The Design of Epidemiological

Study

Widana Primaningtyas, dr., MKM

Medical Faculty of Sebelas Maret University
INTRODUCTION OF EPIDEMIOLOGY
 Definition of Epidemiology
the study of the
distribution, determinants
and control of diseases in
populations (Paul Pharoah,
Cambridge University)
the study of factors affecting the
health and illness of populations
(or how often diseases occur in
different groups of people and
why)(Janusz Kaczorowski
University of British Columbia)

The study of determinants of

health and illness and it’s
distribution, also it’s application
to solve the health problems in
population (CDC, 2002; Last
2001; Gordis 2000).
 News: Diarrhea outbreak

Upper
section
of the Area A: no diarrhea
River:

investigations
water
source WHY area A no
diarrhea?
Water

Lower
section
of the
Area B: diarrhea outbreak
river:
water
source
 Key Assumptions

Disease doesn’t occur at Disease has causal and

random preventive factors
Find out about : Bradford-Hill criteria !
 Types of Epidemiology

Descriptive

●
Studying the distribution of health state
●
Incidence and prevalence
●
Explaining: time, person, place

Analytic

●
Studying the risk factors of health state
 How to measure disease/ illness/ health
problems?

Measure it’s frequency

prevalence incidence
 Incidence Rate
“the number of NEW cases of a condition in a
defined population over a specified period of
time”

Cummulative Incidence
 Prevalence Rate
the number of people with a particular
condition at a specified time within a defined
population

Per 100 atau 1000 atau 10000 (10n)

How to start the study/ research?
EPIDEMIOLOGICAL STUDY DESIGN
 What is study design?

A study design is a specific plan followed

for conducting the study, that allows the
researcher to translate the conceptual
hypothesis into an operational one (Ahmed
Mandil,nd, University of Alexandria)
 Types of the study
Postpositivist Experimental

Interpretivist

Ethnography

Observational

QUANTITATIV
QUALITATIVE E
Phenomenology

Case Study, etc

Which one you choose?
Experimental Designs
 Experimental Study Design
A study in which a population is selected for
a planned trial or intervantion to a
regimens. The upcoming effects are
measured by comparing the effect of the
regimen in the experimental group VS the
effect of another regimen in the control
group

There is manipulation of the

study factor (exposure/
intervention), and randomization OBSERVASIONAL
(random allocation) of subjects STUDY
to treatment
(exposure/intervention) groups.

(Ahmed Mandil,nd, University of Alexandria).

 Why Performed ?

Determine
whether
experimental
Provide stronger
Yield more validtreatments are
evidence of the
results, assafe and effective
effect (outcome)
variation under
is “controlled
compared to
minimized environments”
and (as
observational
bias controlledopposed to
designs
“natural settings”
in observational
designs)
 RANDOMIZATION outcome

Intervention
Experimental Design
no outcome

Study
population
outcome
Control

no outcome

baseline
future

time
Study begins here (baseline point)

(Ahmed Mandil,nd, University of Alexandria).

 Types of trials

T r ia l

C o n t r o lle d N o t c o n t r o lle d

R a n d o m is e d N o t r a n d o m is e d

B lin d e d N o t b lin d e d

(Ahmed Mandil,nd, University of Alexandria).

 RCT Advantages (I)

The “Gold Standard” of

study designs.
Provide the most convincing evidence of relationship between
exposure and effect/ outcome.
 RCT Advantages (II)
Best evidence
study design
Comparable
Groups (by using
randomization)

No inclusion
bias (by using
blinding)

Controlling for
possible
confounders
 RCT Disadvantages

Large trials
(might affect
ethical
statistical
questions ; power)
consideration

Public health Long term

perspective ? follow-up (might
Need more losses the
effort sample)

Couldn’t be
cheap Compliance
 OBSERVATIONAL STUDY DESIGN
• Next power point 
THANK
YOU