LESSON 8 RESEARCH DESIGN
Health Research Triangle
Classification of Research
Biomedical Research – the generation of knowledge on
diseases, health status problems, and the development
of technology
Health Behavioral Research – study leading to behavior
support of health technology
Health Systems Research (HSR) – study to generate the
kind of knowledge required to improve the planning,
organization and operation of the health system
OBSERVATIONAL STUDIES
 No intervention applied to influence the study
 An observation of occurrence and possible
relationships of factors
 Approach maybe purely descriptive or analytic
Descriptive Approach
 Description of various epidemiologic features of a
particular disease or event
 E.g. Studying the course of varicella among Grade
schoolers and take note of the signs and symptoms,
which then becomes the basis of clinical diagnosis
 E.g. Studying the incubation period of varicella,
noting the series of cases, the dates and time of
exposure to date of onset of signs and symptoms,
studying the period of communicability
 e.g. studying the pattern of disease occurrence in a
community at certain points in time (prevalence,
incidence), changing age of the population, or give
some idea on the possible correlation between the
disease and age and sex on the patterns Community
 Health Diagnosis – most noteworthy application of
diagnosis as the first major step in the health
planning process
Analytical Approach
 includes ecological studies, cross-sectional
(analytical), case-control and cohort studies
Ecological Study
also known as correlational study
 e.g. Community A – the incidence of coronary heart
disease (CHD) is 10/10,000 population . In
community B incidence is 5/10,000.
 In Community A – people had high salt intake, while
in Community B - low salt intake.
 Shows correlation but does not conclude that high
salt intake causes CHD
 Refine the study using cohort or case-control
Cross-sectional Study
 Measures prevalence of disease at a certain point in
time and relates it with basic population
characteristics being surveyed such as ages, sex,
ethnicity, socio-economic strata.
 Provides a general figure of the prevalence and the
prevalence rate by basic population profiles
 e.g. Intestinal parasitism survey among the under 5
 Describe other characteristics of the host and the
environment
 ADVANTAGES
o Starts with a reference population from
which the cases and controls are drawn
o Can determine prevalence BUT NOT
ALWAYS INCIDENCE
o They are the starting point in prospective
cohort studies for screening out already
existing conditions
o Provide wealth of data that can be of great
use in health systems
o Allows risk statement to be made but they
are imprecise
 DISADVANTAGES
o They provide no direct estimate of risks
o They are prone to bias form selective
survival
 o Since exposure and disease are measured at
the same point in time, it is not possible to
establish temporality (whether the
exposure or presence of risk factor
preceded the development of disease)
The Case-Control Study
 Attempts to show the influence of a risk factor in
the causation of disease
 Starting point: selection of the people with a
particular disease and those without it
 Pre-select the CASES (with disease) and CONTROLS
(no disease)
 Endpoint /Outcome - number of “exposed” and
“not exposed” to a particular risk factor