Research lecture 1

Dr. Sorin Ioacara

Prevalence represents the percentage of cases with a specific condition within a clearly defined
population, at a specific moment in time. Prevalence is not a rate because it is not expressed over a
time period, but it is measured at a given time point.

Prevalence formula

Example: a national survey conducted during 2012-2014 estimated a diabetes prevalence in

Romania of 11.6%.

Incidence represents the number of new cases with a specific condition occurring during a year
within a clearly defined population. Incidence is a rate because its measurement is made over a time
period, most frequently a year. Results are usually presented as new cases per 100000 persons per
year. “Persons per year” is often contracted to person-years.

Incidence formula

Example: type 1 diabetes incidence in Romania is 9 per 100000 person per year.

Mortality rate represents the number of deaths occurring during a year within a clearly defined
population. It is a rate because its measurement is made over a time period, most frequently a year.
Results are usually presented as deaths per 1000 persons per year.

Mortality rate formula

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Example: Mortality rate in Romania is 14 per 1000 person per year.

Relative risk represents the ratio between the risk of getting the disease within the group exposed
to a certain factor and the risk of getting the disease within the group unexposed to the same factor.
Basically it is a ratio of two prevalences (two percentages).

Relative risk formula

Example: The risk of getting diabetes (the prevalence of diabetes) in obese people is twice as
compared with lean individuals.

Odds ratio represents the ratio between the odds of getting the disease within the group exposed to
a certain factor and the odds of getting the disease within the group unexposed to the same factor.

Odds ratio formula

Example: The odds of getting diabetes in obese people was 1 to 5 (one will get it and five will not),
while the odds of getting diabetes in lean individuals was 1 to 9, leading to an odds ratio of 9/5 =>
1.8. Chances of getting diabetes in obese people are 1.8 times higher as compared with lean
individuals.

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The statistical significance of a calculated ratio or absolute difference (prevalence 1 minus
prevalence 2) between two prevalences can be assessed using:

a) chi-square test of association, if the sample size is not too small (>5 cases in each cell within
the 2x2 table)
b) the Fisher exact probability test, if the sample size is too small (≤5 cases in each cell within
the 2x2 table)

A p<0.05 means statistical significance.

Correlation is a statistical description of the degree to which 2 variables move in relation to each
other. Correlation is positive if both variables move in the same direction, i.e. when variable A is
rising so does variable B. Correlation is negative if the variables move in opposite directions, i.e.
when variable A is rising, variable B is decreasing (and vice-versa).

The strength of the correlation is described by the r, the coefficient of correlation, which can take
any number between 1 (perfect correlation) and 0 (absolutely no correlation). Again, a p<0.05
means statistical significance. A strong correlation is needed, but not sufficient to affirm causality.
Therefore, correlation does not mean or imply causality!

The following factors are arguments in favour of causality:

- there is a strong correlation between the proposed cause and effect

- there is a plausible explanation for that strong correlation found
- there is consistency in finding the same correlation in various studies performed in different
populations, by various investigators
- there is a plausible time sequence, in which the cause precedes the effect
- there is a strong dose – response effect, i.e. the higher the dose (of proposed cause), the
higher the measured effect