Book contents
- Frontmatter
- Contents
- Foreword
- Preface
- 1 Epidemiology is…
- 2 How long is a piece of string? Measuring disease frequency
- 3 Who, what, where and when? Descriptive epidemiology
- 4 Healthy research: study designs for public health
- 5 Why? Linking exposure and disease
- 6 Heads or tails: the role of chance
- 7 All that glitters is not gold: the problem of error
- 8 Muddied waters: the challenge of confounding
- 9 Reading between the lines: reading and writing epidemiological papers
- 10 Who sank the boat? Association and causation
- 11 Assembling the building blocks: reviews and their uses
- 12 Outbreaks, epidemics and clusters
- 13 Watching not waiting: surveillance and epidemiological intelligence
- 14 Prevention: better than cure?
- 15 Early detection: what benefits at what cost?
- 16 A final word…
- Answers to questions
- Appendix 1 Direct standardisation
- Appendix 2 Standard populations
- Appendix 3 Calculating cumulative incidence and lifetime risk from routine data
- Appendix 4 Indirect standardisation
- Appendix 5 Calculating life expectancy from a life table
- Appendix 6 The Mantel-Haenszel method for calculating pooled odds ratios
- Appendix 7 Formulae for calculating confidence intervals for common epidemiological measures
- Glossary
- Index
- References
6 - Heads or tails: the role of chance
- Frontmatter
- Contents
- Foreword
- Preface
- 1 Epidemiology is…
- 2 How long is a piece of string? Measuring disease frequency
- 3 Who, what, where and when? Descriptive epidemiology
- 4 Healthy research: study designs for public health
- 5 Why? Linking exposure and disease
- 6 Heads or tails: the role of chance
- 7 All that glitters is not gold: the problem of error
- 8 Muddied waters: the challenge of confounding
- 9 Reading between the lines: reading and writing epidemiological papers
- 10 Who sank the boat? Association and causation
- 11 Assembling the building blocks: reviews and their uses
- 12 Outbreaks, epidemics and clusters
- 13 Watching not waiting: surveillance and epidemiological intelligence
- 14 Prevention: better than cure?
- 15 Early detection: what benefits at what cost?
- 16 A final word…
- Answers to questions
- Appendix 1 Direct standardisation
- Appendix 2 Standard populations
- Appendix 3 Calculating cumulative incidence and lifetime risk from routine data
- Appendix 4 Indirect standardisation
- Appendix 5 Calculating life expectancy from a life table
- Appendix 6 The Mantel-Haenszel method for calculating pooled odds ratios
- Appendix 7 Formulae for calculating confidence intervals for common epidemiological measures
- Glossary
- Index
- References
Summary
If the results of a study reveal an interesting association between some exposure and a health outcome, there is a natural tendency to assume that it is real. (Note that we are considering whether two things are associated. This does not necessarily imply a causal association. We will discuss approaches to determining causality further in Chapter 10.) However, before we can even contemplate this possibility we have to attempt to rule out other possible explanations for the results. There are three main ‘alternative explanations’ that we have to consider whenever we analyse epidemiological data or read the reports of others: namely, could the results be due to
chance
bias or error or
confounding?
We will discuss the first of these, chance, in this chapter and will cover bias and confounding in Chapters 7 and 8.
Random sampling error
When we conduct a study or survey it is rarely possible to include the whole of a population so we usually have to rely on a sample of that population and trust that this sample will give us an answer that holds true for the general population. If we select the sample of people wisely and they are truly representative of the target population (the population that we want to study) then we will not introduce any selection bias into the study (see Chapter 7).
- Type
- Chapter
- Information
- Essential EpidemiologyAn Introduction for Students and Health Professionals, pp. 154 - 166Publisher: Cambridge University PressPrint publication year: 2010