CLINICAL TYPES OF EPIDEMIOLOGICAL STUDIES

1. Descriptive Studies
These studies describe the frequency and the most important features of a health problem.
Data from these studies are essential for health administrators and for epidemiologists and
clinicians. The first will identify the most vulnerable population groups and allocate
resources according to these needs and the latter are the first step in the investigation of
the determinants of disease and identification of risk factors (5,6).
The main types of descriptive studies are ecological studies, case series studies and crosssectional or prevalence.

1.1.

Ecological studies.

These studies do not use the information of the individual in isolation but use aggregate data for
the entire population. Describe the disease in the population in relation to variables of interest
may be age, service utilization, consumption of food, alcoholic beverages, snuff, income per
capita ... An example of this study would correlate mortality coronary disease in per capita
cigarette consumption. These studies are the first step in many occasions in the investigation of
a possible link between a disease and a given exposure. Its great advantage is that occur very
quickly with virtually no cost and with information that is generally available. For example
demographics and consumption of different products can be correlated with the use of health
services, with records of mortality and cancer registries.
The main limitation of these studies is that they can not determine whether there is an
association between an exposure and a disease at the individual level. The ecological fallacy is
precisely to obtain improper individually conclusions based on population data.
Another major limitation of ecological studies is the inability to control for potential confounding
variables. The association or correlation we find between two variables may be due to a third
variable which in turn is associated with the disease and exposure under study.

1.2.

Cross-sectional studies

Such studies also called prevalence, simultaneously with exposure and disease in a well
defined population at a given time. This simultaneous measurement does not reveal the
temporal sequence of events and is therefore not possible to determine whether exposure
preceded the disease or vice versa.
Conducting such studies requires clearly defined:
The reference population for which you want to extrapolate the results.
The susceptible population to be included in our sample clearly defining which may be
included in the study.
The selection and definition of variables for which will characterize the process.
The measurement scales used.
The definition of "case"
Cross-sectional studies are used primarily to determine the prevalence of a disease or a risk
factor.

This information is useful to assess the health of a community and determine their needs. Also
serve as all descriptive studies to formulate etiological hypotheses.

2. Analytical Studies

2.1.

Case Control

A casecontrol study involves the identification of individuals with (cases) and without
(controls) a particular disease or condition. The prevalence (or level) of exposure to a factor is
then measured in each group. If the prevalence of exposure among cases and controls is
different, it is possible to infer that the exposure may be associated with an increased or
decreased occurrence of the outcome of interest.
Casecontrol studies are particularly suitable for the study of relatively rare diseases with long
induction period, such as cancer. This is because a casecontrol study starts with subjects who
have already developed the condition of interest, so that there is no need to wait for time to
elapse between exposure and the occurrence of disease, as in prospective cohort studies.
Historical cohort studies allow similar savings in time, but can be conducted only in the rare
situations when past records with data on relevant exposures have been kept or when banks of
biological specimens have been properly stored and appropriate laboratory assays are available
for measurement of the exposures of interest.
If the frequency of exposure to the cause is higher in the group of cases of disease than in
controls, we can say that there is an association between cause and effect. The measure of
association which quantifies this association is called "odds ratio" (odds ratio, odds ratio,
prevalence ratio, odds ratio, because of opposition, opposition contrary odds, odds ratio relative
odds ratio) and calculating an estimated:

The major issues to be addressed to make a study of cases and controls are following the case
definition, selection of controls and sources of information on exposure and disease.
It is not the purpose of this paragraph conduct a thorough review of the design of such studies
so summarize by saying that the selection of cases should:
1. Establish clear and explicit definition of the disease and the inclusion criteria.
2. Cases are incidents as prevalent cases:
Change their habits regarding exposure.
Prevalent cases may be survivors of incident cases and survival may be related to
exposure.

The selection of the control group should consider:

1. The function of the control group to estimate the proportion of expected exposure in a group that
does not have the disease.
2. The controls must be representative of the population from which the cases. The cases and
controls should not be understood as two representative groups of two distinct populations, but as
two groups from the same population.

Controls should be comparable to the cases in the sense of having the same probability of
being exposed.