现场流行病学的基石病例定义培训课件.PPTVIP

病例的错误分类可导致流行病学分析偏差Misclassified cases can bias epidemiologic analysis 暴露 Exposed 病例 Cases 非病例 Not Cases 合计 Total 真实 True 相似疾病Similar disease 小计 Total 是 Yes 80 20 100 900 1000 否 No 20 20 40 960 1000 合计Total 100 40 140 1860 2000 暴露组发病率 Rate in exposed 10% 未暴露组发病率 Rate in unexposed 4% 相对危险 Risk ratio（RR） 2.5 危险差异 Risk difference 6% 完美的病例分类则可给出不同的率Perfect classification gives different rates 暴露 Exposed 病例Cases 非病例 Not Cases 合计 Total 真实病例 True 相似疾病Similar disease 合计 Total 是 Yes 80 0 80 920 1000 否 No 20 0 20 980 1000 合计Total 100 0 100 1900 2000 暴露组发病率 Rate in exposed 8% 10% 未暴露组发病率 Rate in unexposed 2% 4% 相对危险度 Risk ratio（RR） 4.0 2.5 危险差异 Risk difference 6% 6% 在消灭某种疾病X的过程中与其相似疾病的发病率等于10During elimination of disease X the incidence of similar disease = 10 相似疾病 Similar disease 疾病X Disease X 监测到的疾病总数 Total disease detected 在消灭某种疾病X的过程中与其相似疾病的发病率等于1During elimination of disease X the incidence of similar disease = 1 监测到的病例总数 Total disease detected 疾病X Disease X 相似疾病 Similar disease 什么是病例定义? What is a case definition? 一套标准 A set of standard criteria 用于确定是否感染 Used to decide if a person has an infection 保证卫生统计结果是真实可信的 Assures that differences in health statistics are real 根据目的不同而不同 Varies with the purpose 不同专家会对同一（群）病人进行相同分类吗？Will experts classify the same patients the same? 10位专家会诊100位病人 10 experts review 100 patients 每位专家均将他们划分为某病病人或非病人 Each expert classifies them as a case or not a case of a disease X 每位专家会按同样方法对每位病人进行分类吗？Will every expert classify every patient the same way? Case or not a case? 是否可能存在完美专家？Will one expert be perfect? 假设一位专家审阅100位病人的诊疗记录 One expert reviews 100 patient records. 他将如何判定病人与非病人？ A case or not a case of a disease X? 一个月后同一专家重新审阅上述100位病人的诊疗记录又将如何？ One month later the expert reviews the same 100 records. 不同专家将会用同一方法或标准判定每位病人？Will every expert classify every patient the same way? Case