流行病学EPIEMIOLOGY.pptVIP

流 行 病 学EPIDEMIOLOGY 第五章 队列研究 Chapter Five Cohort Study 卢智泉 预防医学教研室 2006.03.08 第五章 队列研究Chapter Five Cohort Study 队列研究 Cohort study 亦称前瞻性研究prospective study，与病例对照研究方法同属分析性流行病学研究中两种重要的方法，广泛地用来探索疾病的危险因素，检验病因假设。使用这种方法可以直接观察人群暴露于病因的情况及其结局，从而确定危险因素与疾病的关系，在验证假设上是一种介于病例对照研究与人群试验之间的一种研究方法。本研究方法可在描述性流行病学工作基础上，初步形成病因假设之后，或经病例对照研究初步检验了病因假设之后，再进一步确证该假设的正确性。 第一节 概述 Section One Introduction 一、基本概念 Basic principle A study design in which a population cohort is prospectively defined and divided according to the presence or absence of an exposure variable of interest and then followed over time for the occurrence of prespecified outcomes. A type of study in which investigators begin with a group of subjects without the disease of interest (eg, lung cancer), classify them according to their exposure status (eg, people who smoke a pack of cigarettes a day compared with people who do not smoke), then monitor them over time for subsequent disease development; this is also called a follow-up study. 第一节 概述 Section One Introduction 所谓队列是指具有共同经历，共同暴露于某一种因素或共同具有某一特征的人群。队列研究是将特定的人群按其暴露于某因素的有无，或按暴露水平的不同分为几个群组或队列，追踪观察其将来两组人群某病的结局（发病或死亡），比较两组或各组的发病率或死亡率的差异，以检验暴露因素于某病有无因果联系及联系强度大小的一种观察性研究方法。队列研究方法的基本模式见图5-1。 第一节 概述 Section One Introduction In a cohort study, a group exposed to a particular factor and another group not exposed to this factor is followed up over time to determine occurrence of disease. The incidence of disease in the exposed group is compared to the incidence of disease in the unexposed group. This is called the relative risk and it allows us to make a judgment on whether the exposure factor and the disease are causally linked. If the disease has a long latent period eg. cancer, individuals have to be followed up for many years at a substantial cost and some may be lost to follow up because of migration, death or drop-outs. 第一节 概述 Section One Introduction 第一节 概述 Section One Introduction 第一节 概述 Sect