Clinical Epidemiology.pptx

Clinical prediction models

1. Clinical Epidemiology Dr Vinodh Kumar O.R Senior Scientist Division of Epidemiology

2. Introduction Clinical epidemiology is a subfield of epidemiology specifically focused on issues relevant to clinical medicine. The term was first introduced by John R. Paul in his presidential address to the American Society for Clinical Investigation in 1938. Clinical epidemiology can be defined as the investigation and control of the distribution and determinants of disease (Stephenson & Babiker , 2000). J. M. Last - Oxymoron

3. Introduction The term clinical epidemiology is derived from its two parent disciplines: clinical medicine and epidemiology . “ Clinical “ - because it seeks to answer clinical questions and to guide clinical decision making with the best available evidence. “ Epidemiologic “ - because many of the methods used to answer these questions have been developed by epidemiologists and because the care of individual patients is seen in the context of the larger population of which the patient is a member.

4. It  is the study of the determinants and effects of clinical  decisions. It is the science of making predictions about individual patients by counting clinical events in similar patients , using strong scientific methods for studies of groups of patients to ensure that the predictions are accurate . Used as an aid to clinical decision making. Lead to valid conclusions by avoiding being misled by systematic error (bias) and chance.

5. Purpose To develop and apply methods of clinical observation that will lead to valid conclusions by avoiding being misled by systematic error and chance. To foster methods of clinical observation and interpretation that lead to valid conclusions.

6. ELEMENTS OF CLINICAL EPIDEMIOLOGY In most clinical situations the diagnosis, prognosis, and results of treatment are uncertain for individual patients and, therefore', must be expressed as probabilities. Probability for an individual patient is best estimated by referring to past experience with groups of similar patients. Because clinical observations are made on people who are free to do as they please and by clinicians with variable skills and biases, the observations may be affected by systematic errors that can cause misleading conclusions. All observations, including clinical ones, are also influenced by the play of chance. To avoid being mislead, clinicians should rely on observations that are based on sound scientific principles, including ways to reduce bias and estimate the role of chance.

7. Questions addressed by clinical epidemiology

8. Methods of clinical epidemiology Formulate question (hypothesis). Choose study design. Choose study population and sample. Collect and analyze data. Interpret results.