CLINICAL EPIDEMIOLOGY AND CLINICAL RESEARCH

An Academic presentation byDr. Nancy Agens, Head, Technical Operations, Pubrica Group: www.pubrica.comEmail: sales@pubrica.com

In brief

What is Done in Clinical Epidemiology

Three Kinds of Diseases in Clinical Epidemiology

Types of Clinical Research

Four Phases of Clinical Research

Conclusion

Outline

Today's Discussion

Clinical epidemiology aims at preventing, detecting and treating diseases in an efficient manner. Clinical epidemiology focuses on medicines to improve health, especially in the present world, when individuals are encouraged to take care of their own health. Either a patient population could be chosen or some other community

based population can also be considered which has the conventional numerator and denominator values of an

epidemiological study.

In Brief

The image given below illustrates what is done in clinical epidemiology:

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What is Done in Clinical Epidemiology

Figure 1: Distribution and Determinants of Diseases in Human Population

The distribution and determinants of diseases in human population is investigated in these studies and clinical epidemiology serves as the right tool in this respect.

Clinical epidemiology cannot be considered as an independent science because several skill sets are required in this field such as biostatistics, health social science and clinical economics.

A gold standard testing procedure is used in clinical epidemiology.

Results are the strength of relationship between two events which are measured through ratios, rates and proportion tests in clinical epidemiology.

This relationship data is presented in a table wherein the number of false positive and true positive diagnostic test results is visualized.

Contd..

Figure 2: False Positive and True Positive Diagnostic Test Results

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Figure 3: Illustrating Clinical Epidemiology Study Results of Patients Suffering from Covid-19 in Wuhan, China

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Three Kinds of Diseases in Clinical Epidemiology

Endemic disease - it affects the population at a relatively constant and expected rate within a specific region. The spread of pathogens and vectors, which are the reservoirs of disease is the main cause of an endemic disease. Example includes Malaria in Africa.

Epidemic disease -the population is affected at an unusually fast or unexpected rate. It occurs due to the increase in infectivity of a pathogen, poor living conditions such as crowded areas and improper sanitation systems. Example includes Ebola fever in West Africa.

Pandemic - it is defined as a worldwide epidemic, the reasons being global trade and worldwide travelling and the increased infectivity of pathogens due to antigenic shift and gene mutations. Example includes Covid-19.

Types of Clinical Research

Treatment Research : It involves an intervention such as medication, psychotherapy, new devices, new approaches to surgery and radiation therapy.

Prevention Research: Finds out better ways to prevent the development or the return of diseases. Medicines, vitamins, vaccines, minerals and lifestyle changes are usually studied here.

Diagnostic Research: This refers to the practice to look out for better ways for the identification of a particular disorder or condition

Contd..

Screening Research: It aims to find the best possible ways for the detection of particular disorders or typical health conditions

Quality of Life Research: This explores ways to improve comfort levels and the quality of life for individuals suffering from a chronic illness

Genetic Studies: These studies aim to improve the prediction of disorders through identification and understanding of the relationship between genes and ill health.

Epidemiological Studies:They seek to identify the patterns, causes and control of disorders in different groups of people.

Contd..

Given below is an illustration of clinical research study results on the causes, clinical manifestation, epidemiology, control and prevention of Covid-19 at the outbreak of the disease:

Figure 4: Illustration of Clinical Research Study Results

Four Phases of Clinical Research

Clinical research involves conducting of clinical trials. These are done in four phases:

Phase I: An experimental drug or treatment is tested in a small group of people for the first time. The safety of treatment is determined by the researchers and they suggest a safe dosage range of the drug, with the identificationof side effects

Phase II :The experimental drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety

Phase III:The experimental drug or treatment is given to large groups of people. The effectiveness is confirmed, side effects are monitored, and these are compared to commonly used treatments.

Phase IV: Post marketing studies are conducted after a treatmentis FDA approved. It provides additional information about the risks, benefits and best usage of the drug or treatment.

The factors considered in a clinical research study include age, gender, underlying disease and health history.

Clinical trials are carried out in hospitals, clinics, individual physician’s chambers, university health centres and community health centres, and patient privacy is essentially maintained during any clinical trial.

Conclusion

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