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The progression of designs at this point depends on the nature of the disease and exposure - the rarity of the disease herbalshopcompanynet buy hoodia 400 mg low cost, the length of its natural history, the problems in measuring disease and exposure, and other factors. For many diseases, especially rare ones, the usual sequence is to begin with casecontrol studies (since these are generally the most efficient and logistically practical design) and, unless negative results occur and are accepted, move towards follow-up studies and possibly intervention studies. Individual-level studies Although an "epidemiologic transition" appears to be underway, most analytic studies have the person as the unit of data collection and analysis. Thus, the four classic analytic study designs are generally thought of in relation to individual-level studies, though as we shall see they can also be employed for studies where the group is the unit of analysis. These four primary designs are: The term "cross-sectional study" (or "prevalence study") usually refers to studies at the individual level, even though ecologic studies are typically (though not necessarily) cross-sectional, also. The target population is generally one whose identity is of some wider interest. In a cross-sectional study, the current or historical status of individuals is assessed and may be examined in relation to some current or past exposure. These studies are obviously most useful for conditions that are not rapidly fatal, not terribly rare, and/or not routinely brought to medical attention. Since participants for a cross-sectional study are generally chosen without previous knowledge of their disease or exposure status, such studies can be used to estimate prevalence of both diseases and exposures and therefore to compute prevalence ratios and prevalence odds ratios. Among the more widely known cross-sectional studies are the periodic national household (interview) surveys by the U. Not good for rare diseases or rare exposures Case-control studies are used in infectious disease epidemiology, but they have become the primary strategy in chronic disease epidemiology. The investigation and refinement of the case-control design, a process which began in about the middle of the 20th century (see classic articles by Cornfield, 1951 and Mantel and Haenszel in 1959) constitutes a significant innovation in population-based research. However, because of the fundamentally different architecture of experimental and case-control designs, the analogy ends there and has probably been a source of confusion in earlier writings about the case-control design. The "backwards" design poses greater demands in terms of methodological and analytic sophistication. However, by ensuring a greater balance between the numbers of cases and noncases, the case-control design generally offers much greater statistical efficiency than other designs, giving it a crucial advantage for studying rare diseases.
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