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?????(prospective study)?

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(prospective study) (incidence study) (follow-up study) (longitudinal study) – PowerPoint PPT presentation

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Title: ?????(prospective study)?


1
? ? ? ?
?????(prospective study)? ?????(incidence
study)? ????(follow-up study)? ????(longitudinal
study)?
???????????????,?????????????????????????????????
2
??? ? ?
  • ??? ?
  • ??????
  • ??????
  • ??????

3
????
  • ???????
  • ??
  • ????
  • ????
  • ???????
  • ????
  • ????

4
???????
???????????????????????????????????,????????,?????
????????,???????????????????????????????????
5
??
?????????????????(????)???????????(??????????)???(
???)??????????????
6
????
????,??????????(outcome)(???)??,?????????????,????
?????????????????????
7
??(cohort) ?????
1)????(birth cohort) ??????????????? 2)?????????
??????????????????????86???,?????????
8
?????
?????????????,????? 1)????(fixed
cohort)????????????????????????,???????????,?????
??,????????,?????????,????????????????
9
2)????(dynamic population) ????????,?????????????
,?????????????
10
?4-1 ???????I????x??????0??????
1990
2000 ? ????

???? ????
11
??????
?????????????????,??????????????????????????,?????
????????????????,?????????,??????????????,????????
,??????????????????????(??????????????),??????????
,??????????????????
12
?4-2 ??????????
13
?????????
1. ??????????????,????????????,?????????????? 2.
???????????????????,?????????????
14
3. ???????(??????)?????????????,?????????????
?,??????,???????????,????????????? 4.
??????????????
15
??????
1??????? 2??????? ??????????????????????? 3?
???????
16
??????
17
?4-3 ?????????
18
(?)???????
  • ?????(concurrent) ????
  • ???????????????(??)???????????????,??????????,????
    ???????????,????????
  • ?????????,?????
  • ?????????,?????????,???????

19
????????????
1. ?????????,????????? 2. ????????????????,??????
? 3. ?????????,?????????????????
20
  • 4. ?????????,??????,?????????????????
  • 5. ?????????????,????????????????
  • 6. ????????????????,????????????????????????????

21
(?)???(historical)????
????(non-concurrent)???? ?????????????????????????
?????????????????????????????????????,???????????
?,????????,?????????
????????????? ?????????????????,??,?????????
22
?????????????
1.?????????,????????? 2.????????????????,???????
3.?????????,?????????????????
23
  • 4.?????????,??????,?????????????????
  • 5.?????????????,????????????????
  • 6.?????????????????????????????????????????????,??
    ????????????????????????

24
(?)???????
??????? ??????????,???????????,?????????????
????????????????? ?????????,?????????????????
??
25
??? ???????
(????) ???????? ???????? ????????????? ?????? ????
????? ????
26
??? ??????????
  • ????????
  • ????????
  • ?????????????
  • ????????
  • ?????????
  • ??????

27
????????
???????????????????????,??,??????????????????? ???
??????????????????????????????????,???????????,???
??????? ??????????????????????????????????????
?
28
??????????????,?????????????????????
29
????????
????(outcome variable)?????,?????????????????????
????????????,??????????????
30
??????????????????????????????????????????????
??????????,????????????????????
31
?????????????(?)????
????????????????????????????,???????,???????????
???,????????,????????????????
32
(?)????
1???????? 2????????
33
1????????
(1)?????????????????,??????????? (2)????????????
???????????,?A-Bom?????
34
3)???????????????????????????????,???????? (4)???
???????????????????????????????????????????,???
?????
35
2????????????
????????????????,?????????????(?????????????????)?
???????????,???????
36
1.???????????A,?A??E?????,A??E???????(???)??E????
??,?????????????????? ??????????????????????
2.????(???)??????????????????????
37
3.?????????,????????????????????,??????????
??????????? ????????,????,??????????,???????
?????? 4.??(?)?????????????????????????,?????????
??????,?????????
38
????
??????????????????????????????,?????? ????????????
???????,????????,??????????
39
  • ????????????????,?????????,??????????1,?????
    ??????????????1,???????????????????1,???????????

40
????????
(?)????????????? ?? (?)??????????? (?)
???????
41
(?)????????
1. ????????? 2. ?????????????,??????????????????
??????? 3. ???????10,????????????10??????
42
(?)???????????
1.????(????)?????????p0 n?p0q0 ??q01 - p0 ?
p0?0.5,p0q0?Max,n?Min 2.????????????(dp1 - p0)
d??,n???
43
  • 3.????????a?
  • ???a??,n?????a 0.05?0.01?
  • 4.????(power of test)???? 1-ß
  • ??(1-ß)??,ß??,?n?????ß0.10,???0.20?

44
(?)???????
??????????????? ?? ????????????? p
?????????,ql-p, ? ?????????(?)
????? ??????,???10???? ?????????,????????? ?????
????
45
?????????
(?)??????? (?)??
46
(?)??????????????
????(baseline information)??????,????????????????
??,????????????????
47
  • ??????????????????????,???????,????????????
    ???????,???????????????????

48
????????
(1)??????????????????????? (2)?????????????????
(3)????????????????? (4)????????
49
(?) ? ?
1.?????????????/???? 2.????????????????????????
????????????????????????????????????????????????,?
?????????????????????????????????????,???????
50
3.??????????????,???????? 4.????(end-point)????
????????(?????????????),?????????????????,??????,?
?????,????????????,???????,??????
????????????1-2??
51
??????
1.?????? ??????????3040?????? 2.?????
???????,????? 3.??????? ??????????????????????
?? 4.??????
52
????????????
(1)?????????????? (2)???????????????????? (3)???
?????????
53
(4)?????????????? ???? (5)???????????? (6)?
????????????
54
??? ????????? ???
?????????
??????? ??????? ?????? ???????
55
?????????
1)?????,????,??????????????????????????? 2)?????
??????????????????????????????????????? 3)?????
????????,????????????
56
???????
?4-3 ???????????
?? ??? ?? ???
??? a b abn1 a/n1
???? c d cdn0 c/n0
?? acm1 bdm0
abcdt
57
???????
????,?????????,??????????? ?????????? ???
??????3? 1. ??? 2.?????????? 3.?????????
58
1.???
????????????, ????,????,??????
59
2???????????
?????????????????,??????????????????????????? ????
??,???????
60
3??????????
?????????,????????????,???????????,???????????? ??
?????????????????????l/2?????,??????????????l/2??
????
61
??Lx?x?????????,Ix?x??????????,Nx?x??????????,Dx?
x????????????,Wx?x?????????
62
?4-7 ??????????
63
(No Transcript)
64
??????
(?)???? 1??????(cumulative incidence) 2.????
(incidence density) 3.??? (?) ????? 1?U?? 2.?????
?
65
(?)????1.?????(cumulative incidence)
??????????,?????,??????,??????????????,??????????(
???)?????,?????????? ?????????????0l?
66
2.???? (incidence density)
???????????,??/???????,????????? ?????????????????
?,????????????????????????????(??)??
67
??????????????????????????? ???????????,????????
(??)?? ?????????,?????????0?????
68
3.???
?????????,????????????,??????????,????????????
????(??)?????,????????????(??)??(????/????),??????
?????(??)????????????,??????(??)??
69
?????? ?????(standardized mortality
ratio,SMR)????????????? ?????????,?????????(??)??
???????????,??????????
70
SMR??????
71
? ? ??3040?????500?,????2?????,???????3040????
????2,??SMR? ??O2,E50021,SMR2/12?
???3040??????????????????????2??
72
SPMR??????
???????(standardized proportional mortality
ratio) ?????????????????????,????????????,???????
????,??????????????????
73
(?) ?????1?U??
??????????,??????,???????????? ?n??,p?1-p????np?
n(1-p)gt5,???????????????(U???)???????
74
?? p1 ?????,p0 ?????,n1 ???????,n0 ????????,pc
?????,
??X1?X0?????????????????????u??,?u????P?,?????????
??????
75
2.??????
??????,?????,??????????????????
(Poisson)???? ????????????????????? ?SMR?SPMR???
,??????????1???,???????x2???????(score
test),????????????
76
???????
1.?????(relative risk,RR), ??(rate
ratio)?????(risk ratio) 2.?????(attributable
risk,AR),??(rate difference,RD)???????,?????(exces
s risk)
77
3.????????(AR),????(etiologic fraction,EF) 4.????
???(population attributable risk,
PAR) 5.??????????(PAR) 6.?????????(Dose-response
Analysis)
78
?????????
??????????????????,??????????????????????????,????
??RR(relative risk)??????AR (attributable
risk),????????????????
79
1.?????(relative risk)
???????(??)???????????
?? Ie??????(??)? I0???????
80
RR???????????????????????RR???,?????????,????
?????????
81
?4-8 ???????? ???
82
??????95????
??RR95?????????,????Woolf??Miettinen?,?????Woolf?
??? Woolf?????RR??????????????
83
????????RR?95?????
84
2.?????
????????????????????,???????????????????
??
??
85
RR?AR??????
???????????????,??????(???????????,??????????
?),???????????? RR????????????,????????????????
???
86
AR????????,????????????,??????????,????????,?
???????????????????????????????
87
??
88
3.????????
?????????????????????????????????
??4-9???????
????????????90.6??????
89
4.???????
???????(population attributable risk,
PAR)????????????????????????
It?????, I0??????
90
5.??????????
PAR??PAR????????(???)?????
It?????, I0??????
91
??Pe??????????????,??????PAR??????????????????
?
92
RR?AR???????????(??????????) PAR?PAR????????????
?????,????????????????????????,???RR?AR??,????????
????????????????????????????,??,?????AR?AR?PAR?PA
R??????
93
5.?????????
????????????????????????????,?????????????????
??1)????????????? 2)???????????,??
?????????????? 3)???,?????????
94
??? ???????????
????????? ????????? ????????????
95
?????????
1.???? (selection bias) 2.???? (lost to
follow-up)?????????????10,????????????????
96
  • 3.???? (information bias),
  • ????(misclassification bias)????
  • ?????????
  • 4.???? (confounding bias)???????????,???????????,
    ??????????????????????????,???????????????

97
?????????
1.????????????????,?????????????????????????????
????????????????????????????? 2.?????????????????
?????,???????20??????????????,???????????????????
???,????????????????
98
  • 3.????????????????????????????????????????????????
    ????????????????????????????,?????????????????????
    ?????
  • 4.?????????????,?????????????????????????????????
    ????????????????????,???????????

99
????????????
1.????????????????????????????????????????????????
????????,???????????????????????????,?????????????
100
  • 2.????????????,????,???????????????????????????,??
    ??????????????????????????
  • 3.????????????????????,???????????????????????????
    ???????????????????????????????????

101
??? ????????1.??
(1) ?????????? (2)?????RR????????????? (3)???????
???,???????? (4)?????????????? (5)????,???????
102
2.??
(1)????????????????? (2)?????????????? (3)????????
??????????,??????????????
103
  • (4)??????,????????????,?????????????????,?????????
    ?????
  • (5)??????,????????,????????????,?????????,???????
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