Descriptive

Study
FUKUSHIMA
Aya Goto
Medical
University
Hospital

FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 1
 Key concepts
•!• Nicely presented quantitative
data tells a lot WITHOUT p-
values.
•!• Graphs and tables

FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 2
 Grades of
UALJTI evidence
TABl.E 1 . G RADES OF EV1DENCE FOR l l i E P URPORTED Q

OF STUDY D ESIGN•.
J Evidence: obtained from at lease one properly rand.o mized, co ntro lled
rrial.
Il - Evidc:ncc: obtained from ,-vd l - de sign cd co n trolled aials wi-tho u t: ran ­
1 domizarion. This is
TI-
2
Evidence: obtained fro m wc:11-dc:sisned cohort or case- c o n a o l analyt­
ic smdics, prc:fernb ly from more than o n e center or research gro up.
where
11-
3
Evidence: obtained from mulciple rime: series ,vith or- without: the in­
r.cn <c:ncion . Dr:unacic rcsn lts in uncontro lJc:d experiments (such as
research
che results o f the: introduction of penicillin ircaanc:nc in the
1940s) could a.ho be regarded as this rypc: of c:"';d"l:'nce .
starts!
I II Opinions o f e c u : - d :iuthorirics,oosed on d e n i a l c:xpc:nc,ncc:; de­
scriptive studies and case rc:po rr.s; or reports of c:xpecc
committees.
.,The grades arc: those of the U.S. P,r,c: c:nrive Sen 'lCes Task Force?

Concato J, Shah N, Horwitz RI. Randomized, controlled FUKUSHIMA

trials, observational studies, and the hierarchy of research MEDICAL
N Engl J Med. 2000 Jun
designs. UNIVERSITY
22;342(25):1887-92.
Descriptive and Analytical study
•!• Descriptive study:
Describe distribution of
each factor individually.
•!• Analytical study: Analyze
associations among factors.
In any study design, you must describe distribution of
all factors you investigate.
cf1J,J $
This is the very basic and most important HIM A
designs. , UNIVERSITY
MtDf C AL
SLIDE 4
 Abortion trends in Japan, 1975-95.
Goto A, Fujiyama-Koriyama C, et al. Stud Fam Plann. 2000; 31(4):
301-8.

Abortion rate (per 1000

women) 40

- - - .... - - . *

- ..- '25-29
.- .... · 30-
34
1
°F==== ::::::::::::::=::::::::::::,,,, :;;::;;::::::::::=
-
• ' 35-39
• <
* 2 40-
-
=::l
0 44 0
MEDICAL
198 198 1990 * UNIVERSITY
0 5 FUKU
SLIDE 5 SHIM
Abortion ratio (per 1000 live
births)

100
0

100
1980 198 199
FUKUSHIMA
5 0
MEDICAL
UNIVERSITY
SLIDE 6
 Prevalence of and factors associated with reproductive tract infections
among pregnant women in ten communes in Nghe An Province,
Vietnam.
Goto A, Nguyen QV, et al. J Epidemiol. 2005;
N 15(5): 163-72.
Infections Nghi Nghi (%)
Nghi Ngh Hung
Khan Thua i Xa
Thu h n (N Thon
y (N = (N =14 g
Any infection 19 14 = 14 20
(N =
(41.3) 35)
(40.0) 47)
(29.8) 36)
(38.9) (N =
(45.5)
Endogenous 46) 44)
infections
Candidiasis 5 (10.9) 6 (17.1) 8 (17.0) 8 (22.2) 12
(27.3)
Bacterial vaginosis 2 ( 4.4) 4 (11.4) 4 ( 8.5) 2 ( 5.6) 3 ( 6.8)
Group 8 3 ( 6.5) 1 ( 2.9) 3 ( 6.4) 3 ( 8.3) 1( 2.7)
streptococcus
STD
Trichomoniasis 2 ( 4.4) 0 ( 0.0) 0 ( 0.0) 0 ( 0.0) 0 ( 0.0)
 50
s:
:
Is protein causing colon • NZ
e
cancer?
0
IU
0
0
o. • USA

-­
0
0
.-(
30 • Can
I

i:: Den
·u
-0U
uOJ
• • UK
i:: .s• Net I
...
-1. • we
Nor
O
u • lsr
•
• FOP
DD Pice Ecologic
J
• Ja Fin PR
0u
0
a 10
• J ap m : • Pol
Rom ._ Hun
fallacy
i:: Yug • •
Nig Chi • Col
u 40 80 280
120 160 200 240
320
Per caput daily consumption - grams

Fig. 2-1. Correlation between per capita meat consumption and colon cancer
among women in various countries. (From B. K. Armstrong and R. Doll, IMA
Environmental factors and cancer incidence and mortality in different AL
countries, with special reference to dietary practices. Int.]. Cancer 15:617, SI
1975.) TY
 Table and figure
format
Table
Table 1. Age-specific abortion rates and ratios in Japan and Fukushima, 2000
Age group
Total <20 20-24 25-29 30-34 35-39
Abortion rate (per 1000 women) 40-44 45-49
Japan 11.6 12.2 20.1 15.1 14.2 13.2 6.2 0.5
Fukushima 20.7 18.4 30.8 23.8 22.9 19.9 10.2 0.7
Abortion ratio (per 1000 live births)
Japan 285 2249 512 154 156 420 1624 5775
Fukushima 390 2627 462 203 237 607 2324 13500
FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 9
Bar chart
Figure 1. Trends in abortion rate, Japan, 1995-
2001
16.0
Abortion rate (1000 women)
14.0 -
12.0
-
-
10.0 -
--
8.0
6.0 -
--
4.0
2.0
0.0 - I I I I I I

-
1995 1996 1997 1998 1999 2000 2001
FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 10
 Line
graph2. Trends in abortion rate,
Figure
Japan and Fukushima, 1980-1999
Abortionrate(1000 women)
25

20

1 --- ----=-=-=-=-= ---------- Fukushim

5 - -o-
1 - •
Jaoan
a

0 - - - - - -e - - - - - - e - - - -
5 -- o

0
1980- 1985- 1990- 1995- FUKUSHIMA
84 89 94 99 MEDICAL
UNIVERSITY
SLIDE 11
Histogram
Figure 3. Age-specific proportion of
abortion cases, Japan, 1999
LO
C\I

I....
0
C\I

o . - - - - - - FUKUSHIMA
<2 20- 25- 30-34 35-39 40- - MEDICAL
UNIVERSITY
0 24 29 44
SLIDE 12
USAGE
•!•Table Precise data
•!•Bar chart Trend
•!•Line Trend
graph (Comparing
•! several groups)
•Histogram Distribution

FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 13
 Summary
Table 1. Basicmeasures
characteristics of pregnant
women
Age (years) N (%) or Median
27 (18,
(min,44)
max)
Occupation
Housewife 27 ( 5.4)
Agriculture 317 (62.8)
Business 62 (12.3)
Government 71 (14.1)
employee
Others 28 ( 5.5) * Electri city, bicycle,
Education
None to primary 64 motorbike, running water,
school Secondary (12.7) television, and telephone
school High school 271 were the assets measured.
Professional school (53.7) FUKUSHIMA
University 101 MEDICAL
Household assets (0- (20.0)
3 (1, UNIVERSITY
6)* 536)
Arithmetic rules can NOT be applied.
N (%)
• Categorical data
Blood type: 1= 0, 2=A, 3=8, and 4=AB
Injury: 1=fatal, 2=severe, 3=moderate, 4=minor
Arithmetic rules can be applied.
Summary measures
• Continuous data
Hb level
Number of
births that FUKUSHIMA
MEDICAL
woman has UNIVERSITY

given. SLIDE 15
Summary measures of continuous data
•!•Mean=average
Standard Deviation(SD)
Mean±2SDs = a range in which "most" of
your subjects fit. (About 95°/o lie within 2 SDs)
•!•Median=50thpercentile
Range=Min /Max
•!•Mode=mostfrequent
value(s) FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 16
 Age: 6, 6, 7, 8, and
25
•!•Mean =
•!•Median
=
•!•Mode=
FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 17
Selection of
1. Sample size: Large (>30) --> Mean (SD)
Measures
Small --> Median
(Min,Max)
2.Shape Median/Mode
Mean

Bell-shape More than one Skewed to the right (left)

Mean peaks Mode Median
(=Median= Mode) FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 18
Clinical descriptive epidemiology
Model case from a private clinic in
JP
 ,,
_, •!• Shironishi Clinic '-
•!• Dr. Ogawa, Yutaka 71
I \

•!• General practitioner in a remote area

 ,, JI u ( .. 0 ) - • 4 K C, A fl. ,..

Daily .,
A

lt !I U ll- f
ix. ,s t .:.!i 'tr- "f $ , P'J

practic
-
e - E ' 0 f t l S t ! . . - " ( QJ':ft

notes 't O (1) ti. II

Practice Diary
(Year / Month / Day) No. Out-patients ( ) No. Home visits ( )
ID NAME TEL NO. TREATMENT

Other Notes
Check points
 Referral notes
frB , 11 a i J:l B ir'l ir'§(JJ.] ii 1$(2) 1$(3)

I
'
I
I

I
i

Date ID Name Birth Referral Reason Follow-up #2 #3

date hospital response #1

FUKUSHIMA
MEDICAL
UNIVERSITY
 j ;' I
I

z )
Kasei No Sihyo •R' . ,•
X . ??.\:
ffi..
-
I ·1 .,I
d. t
Pf. n ;P?'-- Pi:r
* -
2000: 47(8): 23-28. .I.. Mr t·. )
f,i';, 0h ii*1
•,it /
\j
:, f , 1· T¥Hl 0_C
2
I
' !(
&O -
2G8 (l 221 3 185 157:59) 28(10) 47il
OU; 82) (13) (69} i8i
.
Total Follow-up response received No
'
\

Tota Brief visit Treatment response

l recordonly record Satisfactory
Total Not
satisfactor
y
268 221 36 185 157 28 47
(100%) (82%) (13%) (69%) (59%) (10%) (18%)

"A systematic referral system should be

established." A referral card was introduced in
the region.
The paper was awarded. SLIDE 23
Simple clinical-oriented
descriptive study

Better
practic
e
FUKUSHIMA
MEDICAL
UNIVERSITY
SLIDE 24