METHODS OF EPIDEMIOLOGY

PRESENTED BY
S. Alice sylviya,
M.Sc. (N) I year,
College Of Nursing,
SRIPMS.
 DEFINITION

“The study of the occurrence and distribution of health

related events, states and processes in specified population,
including the study of the determinants influencing such
processes and the application of this knowledge to control
relevant health problems.”
 DESCRIPTIVE EPIDEMIOLOGY

 Study of frequency and distribution of disease and health

related events in a population in terms of person, place and
time.
PROCEDURE OF DESCRIPTIVE
EPIDEMIOLOGY
1. Defining population to be studied
2. Defining disease under study
3. Describing the disease
4. Measurement of disease
5. Comparing with known indices
6. Formulation of etiological hypothesis
1. DEFINING POPULATION TO BE
STUDIED
2. DEFINING DISEASE UNDER STUDY

 The epidemiologist looks out for an operational definition,

a definition by which disease can be identified and
measured in the population with accuracy.
3. DESCRIBING THE DISEASE

 Time distribution
 Place distribution
 Person distribution
Time distribution
Seasonal trend
Cyclic trend

 Fluctuations over short period of time during course of

day, week, months/ years.
 Eg. Influenza pandemic occurs at an interval of 7 to 10
years due to antigenic variation.
Secular trend

LUNG CANCER
60

50

40

30

20

10

0
1980 1990 2000 2010 2020

Series 1 Column2 Column1

Place distribution
 The second line of investigation is study of geographic
distribution of cases and causes of disease.
 Spot maps are used to represent high and low prevalence
and the boundaries.
Person distribution
4. MEASUREMENT OF DISEASE
 Cross sectional studies:
It is based on single examination of cross section of
population at one point of time. E.g., Study of hypertension in a
given population.
 Longitudinal studies:
Observations are repeated in same population over prolonged
period of time by means of follow up.
5. COMPARING WITH KNOWN INDICES

 The essence of epidemiology is to make comparison and

ask questions.
6. FORMULATION OF HYPOTHESIS

An epidemiological hypothesis must have:

 The population
 Specific cause
 Expected outcome
 Dose response relationship
 Time response relationship
EXAMPLE:
“Smoking of 30-40 cigarettes per day causes lung cancer in
10% of smokers after 20 years of exposure”
 ANALYTICAL EPEDMIOLOGY

 In analytical study, the subject of interest is the individual

within the population.
 There are two types:
1. Case control study
2. Cohort study
 COHORT STUDY

 “Cohort” refers to specific group of people who share a

common characteristic.
 Basic approach is “cause to effect”
 Exposure has occurred, disease has not occurred.
 TYPES OF COHORT STUDIES

 Prospective cohort studies:

 Outcome has not yet occurred at the time of investigation.
Eg., Cigarrete smoking (study group) and group of people
in the same age group but not exposed to risk factors
(Control group)
 Retrospective cohort studies:
 Here, the disease has already occurred. It is also called as
“historical cohort study”
 Investigator goes back in time 10-30 years and identifies
cases from existing record to be included in study group.
 Eg. Study of lung cancer in uranium miners.
 Combination of prospective and retrospective studies.
 ELEMENTS OF COHORT STUDY

OBTAINING SELECTION OF
SELECTION OF FOLLOW
DATA ON COMPARISON ANALYSIS
STUDY SUBJECTS UP
EXPOSURE GROUPS
 ANALYSIS

 Incidence rate
=
Relative risk
=
 DEFINE EPIDEMIOLOGY
 LIST DOWN ANY FOUR USES OF
EPIDEMIOLOGY
 HOW WILL YOU DESCRIBE THE DISEASE IN
DESCRIPTIVE EPIDEMIOLOGY?
WHICH OF THE FOLLOWING IS THE CORRECT
ORDER OF STEPS IN CASE CONTROL STUDY?

A. Matching Selection of cases and controls measurement of

exposure analysis and interpretation.
B. Measurement of exposure Selection of cases and controls
Matching analysis and interpretation.
C. Selection of cases and controls Matching measurement of
exposure analysis and interpretation.
D. Selection of cases and controls measurement of exposure
Matching analysis and interpretation.
What are the types of experimental epidemiology?