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Clinical epidemiology aims at preventing, detecting and treating diseases in an efficient manner. John R Paul coined the term “clinical epidemiology” about fifty years ago. Clinical epidemiology focuses on medicines to improve health, especially in the present world, when individuals are encouraged to take care of their own health. Here, a population is chosen to study the health related phenomena of different diseases. For full information: https://bit.ly/2SjwDKX Reference: https://pubrica.com/services/research-services/ Why pubrica? When you order our services, we promise you the following – Plagiarism free, always on Time, outstanding customer support, written to Standard, Unlimited Revisions support and High-quality Subject Matter Experts. Contact us : Web: https://pubrica.com/ Blog: https://pubrica.com/academy/ Email: sales@pubrica.com WhatsApp : +91 9884350006 United Kingdom: +44- 74248 10299
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Copyright © 2020 pubrica. All rights reserved 1
Clinical Epidemiology and Clinical Research
Dr. Nancy Agens, Head,
Technical Operations, Pubrica
sales@pubrica.com
In Brief
Clinical epidemiology aims at preventing,
detecting and treating diseases in an
efficient manner. John R Paul coined the
term “clinical epidemiology” about fifty
years ago. Clinical epidemiology focuses
on medicines to improve health,
especially in the present world, when
individuals are encouraged to take care
of their own health. Here, a population is
chosen to study the health related
phenomena of different diseases. Either a
patient population could be chosen or
some other community based population
can also be considered which has the
conventional numerator and denominator
values of an epidemiological
study(Ehrenstein et al., 2017).
The image given below illustrates what is
done in clinical epidemiology:
Fig 1. Distribution and
Determinants of Diseases in Human Population
The distribution and determinants of
diseases in human population is
investigated in these studies and clinical
epidemiology serves as the right tool in
this respect. However, clinical
epidemiology cannot be considered as an
independent science because several skill
sets are required in this field such as
biostatistics, health social science and
clinical economics. A gold standard testing
procedure is used in clinical epidemiology.
Results are the strength of relationship
between two events which are measured
through ratios, rates and proportion tests in
clinical epidemiology. This relationship
data is presented in a table wherein the
number of false positive and true positive
diagnostic test results is visualized. This
Copyright © 2020 pubrica. All rights reserved 2
table also gives an idea about the number
of patients actually having and not having
this disease(Huang et al., 2020).
Fig 2. False Positive and True Positive Diagnostic Test Results
Fig 3. Illustrating Clinical Epidemiology Study Results of Patients Suffering from Covid-19
in Wuhan, China
Copyright © 2020 pubrica. All rights reserved 4
Given below are a few figures illustrating
clinical epidemiology study results of
patients suffering from Covid-19 in
Wuhan, China. The graphs depict their
clinical features.
Clinical epidemiology studies three
kinds of diseases:
a. Endemic disease - it affects the
population at a relatively constant and
expected rate within a specific region.
The spread of pathogens and vectors,
which are the reservoirs of disease is
the main cause of an endemic disease.
Geographical features, climate
changes, poor living conditions such as
dull houses, improper sewage systems
and hazardous work conditions are
other responsible factors for an
endemic disease. Example includes
Malaria in Africa.
b. Epidemic disease -the population is
affected at an unusually fast or
unexpected rate.It occurs due to the
increase in infectivity of a pathogen,
poor living conditions such as crowded
areas and improper sanitation systems,
spreading and introduction of the
pathogen in a new geographical
condition. Example includes Ebola
fever in West Africa.
c. Pandemic - it is defined as a worldwide
epidemic, the reasons being global
trade and worldwide travelling and the
increased infectivity of pathogens due
to antigenic shift and gene mutations.
Example includes Covid-19.
Clinical epidemiology calls in for
clinical research, so that the population
affected in the epidemic get the required
treatments to eradicate the disease as fast
as possible(Adhikari et al., 2020).
Clinical research is defined as “a
careful study and an investigation in order
to discover new facts and information”.
Unbiased, reliable and valid measurements
are required to carry out a clinical research
programme. Clinical research addresses a
specific question in an organized and
objective manner(Magnin et al., 2019).
The different types of clinical researches
are described below.
1. Treatment research : It involves an
intervention such as medication,
psychotherapy, new devices, new
approaches to surgery and radiation
therapy
2. Prevention research: Finds out better
ways to prevent the development or the
return of diseases. Medicines,
vitamins, vaccines, minerals and
lifestyle changes are usually studied
here.
3. Diagnostic research: This refers to the
practice to look out for better ways for
the identification of a particular
disorder or condition
4. Screening research: It aims to find the
best possible ways for the detection of
particular disorders or typical health
conditions
5. Quality of life research: This explores
ways to improve comfort levels and the
quality of life for individuals suffering
from a chronic illness
6. Genetic studies: These studies aim to
improve the prediction of disorders
through identification and
understanding of the relationship
between genes and ill health. The
different ways in which genes of an
individual is more likely to develop a
disorder is explored in this research
domain. This in turn leads to the
development of tailor-made treatments
which are based on a person’s genetic
make-up
7. Epidemiological studies:They seek to
identify the patterns, causes and
control of disorders in different groups
of people. “Outpatient” clinical
research requires that participants do
not stay overnight at the treatment
centre. “Inpatient” clinical research
requires the participants to stay for at
least one night in the hospital or
research centre.
Given below is an illustration of
clinical research study results on the
causes, clinical manifestation,
Copyright © 2020 pubrica. All rights reserved 4
epidemiology, control and prevention of
Covid-19 at the outbreak of the
disease(Magnin et al., 2019):
Figure 4: Illustration of Clinical Research
Study Results
Clinical research involves conducting of
clinical trials. These are done in four
phases:
Phase I: An experimental drug or
treatment is tested in a small group
(about 20-80) of people for the first
time. The safetyof treatment is
determined by the researchers and they
suggest a safe dosage range of the
drug, with the identificationof side
effects
Phase II :The experimental drug or
treatment is given to a larger group
(about 100-300) of people to see if it is
effective and to further evaluate its
safety
Phase III:The experimental drug or
treatment is given to large groups
(about 1000 -3000) of people. The
effectiveness is confirmed, side effects
are monitored, and these are compared
to commonly used treatments.
Information is collected that
allowssafe use ofthe experimental drug
or treatment
Phase IV: Post marketing studies are
conducted after a treatmentis
FDAapproved.It provides additional
information about the risks, benefits
and best usage of the drug or treatment.
CONCLUSION
The factors considered in a clinical
research studyinclude age, gender,
underlying disease and health history.
Clinical trials are carried out in hospitals,
clinics, individual physician’s chambers,
university health centres and community
health centres, and patient privacy is
essentially maintained during any clinical
trial.
Copyright © 2020 pubrica. All rights reserved 5
REFERENCES
[1] Adhikari, S.P., Meng, S., Wu, Y.-J., Mao, Y.-P., Ye,
R.-X., Wang, Q.-Z., Sun, C., Sylvia, S., Rozelle,
S., Raat, H. & Zhou, H. (2020). Epidemiology,
causes, clinical manifestation and diagnosis,
prevention and control of coronavirus disease
(COVID-19) during the early outbreak period: a
scoping review. Infectious Diseases of Poverty.
[Online]. 9 (1). pp. 29. Available from:
https://idpjournal.biomedcentral.com/articles/10.1
186/s40249-020-00646-x.
[2] Ehrenstein, V., Nielsen, H., Pedersen, A.B., Johnsen,
S.P. & Pedersen, L. (2017). Clinical epidemiology
in the era of big data: new opportunities, familiar
challenges. Clinical Epidemiology. [Online].
Volume 9. pp. 245–250. Available from:
https://www.dovepress.com/clinical-
epidemiology-in-the-era-of-big-data-new-
opportunities-familia-peer-reviewed-article-CLEP.
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Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z.,
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Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J.,
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[4] Magnin, A., Iversen, V.C., Calvo, G., Čečetková, B.,
Dale, O., Demlova, R., Blasko, G., Keane, F.,
Kovacs, G.L., Levy-Marchal, C., Monteiro, E.C.,
Palmisano, L., Pella, D., Portolés Pérez, A.,
Rascol, O., Schmid, C., Tay, F., von der Leyen, H.
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1186/s13063-019-3702-z.
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