Professional Documents
Culture Documents
Types of Study Designs
Types of Study Designs
Objectives
Types of Studies
Descriptive Studies
Experimental Studies
Descriptive
Case report
Case series
Survey
Analytic
Observational
Cross sectional
Case-control
Cohort studies
Experimental
Randomized
controlled trials
Descriptive studies
Descriptive studies
Analytic Studies
Descriptive
Case report
Case series
Survey
Analytic
Observational
Cross sectional
Case-control
Cohort studies
Experimental
Randomized
controlled trials
Research Question
Is the regular consumption of Red Bull
associated with improved academic
performance among U.S. medical students?
Rationale
Background
Seidl R, Peyrl A, Nicham R, Hauser E. A taurine and caffeinecontaining drink stimulates cognitive performance and well-being.
Amino Acids. 2000;19(3-4):635-42.
What is feasible?
Study Design #1
USMLE Score
time
Cross-sectional Study:
Descriptive value:
Univariate
Multivariate (controlling for confounders)
AAMC
Fast/Inexpensive - no waiting!
No loss to follow up
Measures of association
Risk ratio
(relative risk)
Disease
Yes
No
Yes
No
Risk
Factor
A
A+B
C
C+D
USMLE Score
time
time
Study Design #2
A case-control study
Cases: 4th year med students accepted to
residency in highly selective specialty X.
Controls: 4th year med students who applied
but were not accepted.
Predictor: self-reported regular Red Bull
consumption
ACTUAL CASES
TARGET
CASES
4th year UCSF students
Medical students accepted to
who matched in highly
highly selective residencies
selective specialty X
ACTUAL
CONTROLS
TARGET
CONTROLS
th
4
year students
who to
failed
All unsuccessful
applicants
highly
to
match
in
highly
selective
selective residency programs
specialty X
time
Case-control study-minuses
-
Sensitivity, specificity
Positive predictive value, negative predictive value
Measures of association
Disease
Yes
Sensitivity = A/A+C
Yes
No
Test
Specificity = D/B+D
PPV = A/A+B
NPV = D/C+D
No
Study design #3
Cohort studies
Framingham
Nurses Health Study
Physicians Health Study
Olmsted County, Minnesota
The future
Everyone else
time
CARDIA
Framingham
Retrospective cohort
Double cohort
Descriptive
Case report
Case series
Survey
Analytic
Observational
Cross sectional
Case-control
Cohort studies
Experimental
Randomized
controlled trials
Predictor
Outcome
Examples:
sex (men are more likely to drink red bull and men are
more likely to match in neurosurgery)
Undergraduate institution (students from northwest school are
more likely to drink red bull and also more likely to score higher on
USMLE)
Study design # 4
Sample
Treatment
Dx
No Dx
Randomization
Control
Placebo
Dx
No Dx
Steps in a randomized
controlled trial
1.
Select participants
2.
3.
Steps in a randomized
controlled trial
4.
5.
Follow subjects
6.
As important as randomization
Eliminates
co intervention
Measure outcome
What is Blinding?
investigator judgement
participant reported symptoms, scales
Analysis of randomized
controlled trial
Subgroup analysis
Tamper-proof randomization
Blinding of participants, study
staff, lab staff, outcome
ascertainment and adjudication
Adherence to study intervention
and protocol
Complete follow-up
Descriptive
Case report
Case series
Survey
Analytic
Observational
Cross sectional
Case-control
Cohort studies
Experimental
Randomized
controlled trials