流行病学通常被称为公共卫生的“基石”，它是一门研究疾病的分布和决定因素，健康状况，或人群间的活动和应用于控制健康问题的学科。由于流行病学与现实生活息息相关，并更好地评估公共卫生项目和政策，学生将理解流行病学的研究方法，通过这一门课所学到的理论知识应用到当今的公共健康问题。本课程通过流行病学的视框，探讨了心血管疾病和传染病等公共卫生问题，对地区情况和全球情况都进行了讨论。 翻译: Yi Zhou

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来自 The University of North Carolina at Chapel Hill 的课程

流行病学：基础公共卫生科学

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流行病学通常被称为公共卫生的“基石”，它是一门研究疾病的分布和决定因素，健康状况，或人群间的活动和应用于控制健康问题的学科。由于流行病学与现实生活息息相关，并更好地评估公共卫生项目和政策，学生将理解流行病学的研究方法，通过这一门课所学到的理论知识应用到当今的公共健康问题。本课程通过流行病学的视框，探讨了心血管疾病和传染病等公共卫生问题，对地区情况和全球情况都进行了讨论。 翻译: Yi Zhou

从本节课中

Measures of Association

This module introduces measures of association and confidence intervals.

- Dr. Karin YeattsClinical Associate Professor

Department of Epidemiology, UNC Gillings School of Global Public Health - Dr. Lorraine AlexanderClinical Associate Professor, Director of Distance Learning (North Carolina Institute for Public Health)

Department of Epidemiology, UNC Gillings School of Global Public Health

[MUSIC]

Now so far we've covered both the

definition and calculations for Measures of Association.

Next, let's learn how to correctly interpret the measures of association.

Once you've learned these, you might

actually find yourself critiquing news reports

or discussions in the news that

are incorrectly using the measures of association.

After you have reviewed this segment you should be

able to do the items listed in the learning objectives.

These include interpreting the measures of

association, and recognizing which measures of

disease occurrence or frequency, and association

are commonly used with different study designs.

How do I know if an exposure has a positive

or negative effect on the disease that I'm interested in?

Or how do you know if the exposure doesn't have

any effect at all?

Here are the guidelines for relative measures of association i.e.,

ratios.

If the risk rate is equal to one then there

is no association between exposure and the disease or health outcome.

If the risk ratio or rate ratio is greater than one then the risk

in the exposed or rate in the exposed is greater than in the unexposed.

If the risk ratio or rate ratio is

less than one, then the risk in the exposed is lower than the unexposed.

For absolute measures of association, i.e.,

differences, if the risk difference is equal

to zero, then there is no association, i.e.,

the risk is the same in the both groups.

If the risk difference is greater than zero, then the

risk in the exposed is greater than in the unexposed.

And if the risk difference is less than zero, then the risk in the exposed is less

than in the unexposed.

Note that the null value for differences is zero

while for the ratios the null value is one.

Let's preface the topic of which measures of association

are commonly found with different types of study design by

first noting that all the measures of association we

have covered can be estimated in the cohort study design.

However, some of the other study designs

are not able to directly calculate risks and rates as you can in the cohort.

So, here is a table illustrating the measures of association

that can be commonly used for different types of study designs.

Note that prevalence and odds ratios and

differences are more commonly found with cross-sectional and

case-control studies, while risk and rate ratios and

differences are more commonly used with cohort studies.

Risks and rate ratios cannot be directly

calculated from case control and cross sectional studies.

This concludes the segment on interpreting measures of association.