文档介绍：实验流行病学
Experimental Epidemiology
第五章
广东药学院
姚振江
学习目的
实验流行病学的定义
实验流行病学的特点
实验流行病学的分类
实验流行病学的设计
实验流行病学的强势与弱势
推荐参考文献
吴涛, 詹思延, 李立明. 流行病学实验研究发展历史. 中华流行病学杂志 2004; 25(7): 633-636.
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第五章
实验流行病学研究
(experimental study)
历史
发展
1747年
苏格兰医师James Lind首次对比研究了用桔子、柠檬及其他干预治疗坏血病的疗效
5
第五章
实验流行病学研究
On May 20, 1747
he is ready to begin the first clinical nutrition experiment.
group 1 drank one quart of cider a day
group 2 gargled with sulfuric acid
group 3 had two spoonfuls of vinegar, 3 times a day
group 4 drank 1/2-pint seawater a day
group 5 drank barley water
group 6 ate two oranges and 1 lemon a day
How did he conduct his experiment?
What happened?
Only sailors who ate the oranges and lemon felt better. In fact, in only six days they felt great and were able to start working again. The other sailors in the experiment felt worse.
1816年
法国Hamilton医师首次报道了爱丁堡的一项大型对照实验,评价放血疗法的效果,这是迄今为止有关采用交替法产生对照的最早记载之一。
‘It had been so arranged, that this number was admitted, alternately, in such a manner that each of us had one third of the whole. The sick were indiscriminately received, and were attended as nearly as possible with the same care and modated with the forts. One third of the whole were soldiers of the 61st Regiment, the remainder of my own (the 42nd) Regiment. Neither Mr Anderson nor I ever once employed the lancet. He lost two, I four cases; whilst out of the other third [treated with bloodletting by the third surgeon] thirty five patients died."
1898年丹麦医师Fibiger通过半随机对照实验验证血清治疗白喉的效果。
8 out of 239 patients in the serum treated group and 30 out of 245 in the control group died. No formal statistical analysis was performed but "no objection can be raised against the statistical significance of the numbers," which were deemed correct by an inspector of the sick benefit association (in 1900 Pearson invented the 2 test,10 which would have shown P=). The rate of serum sickness was high at 60%.
Tables - 2-by-2 unstratified
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