Samenvatting MKNO
1
,Inhoud
College 1 MKNO ...................................................................................................................................... 6
Deductief redeneren........................................................................................................................... 6
Inductief redeneren ............................................................................................................................ 6
Etiologisch onderzoek ......................................................................................................................... 6
Diagnostisch onderzoek ...................................................................................................................... 6
Interventie onderzoek ........................................................................................................................ 7
Klinimetrisch onderzoek ..................................................................................................................... 7
Algemene epidemiologische breuk: ................................................................................................... 7
College 2 MKNO ...................................................................................................................................... 9
Probleem- doel- en vraagstelling ........................................................................................................ 9
Probleemstelling ................................................................................................................................. 9
Doelstelling ......................................................................................................................................... 9
Ontwikkelfase van de onderzoeksvraag ............................................................................................. 9
Formuleren onderzoeksvraag, bestaat uit 2 stappen ....................................................................... 10
Definitie hypothese .......................................................................................................................... 11
Toetsen van hypothesen................................................................................................................... 11
Domein versus studiepopulatie ........................................................................................................ 12
Census ............................................................................................................................................... 13
Steekproef trekking – sampling ........................................................................................................ 13
Sampling technieken......................................................................................................................... 13
Epidemiologische functie à ............................................................................................................. 13
Selecte steekproeven........................................................................................................................ 14
Cohort VS dynamische populatie ...................................................................................................... 14
Voor- en nadelen cohortstudie ......................................................................................................... 15
Dynamische populatie ..................................................................................................................... 15
Case-control study ............................................................................................................................ 16
Voor- en nadelen case-control study ................................................................................................ 17
Generaliseerbaarheid – representativiteit ....................................................................................... 17
Aspecten in studie design ................................................................................................................. 17
Uitkomst en determinanten ............................................................................................................. 18
Beschrijvend vs. verklarend .............................................................................................................. 18
College 3 MKNO .................................................................................................................................... 19
Frequentie maten ............................................................................................................................. 20
Epidemiologische breuk incidentie/prevalentie ............................................................................... 20
Prevalentie ........................................................................................................................................ 20
2
, Punt-prevalentie ............................................................................................................................... 21
Periode-prevalentie .......................................................................................................................... 21
Incidentie .......................................................................................................................................... 21
Cumulatieve incidentie ..................................................................................................................... 21
Incidentie dichtheid .......................................................................................................................... 22
Associatiematen ............................................................................................................................... 24
Risicoverschil (RV) ............................................................................................................................. 24
The Number Needed to Treat (NNT) ................................................................................................ 25
Relatief risico (RR) ............................................................................................................................. 25
Attributieve proportie van de blootgestelde populatie (APE) .......................................................... 26
Attributieve proportie van de totale populatie (APT) ....................................................................... 26
Odds ratio (OR) ................................................................................................................................. 26
(Correlatiematen (pearson r, ICC, Spearman rank)) ......................................................................... 27
College 4 MKNO .................................................................................................................................... 28
Externe validiteit ............................................................................................................................... 28
Interne validiteit ............................................................................................................................... 28
Betrouwbaarheid .............................................................................................................................. 28
Standaard fout .................................................................................................................................. 29
Betrouwbaarheidsinterval ................................................................................................................ 29
Grote en kleine precisie .................................................................................................................... 29
Validiteit van onderzoeksresultaten ................................................................................................. 29
Bias.................................................................................................................................................... 29
Response verhogen .......................................................................................................................... 30
Selectie bias = ................................................................................................................................... 30
Selectie bias: cohortonderzoek......................................................................................................... 31
Informatiebias................................................................................................................................... 31
Observer bias .................................................................................................................................... 31
Recall bias ......................................................................................................................................... 32
Confounding ..................................................................................................................................... 32
Verschil confounding en bias ............................................................................................................ 33
Elimineren van confounding ............................................................................................................. 34
Effect modificatie .............................................................................................................................. 34
Verschil effectmodificatie en confouding: ........................................................................................ 35
College 5 en 6 MKNO ............................................................................................................................ 36
Verschil interactie en effectmodificatie ............................................................................................ 36
Etiologisch onderzoek ....................................................................................................................... 37
3
, Aard onderzoeksbevindingen ........................................................................................................... 38
Causaliteit – Criteria van Hill ............................................................................................................. 38
Etiologisch onderzoek – designs ....................................................................................................... 38
Design van data-analyse bij etiologisch onderzoek ........................................................................ 39
Voorbeeld confounding case-control study...................................................................................... 40
College 7 en 8 MKNO ............................................................................................................................ 41
Interventie onderzoek ...................................................................................................................... 41
Klinisch epidemiologisch onderzoeksopzet ...................................................................................... 41
Interventieonderzoek (achtergrond) ................................................................................................ 41
Experimenteel vs. niet-experimenteel onderzoek ............................................................................ 42
Confounding interventie onderzoek ................................................................................................. 42
College 9 MKNO .................................................................................................................................... 43
Diagnostisch onderzoek .................................................................................................................... 43
Prognostisch onderzoek ................................................................................................................... 43
Diagnostisch versus Prognostische onderzoek ................................................................................. 43
Selectie bias ...................................................................................................................................... 44
Measurement bias ............................................................................................................................ 44
Attrition bias ..................................................................................................................................... 44
Vaststellen van het model ................................................................................................................ 45
College 11 en 12 MKNO ........................................................................................................................ 47
Klinimetrisch onderzoek ................................................................................................................... 47
Klinimetrisch versus Diagnostisch onderzoek ................................................................................... 47
Voorbeeld klinimetrisch onderzoek .................................................................................................. 48
Klinimetrisch onderzoek à theoretisch design ................................................................................ 48
Kwaliteit meetinstrumenten ............................................................................................................. 48
Vormen van validiteit........................................................................................................................ 48
Face validiteit: ................................................................................................................................... 49
Content validiteit: ............................................................................................................................. 49
Construct validiteit ........................................................................................................................... 49
Criterium validiteit ............................................................................................................................ 49
Vormen van betrouwbaarheid ......................................................................................................... 50
Betrouwbaarheid/interne consistentie ............................................................................................ 50
Responsitiviteit longitudinale validiteit .......................................................................................... 50
Klinische bruikbaarheid .................................................................................................................... 50
Klinimetrisch onderzoek – dataverzameling ..................................................................................... 51
Opzet klinimetrisch onderzoek KIPPI ................................................................................................ 51
4
1
,Inhoud
College 1 MKNO ...................................................................................................................................... 6
Deductief redeneren........................................................................................................................... 6
Inductief redeneren ............................................................................................................................ 6
Etiologisch onderzoek ......................................................................................................................... 6
Diagnostisch onderzoek ...................................................................................................................... 6
Interventie onderzoek ........................................................................................................................ 7
Klinimetrisch onderzoek ..................................................................................................................... 7
Algemene epidemiologische breuk: ................................................................................................... 7
College 2 MKNO ...................................................................................................................................... 9
Probleem- doel- en vraagstelling ........................................................................................................ 9
Probleemstelling ................................................................................................................................. 9
Doelstelling ......................................................................................................................................... 9
Ontwikkelfase van de onderzoeksvraag ............................................................................................. 9
Formuleren onderzoeksvraag, bestaat uit 2 stappen ....................................................................... 10
Definitie hypothese .......................................................................................................................... 11
Toetsen van hypothesen................................................................................................................... 11
Domein versus studiepopulatie ........................................................................................................ 12
Census ............................................................................................................................................... 13
Steekproef trekking – sampling ........................................................................................................ 13
Sampling technieken......................................................................................................................... 13
Epidemiologische functie à ............................................................................................................. 13
Selecte steekproeven........................................................................................................................ 14
Cohort VS dynamische populatie ...................................................................................................... 14
Voor- en nadelen cohortstudie ......................................................................................................... 15
Dynamische populatie ..................................................................................................................... 15
Case-control study ............................................................................................................................ 16
Voor- en nadelen case-control study ................................................................................................ 17
Generaliseerbaarheid – representativiteit ....................................................................................... 17
Aspecten in studie design ................................................................................................................. 17
Uitkomst en determinanten ............................................................................................................. 18
Beschrijvend vs. verklarend .............................................................................................................. 18
College 3 MKNO .................................................................................................................................... 19
Frequentie maten ............................................................................................................................. 20
Epidemiologische breuk incidentie/prevalentie ............................................................................... 20
Prevalentie ........................................................................................................................................ 20
2
, Punt-prevalentie ............................................................................................................................... 21
Periode-prevalentie .......................................................................................................................... 21
Incidentie .......................................................................................................................................... 21
Cumulatieve incidentie ..................................................................................................................... 21
Incidentie dichtheid .......................................................................................................................... 22
Associatiematen ............................................................................................................................... 24
Risicoverschil (RV) ............................................................................................................................. 24
The Number Needed to Treat (NNT) ................................................................................................ 25
Relatief risico (RR) ............................................................................................................................. 25
Attributieve proportie van de blootgestelde populatie (APE) .......................................................... 26
Attributieve proportie van de totale populatie (APT) ....................................................................... 26
Odds ratio (OR) ................................................................................................................................. 26
(Correlatiematen (pearson r, ICC, Spearman rank)) ......................................................................... 27
College 4 MKNO .................................................................................................................................... 28
Externe validiteit ............................................................................................................................... 28
Interne validiteit ............................................................................................................................... 28
Betrouwbaarheid .............................................................................................................................. 28
Standaard fout .................................................................................................................................. 29
Betrouwbaarheidsinterval ................................................................................................................ 29
Grote en kleine precisie .................................................................................................................... 29
Validiteit van onderzoeksresultaten ................................................................................................. 29
Bias.................................................................................................................................................... 29
Response verhogen .......................................................................................................................... 30
Selectie bias = ................................................................................................................................... 30
Selectie bias: cohortonderzoek......................................................................................................... 31
Informatiebias................................................................................................................................... 31
Observer bias .................................................................................................................................... 31
Recall bias ......................................................................................................................................... 32
Confounding ..................................................................................................................................... 32
Verschil confounding en bias ............................................................................................................ 33
Elimineren van confounding ............................................................................................................. 34
Effect modificatie .............................................................................................................................. 34
Verschil effectmodificatie en confouding: ........................................................................................ 35
College 5 en 6 MKNO ............................................................................................................................ 36
Verschil interactie en effectmodificatie ............................................................................................ 36
Etiologisch onderzoek ....................................................................................................................... 37
3
, Aard onderzoeksbevindingen ........................................................................................................... 38
Causaliteit – Criteria van Hill ............................................................................................................. 38
Etiologisch onderzoek – designs ....................................................................................................... 38
Design van data-analyse bij etiologisch onderzoek ........................................................................ 39
Voorbeeld confounding case-control study...................................................................................... 40
College 7 en 8 MKNO ............................................................................................................................ 41
Interventie onderzoek ...................................................................................................................... 41
Klinisch epidemiologisch onderzoeksopzet ...................................................................................... 41
Interventieonderzoek (achtergrond) ................................................................................................ 41
Experimenteel vs. niet-experimenteel onderzoek ............................................................................ 42
Confounding interventie onderzoek ................................................................................................. 42
College 9 MKNO .................................................................................................................................... 43
Diagnostisch onderzoek .................................................................................................................... 43
Prognostisch onderzoek ................................................................................................................... 43
Diagnostisch versus Prognostische onderzoek ................................................................................. 43
Selectie bias ...................................................................................................................................... 44
Measurement bias ............................................................................................................................ 44
Attrition bias ..................................................................................................................................... 44
Vaststellen van het model ................................................................................................................ 45
College 11 en 12 MKNO ........................................................................................................................ 47
Klinimetrisch onderzoek ................................................................................................................... 47
Klinimetrisch versus Diagnostisch onderzoek ................................................................................... 47
Voorbeeld klinimetrisch onderzoek .................................................................................................. 48
Klinimetrisch onderzoek à theoretisch design ................................................................................ 48
Kwaliteit meetinstrumenten ............................................................................................................. 48
Vormen van validiteit........................................................................................................................ 48
Face validiteit: ................................................................................................................................... 49
Content validiteit: ............................................................................................................................. 49
Construct validiteit ........................................................................................................................... 49
Criterium validiteit ............................................................................................................................ 49
Vormen van betrouwbaarheid ......................................................................................................... 50
Betrouwbaarheid/interne consistentie ............................................................................................ 50
Responsitiviteit longitudinale validiteit .......................................................................................... 50
Klinische bruikbaarheid .................................................................................................................... 50
Klinimetrisch onderzoek – dataverzameling ..................................................................................... 51
Opzet klinimetrisch onderzoek KIPPI ................................................................................................ 51
4
