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L . Additional textbook resources can be found in the following annotated bibliographies on my Web site: Annotated Biostatistics Bibliography Annotated Epidemiology Bibliography Annotated Research Methods Annotated Research Practice (A .This lecture seeks to provide you with a basic understanding of Experimental Studies. the most respected type of research study used by Epidemiologists.

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Public Health support the work of researchers in its field. it’s Epidemiology. because a better understanding of how disease impacts populations is crucial before we can even think of how to better deliver services. and develop rational public policy.e. health education. health services researchers look at how health services differ for different populations. findings from epidemiological studies should serve as the foundation for research in health education. Health education researchers look at how people react to disease and how these behaviors impact quality of life. the research methods used and developed by epidemiologists have been used also to study “disease-related” issues. etc. etc. health policy. For example.Just like other scientific disciplines. health policy. Just like other academic disciplines.. Thus. each conducting their own research. educate people about health behaviors. i. if you had to choose one area that is most close to the heart of what Public Health is all about. . Public Health includes many specialty areas. But. While Epidemiology is the study of the distribution of disease.

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in order for these kinds of studies to attempt such an explanation.It can be said. . if that. there would have to be many. While we would like to say that A causes B. and explain what they observe with measures of association. in general. They record their observations of what’s going on. many studies that observed the same chain of events before there is a consensus that A causes B. that there are two main types of studies. Observational studies are those in which the researchers do not interfere or manipulate any of the factors under study.

In Public Health. can provide us with insights on how to control disease and improve quality of life. it’s difficult to show that a specific factor caused a particular outcome. There are usually many factors that can result in a particular outcome. And because it is unethical to conduct testing on human subjects without people’s consent. These usually look at how well some treatment work. from a feasibility standpoint. and if done well. when we are talking about populations. . So.Interventional studies are when researchers attempt to show that A causes B by actually manipulating those factors they think have something to do with causing some outcome. conducting research involving general populations is infeasible as well. observational studies are more common.

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preventive and other measures. both in Clinical Medicine and in Public Health. The randomized trial is considered the gold standard for evaluating the effectiveness of therapeutic. Such purposes include: Assessing new screening and early detection programs. or new ways of organizing and developing health services. or randomized trials are used for many purposes.Experiments. . evaluating new drugs and other treatments of disease.

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case-control and cohort studies. “Experimental” studies are referred to as “experimental epidemiology. Of these 3 study designs. A “natural experiment” would follow a cohort exposed to a natural phenomenon of health consequences and then compare the health effects in the exposed population with those not exposed to the phenomenon.” They are applied as “clinical trials” to assess the efficacy of some intervention (or procedure). or type of health service. the cohort method is the preferred design for confirming causal (antecedent) associations of health outcomes.Observational studies include cross-sectional. as surgical technique. The more common term used in Epidemiology is “randomized trial. type of facility. to name a few.” . An extension of the cohort design would be an “experiment” to see whether the expected outcome is found in a group receiving the exposure (antecedent) with a control group not receiving the exposure.

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To show that a treatment is effective. . or current standard of care. The control group may be receiving the prevailing. the improvement rate in a treated group (T) should be greater than the improvement rate in the untreated group (NT). and should not receive the studied treatment. and that the differences in rates should be unlikely they are due to chance. The control group (NT) should be similar to the treatment group (T) in all characteristics associated with the expected outcome (recovery). or a placebo.This is the basic strategy behind an experimental epidemiological study.

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say. with many groups (arms) involved in one study. . race and sex. So for a matched pair of white females. random allocation (or randomization) is used to ensure the groups are comparable. the researcher may match for. especially clinical trials. I am trying to keep this as simple as possible. After all the matched pairs have been assigned. as well as about the same distribution for other variables because of random allocation. can become very complex. the two study groups would then have the same race and age distribution. the researcher would then randomly assign one subject to the treatment group and the other to the control group. Regardless of how many groups are in a study.To cover the basics. Randomized trials. In matching.

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but this is very rare. the researcher starts with a defined population that is randomized to a new treatment or current treatment. it is best to compare the new treatment to a treatment already in place. The subjects are then followed to see how many improve for the new treatment and current treatment. If there is already a treatment in place. age. the groups tend to be similar. Sometimes a treatment may be compared to no treatment. Then again randomization isn’t a guarantee of comparability because chance does play a role in the process. Basically. Such characteristics include sex. race and severity of disease. Finally. randomization is ethical only when we do not know whether one treatment is better than the other. .This graphic shows when random allocation (randomization) should take place during the study process. Randomization increases the likelihood that the groups will be comparable in regard to characteristics that may affect prognosis. In the long run.

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Despite the negatives. If done right. contributes to the collective scientific body of knowledge. results. whether good or bad. randomized controlled studies are still considered the gold standard of clinical research. .