实习3病例对照研究.docVIP

实习3 病例对照研究 【目的】通过课题资料分析, 掌握病例对照研究的基本原理，病例对照研究常用指标的计算及资料基本整理分析方法。 【时间】6～9学时。 【内容】 第一部分 病例对照研究的基本原理 【课题一】 1、Background Many countries, especially industrialized countries, reported the annual mortality rate of lung cancer increased year by year since the 1920s. The mortality rate were 1.1/100,000 for male and 0.6/100,000 for female from 1901 to 1920, it increased to 10.6/100,000 for male and 2.5/100,000 for female from 1936-1939. It was raised that the smoking, air pollution and other risk factors were the cause of lung cancer, but it was also pointed out that the increasing lung cancer death rate is due to human longevity, aging of population and/or the improvement of diagnostic methods for lung cancer and so on, the latter resulted in the elevation of detection rate and the level of diagnosis for lung cancer. Question 1：To determine the relationship between lung cancer and smoking, what kind of epidemiological study should be performed? How to test the hyposis using the method? How to exclude other factors? 2、Study method Aim at the above-mentioned problems, Doll and Hill studied the relationship between smoking and lung cancer using epidemiological methods. They collected inpatients of lung cancer from 20 hospitals in and around London (added some hospital in other cities later) as investigation subjects from April 1948 to February 1952, interviewers surveyed all the new patients of lung, stomach and colon cancer in those hospitals during those four years. Each survey case of lung cancer matched one case of other cancer who hospitalized over the same period as control. A concise questionnaire was developed to study the cause of the disease. Both case and control were surveyed the informations of past and present in detail, filled the uniform questionnaire with the exactly same items (Table 1). Surveys were carried out by investigators with four-year investigation experience and the investigation of control should be detailed and precise as same as case. Questio