Case control studies in epidemiology

Epidemiologic Case Studies Overview These case studies are interactive exercises developed to teach epidemiologic principles and practices.

Case control studies in epidemiology

Introduction A case-control study is designed to help determine if an exposure is associated with an outcome i. In theory, the case-control study can be described simply.

First, identify Case control studies in epidemiology cases a group known to have the outcome and the controls a group known to be free of the outcome. Then, look back in time to learn which subjects in each group had the exposure scomparing the frequency of the exposure in the case group to the control group.

By definition, a case-control study is always retrospective because it starts with an outcome then traces back to investigate exposures. When the subjects are enrolled in their respective groups, the outcome of each subject is already known by the investigator.

Advantages of Case-Control Studies Case-control studies have specific advantages compared to other study designs. They are comparatively quick, inexpensive, and easy.

They are particularly appropriate for 1 investigating outbreaks, and 2 studying rare diseases or outcomes. An example of 1 would be a study of endophthalmitis following ocular surgery.

When an outbreak is in progress, answers must be obtained quickly. An example of 2 would be a study of risk factors for uveal melanoma, or corneal ulcers.

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Since case-control studies start with people known to have the outcome rather than starting with a population free of disease and waiting to see who develops it it is possible to enroll a sufficient number of patients with a rare disease. The practical value of producing rapid results or investigating rare outcomes may outweigh the limitations of case-control studies.

Because of their efficiency, they may also be ideal for preliminary investigation of a suspected risk factor for a common condition; conclusions may be used to justify a more costly and time-consuming longitudinal study later. Cases Consider a situation in which a large number of cases of post-operative endophthalmitis have occurred in a few weeks.

The case group would consist of all those patients at the hospital who developed post-operative endophthalmitis during a pre-defined period. The definition of a case needs to be very specific: Within what period of time after operation will the development of endophthalmitis qualify as a case — one day, one week, or one month?

Will endophthalmitis have to be proven microbiologically, or will a clinical diagnosis be acceptable? Clinical criteria must be identified in great detail.

If microbiologic facilities are available, how will patients who have negative cultures be classified? How will sterile inflammation be differentiated from endophthalmitis? Controls Controls should be chosen who are similar in many ways to the cases. The selected control group must be at similar risk of developing the outcome; it would not be appropriate to compare a group of controls who had traumatic corneal lacerations with cases who underwent elective intraocular surgery.

In our example, controls could be defined as patients who underwent elective intraocular surgery during the same period of time. Matching Cases and Controls Although controls must be like the cases in many ways, it is possible to over-match.

Over-matching can make it difficult to find enough controls. Also, once a matching variable has been selected, it is not possible to analyse it as a risk factor. Matching for type of intraocular surgery e. An important technique for adding power to a study is to enroll more than one control for every case.

For statistical reasons, however, there is little gained by including more than two controls per case. Collecting Data After clearly defining cases and controls, decide on data to be collected; the same data must be collected in the same way from both groups. Care must be taken to be objective in the search for past risk factors, especially since the outcome is already known, or the study may suffer from researcher bias.

Although it may not always be possible, it is important to try to mask the outcome from the person who is collecting risk factor information or interviewing patients.

Case control studies in epidemiology

Sometimes it will be necessary to interview patients about potential factors such as history of smoking, diet, use of traditional eye medicines, etc. It may be difficult for some people to recall all these details accurately. Furthermore, patients who have the outcome cases are likely to scrutinize the past, remembering details of negative exposures more clearly than controls.

This is known as recall bias. Anything the researcher can do to minimize this type of bias will strengthen the study. Analysis; Odds Ratios and Confidence Intervals In the analysis stage, calculate the frequency of each of the measured variables in each of the two groups. As a measure of the strength of the association between an exposure and the outcome, case-control studies yield the odds ratio.

An odds ratio is the ratio of the odds of an exposure in the case group to the odds of an exposure in the control group.Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands, 2 Faculty of Epidemiology and Population Health, Case–control studies can also be conducted within a cohort; in this situation, control subjects can be sampled in three different ways.

ERIC at the UNC CH Department of Epidemiology Medical Center Case-Control Studies E R I C N O T E B O O K S E R I E S Case-control studies are used to determine if there is an association. Case Control Studies in CVD Epidemiology As Oppenheimer has discussed in his historical background of CVD epidemiology, the field emerged with almost exclusive use of prospective designs for observational studies of risk, in contrast to the case-control approach that dominated the origins of cancer epidemiology (Oppenheimer ).

Case Control Studies in CVD Epidemiology. As Oppenheimer has discussed in his historical background of CVD epidemiology, the field emerged with almost exclusive use of prospective designs for observational studies of risk, in contrast to the case-control approach that dominated the origins of cancer epidemiology (Oppenheimer ).

Case–control studies are one of the fundamental designs utilized in epidemiologic studies Case-control study. Case-control studies start with the outcome of interest, for example, a disease, and then look backward in time to detect possible causes or risk factors for that disease.

Case–control study - Wikipedia Introduction to study designs - case-control studies Introduction Learning objectives:
Search form Share Case Control Studies in CVD Epidemiology As Oppenheimer has discussed in his historical background of CVD epidemiology, the field emerged with almost exclusive use of prospective designs for observational studies of risk, in contrast to the case-control approach that dominated the origins of cancer epidemiology Oppenheimer Among many influences on this simple truth were the greater frequency of coronary than cancer events, along with the unreliability of coronary diagnoses and the easier comprehension of the cohort approach by the predominantly amateur investigators in CVD epidemiology.
Epidemiology in Practice: Case-Control Studies Fundamentals in Epidemiology Course Description Fundamentals of Epidemiology introduces the basic concepts of epidemiology and biostatistics as applied to public health problems.
Epidemiologic Case Studies | CDC Case-control and cross sectional studies Chapter 8. Case-control and cross sectional studies More chapters in Epidemiology for the uninitiated Case-control studies As discussed in the previous chapter, one of the drawbacks of using a longitudinal approach to investigate the causes of disease with low incidence is that large and lengthy studies may be required to give adequate statistical power.
Case-control study | epidemiology | timberdesignmag.com Definition[ edit ] The case—control is a type of epidemiological observational study.

Case-control studies cannot provide any information about the incidence or prevalence of a disease because no measurements are made in a population based sample. Risk Factors and Sampling Another use for case-control studies is investigating risk factors for a rare disease, such as uveal melanoma.

Case Control Studies in CVD Epidemiology « Heart Attack Prevention