Types of scientific research &

studies
Lecturer
Dr Shahow A Ezzaddin
PhD Community Medicine
 Clinical Study Types:
1- Observational Studies (Descriptive and analytic):
• Case Report
• Case Series
• Ecologic (Aggregate) Study
• Cross-Sectional (Prevalence Study) Study
• Case-Control Study
• Cohort (Incidence, Longitudinal Study) Study
2- Experimental Studies ( intervention studies):
• Randomized Controlled Clinical Trial (RCT)
• Randomized Cross-Over Clinical Trial
• Randomized Controlled Laboratory Study
 1- Observational Studies:
The greatest value of these types of studies
(e.g., case report, case series, ecologic, case-
control and cohort) is that they provide
preliminary evidence that can be used as the
basis for hypotheses in stronger
experimental studies, such as randomized
controlled trials
 A- Case Report:
• A description of a single case, typically
describing the manifestations, clinical course,
and prognosis of that case.

• Due to the wide range of natural biologic

variability in these aspects, a single case report
provides little empirical evidence to the clinician.
 Case Report
Case reports often describe:
1. Unique cases that cannot be explained by known
diseases or syndromes

2. Cases that show an important variation of a disease

or condition

3. Cases that show unexpected events providing a

new or useful information

4. Cases in which one patient has two or more

unexpected diseases or disorders
 B- Case Series:
• A descriptive, observational study of a series
of cases, typically describing the
manifestations, clinical course, and prognosis
of a condition

• A case series provides weak empirical

evidence because of the lack of
comparability unless the findings are
dramatically different from expectations
 B- Case Series:
• Case series are best used as a source of
hypotheses for investigation by stronger study
designs, leading some to suggest that the case
series should be regarded as clinicians talking
to researchers
C- Ecologic (Aggregate) Study:
• An observational analytical study based on aggregated
secondary data
• Aggregate data on risk factors and disease prevalence
from different population groups is compared to identify
associations
• Because all data are aggregate at the group level,
relationships at the individual level cannot be
empirically determined
• Thus, because of the likelihood of an ecologic fallacy,
this type of study provides weak empirical evidence
• i.e. Breast CA and high fat diet
 D- Cross-Sectional (Prevalence ) Study:

• A descriptive study of the relationship

between diseases and other factors at one point
in time (usually) in a defined population

• Cross sectional studies lack any information

on timing of exposure and outcome
relationships and include only prevalent
cases
 E- Case-Control Study:
• A retrospective, analytical, observational study
often based on secondary data in which the
proportion of cases with a potential risk factor
are compared to the proportion of controls
(individuals without the disease) with the same
risk factor
 E- Case-Control Study:
• It compares patients who have a disease or
outcome of interest (cases) with patients who do
not have the disease or outcome (controls),

• Looks back retrospectively to compare how

frequently the exposure to a risk factor is present
in each group to determine the relationship
between the risk factor and the disease.
 E- Case-Control Study:
• They are observational because no intervention is
attempted

• Case control studies are also known as "retrospective

studies" and "case-referent studies."
• The common association measure for a case-control
study is the odds ratio

• These studies are commonly used for initial, evaluation

of risk factors and are particularly useful for rare
conditions or for risk factors with long induction
periods.
 Cohort:
A group of individuals identified on the basis
of a common experience or characteristic
that is usually monitored over time from
the point of assembly
 A- Cohort (Incidence, Longitudinal) Study:

• A prospective, analytical, observational study,

based on data, usually primary, from a follow-
up period of a group in which some have had,
have or will have the
• exposure of interest,
• to determine the association between that
exposure and an outcome
 A- Cohort (Incidence, Longitudinal) Study:

• Cohort studies are susceptible to bias by:

– Differential loss to follow-up,
– The lack of control over risk assignment
• Because of their prospective nature, cohort studies are
stronger than case-control studies when well
executed but they also are more expensive
• Because of their observational nature, cohort studies
do not provide empirical evidence that is as strong
as that provided by properly executed randomized
controlled clinical trials
 2- Experimental Studies:
The hallmark of the experimental study is that
the allocation or assignment of individuals is
under control of investigator and thus can be
randomized.
 2- Experimental Studies:
Properly performed experimental
studies provide the strongest empirical
evidence.
A- Randomized Controlled Clinical Trial:
A prospective, analytical, experimental
study

Individuals similar at the beginning are

randomly allocated to two or more
treatment groups and the outcomes
A- Randomized Controlled Clinical Trial:
The groups are compared after
sufficient follow-up time

The RCT is the strongest evidence

of the clinical efficacy of
preventive and therapeutic
procedures in the clinical setting
B- Randomized Cross-Over Clinical Trial:
A prospective, analytical, experimental study.

Individuals with a chronic condition are

randomly allocated to one of two treatment
groups

After a sufficient treatment period and often a

washout period, each group is switched to the
other treatment for the same period ( Group
with Dg1 switched to Dg2 and the group with
Dg2 switched to Dg1)
B- Randomized Cross-Over Clinical Trial:
This design is susceptible to bias if carry over
effects from the first treatment occur

The alternative treatments for a chronically

affected individual are administered in a
random sequence and the individual is
observed in a double blind fashion to
determine which treatment is the best
 Cross Sectional Studies

Defined Population

Risk Factor + Risk Factor -

No No
disease Disease disease Disease

Determine presence of disease and risk factors at the same time –

“snapshot”
 a) ----------- b)
a)

b)
Pyramid of clinical studies
Meta-analysis
Systematic review
Randomized controlled trial
Cohort studies
Case Control studies
Case Report, Case series
Animal research