

iu tr th nghim

nh gi trc can thip nh gi sau can thip

Trong trng hp ny ch c mt nhm c quan st t trc

v sau khi bin c lp c gii thiu
Khng c nhm chng c th lm gim gi tr ca nghin cu
nhng vn cn dng trong cc trng hp khng th c nhm
chng.
 Quasi- experimental design
C nhm chng nhng khng chia ngu nhin.
C 3 loi nh bao gm:

Thit k c nhm chng nhng khng tng ng vi nhm can thip

Theo chui thi gian

Thit k nghin cu theo chui thi gian kp

 Quasi-experimental design

Nhm th nghim( khng la chn ngu nhin)

iu tr th nghim

Kim tra trc Kim tra sau

Nhm kim sot ( khng c la chn ngu nhin)

Kim tra trc Kim tra sau

 Quasi-experimental design
Theo chui thi gian

iu tr th nghim

KT trc 1 2 3 4 5 6 6 5 4 3 2
KT sau 1
 Quasi-experimental design
theo chui thi gian kp
Nhm th nghim

Can thip
KT trc 1 2 3 4 5 6 6 5 4 3 2
KT sau 1

Nhm chng

KT trc 1 2 3 4 5 6 6 5 4 3 2
KT sau 1
 Thit k nghin cu khng can thip

Strongest Weakest
Design Non Experimental Designs Design

_______________________________________

20
Nghin cu nh lng
Nghin cu ct ngang
D liu c thu thp v mt vn g
cng lc

M t mi lin quan

T l bnh hin mc

A Snapshot
 V d nghin cu ct ngang
Mi lin h gia gi nh v ti v CAD ti
phng khm bc s gia nh

n ti
+ -
B

n
h + 10 90
ti
m
m

c - 90 10
h
Nghin cu ct ngang

u im
Nhanh chng
Ch ph thp

Nhc im
Khng th ch ra mi quan h nguyn
nhn-hu qu
Nghin cu bnh chng

Bt u vi ngi b bnh
Chn nhm chng tng ng khng b bnh
Hi li cc yu t nguy c
 Nghin cu kim sot tnh hung
Ch n nhiu ti (a)

Nhm b bnh
Ch n t ti (b)
CAD

Ch n nhiu ti (c)

Khng b CAD
Ch n t ti (d)

Qu Hin ti
kh
a/b
OR= ---------= ad/bc
c/d
V d v nghin cu bnh chng
nhng ngi b bnh tim- c phi do h n t ti khng
n t ti n nhiu ti Tng

Bnh tim 693 307 1000

Khng bnh 320 680 1000

tim
Tng 1013 987 2000

693/320
OR = = 4,8
307/ 680
Nghin cu bnh chng
u im
Hu ch vi cc trng hp bnh him: ung th
C th khm ph nhiu yu t phi nhim
Nhanh, R
Cung cp OR

Nhc im
Khng th o c
T l mi mc
T l hin mc
Nguy c tng i Risk ratio
Ch c th nghin cu c mt bnh
C th b nh hng bi nhiu yu t nhiu
Nghin cu thun tp

Bt u vi bnh nhn khng b bnh

Chia bnh nhn thnh nhm c phi nhim v khng

phi nhim

Theo di mc bnh ca 2 nhm

So snh kt qu s dng relative risk

 Nghin cu thun tp tng lai
CAD (a)
Khng n ti
No CAD (b)

CAD (c)
Ngi n ti
No CAD (d)

Hin ti Tng lai

a/(a+b)
RR= --------------
c/(c+d)
Nghin cu thun tp: u im

Cung cp t l bnh mi mc
Tm hiu nguyn nhn gy bnh theo thi gian
Loi b cc sai lch do phi nh li
Cho php o lng chnh xc cc bin phi nhim
Theo di c nhiu bnh
Kim sot cc yu t nhiu
 Nghin cu thun tp: Nhc im
Chi ph cao
Tn nhiu thi gian
Khng th nghin cu cc bnh him
Phi nhim c th thay i theo thi gian
Kh vi cc bnh c thi gian bnh lu
i tng nghin cu b khng theo nghin cu
Nghin cu vin can
thip?
Tho lun nhm nh
La chn nhm trng v ngi trnh by
c tnh hung
Thit k mt nghin cu tr li cu hi nghin cu
Gi s khng lo lng v tin!
Trnh by ngn gn nghin cu ca nhm
Thi gian:
10 pht cho thit k nghin cu
10 pht cho trnh by kt qu tho lun
 VIN NGHIN CU Y X HI HC

Tnh hung 1

Nhng yu t nguy c gy bnh ung th

phi l g?
 VIN NGHIN CU Y X HI HC

Tnh hung 2

Hiu qu lu di ca vic s dng

multivitamin i vi ph n c thai l g?
Tnh hung 3
C s khc nhau gia bc s nhi khoa bnh
vin v bc s gia nh khi iu tr bnh
vim phi s sinh hay khng?
Tnh hung 4

Ht thuc l c gy ung th phi hay

khng?