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1、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、BackgroundManycountries,especiallyindustrializedcountries,reportedtheannualmortalityrateoflungcancerincreasedyearbyyearsincethe1920s.Themortalityratewere1.1/100,000formaleand0.6
2、/100,000forfemalefrom1901to1920,itincreasedto10.6/100,000formaleand2.5/100,000forfemalefrom1936-1939.Itwasraisedthatthesmoking,airpollutionandotherriskfactorswerethecauseoflungcancer,butitwasalsopointedoutthattheincreasinglungcancerdeathrateisduetohumanlongevity,agingofpopu
3、lationand/ortheimprovementofdiagnosticmethodsforlungcancerandsoon,thelatterresultedintheelevationofdetectionrateandthelevelofdiagnosisforlungcancer.Question1:Todeterminetherelationshipbetweenlungcancerandsmoking,whatkindofepidemiologicalstudyshouldbeperformed?Howtotestthehy
4、posisusingthemethod?Howtoexcludeotherfactors?2、StudymethodAimattheabove-mentionedproblems,DollandHillstudiedtherelationshipbetweensmokingandlungcancerusingepidemiologicalmethods.Theycollectedinpatientsoflungcancerfrom20hospitalsinandaroundLondon(addedsomehospitalinotherciti
5、eslater)asinvestigationsubjectsfromApril1948toFebruary1952,interviewerssurveyedallthenewpatientsoflung,stomachandcoloncancerinthosehospitalsduringthosefouryears.Eachsurveycaseoflungcancermatchedonecaseofothercancerwhohospitalizedoverthesameperiodascontrol.Aconcisequestionna
6、irewasdevelopedtostudythecauseofthedisease.Bothcaseandcontrolweresurveyedtheinformationsofpastandpresentindetail,filledtheuniformquestionnairewiththeexactlysameitems(Table1).Surveyswerecarriedoutbyinvestigatorswithfour-yearinvestigationexperienceandtheinvestigationofcontrol
7、shouldbedetailedandpreciseassameascase.Question2:Whydidtheyinvestigatethegastricandcolorectalcancerpatientsofduringthesameperiod?Questions3:Canthesubjectsrepresentthetargetpopulationwhentheyweresampledfrominpatientsoflungcancer?Howtomakeitcertainthatcontrolgroupwascomparabl
8、etolungcancergroupwhenweselectedthemamonginpatients?表1吸烟与肺癌关系调查表病例对照编号姓名________性别