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第四章. 队 列 研 究. (cohort study). 流行病学教研组 流行病与卫生统计学教研室. 流行病学是研究人群中疾病与健康状况的 分布 及其 影响因素 ,并 研究防制疾病及促进健康的策略和措施 的科学。. 流行病学任务的三个阶段 ---- 揭示现象 ---- 找出原因 ---- 提供措施. 横断面调查 监   测 生态学研究. 描述性研究. 产生假设. 观察法. 病例对照研究 队列研究. 分析性研究. 检验假设. 流行病学方法. 临床试验 现场实验 社区干预实验. 实验法. 实验性研究. 验证假设. 理论法. - PowerPoint PPT Presentation

Text of (cohort study)

  • (cohort study)

  • ------------

  • (cohort)

  • Fixed Cohort

  • Dynamic Cohort

  • >

  • exposure

  • exposure

    risk factor

  • exposure

    risk factor

    protective factor

  • (outcome)

  • Yes NoYes No

  • ,,

  • ( hypothesis) (effect of prevention)( natural history of disease)

  • (prospective cohort study) (historical cohort study(ambispective cohort study)

  • Prospective Cohort Study(concurrent)(follow-up)

  • ,5

  • Historical (Retrospective) Cohort Study

  • Mixed (Ambispective) Cohort Study

  • (quality) (quantity)

  • PHCC

  • : ,.:,,. :. :(,)

  • (internal controls): (external controls): (total population controls)(multiple controls) , (,,,).

  • P0P1(D=P1-P0),D,N risk ratio, RR

    1-

  • P1P0

  • p0=0.007RR=2.5=0.05=0.1 Z=1.96 Z=1.282 q0=0.993 p1=p0RR=0.0175q1=0.9825 N=2310 10%2541

  • (base-line)(follow-up)

  • =a/n1=c/n04-3

    aba+b=n1cdc+d=n0a+c=m1b+d=m0a+b+c+d=t

  • 0~1 (cumulative incidence)CI=

  • (incidence density) 0~ ID =

  • person time: () +/2()

  • (standardized mortality ratio SMR) 0~

    _1243184991.unknown

  • SMR=1 =SMR>1 > SMR SMR
  • standardized proportional mortality ratio,SPMR 0~

    _1137741662.unknown

  • U Poisson 2 score test

  • aba+b=n1a/n1cdc+d=n0c/n0a+c=m1b+d=m0a+b+c+d=t

  • Relative Risk RR ERR

  • 10.7 1.7

    170.32

    1.71/10

  • 4-5 RR

  • RR95%CI RR95%CIRR95%CIWoolflnln

  • (Attributable Risk, AR ) E AR ca

  • RR AR

    4-6 RRAR1/10

  • AR%EF RR

  • (population attributable risk, PAR) PAR PAR= ItI0 ItIo

  • PAR% PAR Pe

  • RR(RD)

  • RR

  • selection bias

  • lost to follow-up

  • 10%

  • information bias

  • confounding bias

  • CS2

  • 2060HernbergTolonen5

  • CS2 CS25

  • 1942~196725645CS2(343,) 3343

  • CS2 CS2

  • CS23.571CS22

  • 1

    5%

    RR

    RR95%CI

    343

    14

    4.08

    4.69

    1.34 ~ 16.47

    11

    3.21

    2.74

    0.86 ~ 8.69

    25

    7.29

    3.57

    1.52 ~ 8.37

    343

    3

    0.87

    4

    1.17

    7

    2.04

  • 2 CS2RRAR

    RRAR3.575.254.693.212.742.041.8911.61.46.1

  • 20~30ppmCS2 CS2 1972CS220ppm10ppm

  • Thank you!

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