《观察性研究方法设计及实例》.pptVIP

观察性研究方法设计及实例 余运贤 浙大医学院流行病学与统计学学科 TelEmail：yunxianyu@zju.edu.cn Induced First-Trimester Abortionand Risk of Mental Disorder Author: Munk-Olsen T, Laursen TM, Pedersen CB, Lidegaard ?, Mortensen PB. Journal: N Engl J Med. 2011;364(4):332-9. Published date: 2011 Jan 27 背景和目的 Background： Concern has been expressed about potential harm to women’s mental health in association with having an induced abortion (人工流产), but it remains unclear whether induced abortion is associated with an increased risk of subsequent psychiatric problems Aim: Assess the risk of a first psychiatric contact (精神症状) after first-trimester induced abortion, as compared with before the event; we also looked at the risk of a first psychiatric contact after, as compared with before, childbirth(分娩). 研究设计(1) Study Population Data from the Danish Civil Registration System (CRS), which holds information on all Danish residents, was used to establish an underlying study population of all girls and women born in Denmark between 1962 and 1993 who were alive on their 15th birthday, for a total of 954,702 girls and women. The CRS was established in 1968, when data were recorded for all people alive and residing in Denmark. Among other variables, it includes each resident’s personal identification number (CRS number), which is assigned to all Danes(丹麦人) at birth or immigration, sex, date of birth, parents’ CRS numbers, and daily updated information on vital status. 研究设计(2) Mental Disorders The Danish Psychiatric Central Register covers information on mental disorders in the girls and women in our study population and their parents. There are no private psychiatric hospitals in Denmark, and the register contains information of inpatient psychiatric contact (ICD-8) from 1969 and information about outpatient psychiatric contact(icd-10)from 1995. The girls and women in the study population, as well as their parents, were classified as having a mental disorder if they had records of inpatient or