SO SNH CC THIT K NGHIN CU COHORT, BNH CHNG V TH NGHIM LM SNG

L Tn Phng* nh ngha, c im, cch thit k, nhng mt mnh v yu ca tng thit k c cp chi tit trong cc sch gio khoa kinh in. Bi ny ch gii thiu (thng qua bng v s ) nhng s khc nhau c bn gia 3 loi thit k nghin cu nhng ngi quan tm n nghin cu c ci nhn khi qut, phn bit c 3 loi thit k nghin cu ny. Ni dung Cohort Bnh chng (Case-control) Th nghim lm sng ngu nhin (RCT)

Mc ch

Tm hiu (cc) bnh c th c trong qun th khi tip xc vi 1 yu t nguy c no Qun th xc nh (defined poluation)

Tm hiu (cc) yu Tm hiu hiu qu ca t nguy c lin quan 1 can thip (bin php n 1 bnh no iu tr) i vi 1 bnh no . - Nhm c bnh - Nhm khng c bnh - C tip xc vi yu t nguy c - Khng tip xc vi yu t nguy c Ghp cp Qun th cn nghin cu (Study population) - Nhm c can thip - Nhm khng can thip

Bt u xy dng thit k vi... Xc nh nhm

- C tip xc vi yu t nguy c - Khng tip xc vi yu t nguy c Khng ngu nhin

Cch chn i tng trong nhm Xc nh yu t nguy c (can thip)

Ngu nhin

Ch c 1 yu t nguy c cn nghin cu

C th xc nh Ch c 1 yu t can cng lc nhiu yu thip t nguy c lin quan n bnh ang nghin cu Ch c th nghin cu trn 1 bnh Ch c 1 bnh c nghin cu

Bnh

C th nghin cu cng lc nhiu bnh khc nhau i vi 1 yu t nguy c C tip xc v khng tip xc

So snh gia cc nhm...

C bnh v khng c bnh

C can thip v khng c can thip

MD, MPH, PhD Candidate, S Y t Khnh Ha, Queensland University of Technology, Australia. Email: letanphung@yahoo.com

Ni dung

Cohort

Bnh chng (Case-control) - T l phi nhim tip xc vi yu t nguy c gia nhm c bnh v khng c bnh - T sut chnh (Odds Ratio: OR)

Th nghim lm sng ngu nhin (RCT) Nhiu, ty theo mc ch nghin cu. C th l: - Nguy c tng i (RR) - Hiu qu (Efficacy) - Phn tch sng cn (survival analysis) - S bnh nhn cn c iu tr (Number of patients need to be treated: NNT)

Phn tch thng k

- T l hin mc (Incidence Rate) gia nhm c tip xc v khng tip xc - Nguy c tng i (Risk Ratio: RR) hoc t sut chnh (OR)

Ci thin

C can thip

Chn
Qun th cn nghin cu

Khng ci thin Ci thin

ngu nhin
Khng can thip
Khng ci thin

Hnh 1: Thit k nghin cu th nghim lm sng ngu nhin (RCT)

Mc bnh

Khng
Qun th xc nh

C tip xc
Khng mc bnh Mc bnh

chn ngu
Khng tip xc

nhin
Khng mc bnh

Hnh 2: Thit k nghin cu cohort

C tip xc C bnh Khng tip xc

C tip xc Khng c bnh Khng tip xc

Hnh 3: Thit k nghin cu bnh chng (case-control)

Bt u vi 2 nhm

Ri theo di xem Mc bnh

C tip xc Khng mc bnh v Mc bnh Khng tip xc Khng mc bnh

Hnh 4: Tin trnh nghin cu theo thit k cohort

Bt u vi 2 nhm

Ri theo di xem tip xc

C bnh Khng tip xc v tip xc Khng c bnh Khng tip xc

Hnh 5: Tin trnh nghin cu theo thit k bnh chng (case-control)

TI LIU THAM KHO Gordis, L. (2009). Epidemiology (Fouth ed.). Philadelphia: Saunders/Elsevier.