Clinical Epidemiology and Clinical Research - Pubrica
                     CLINICAL  
EPIDEMIOLOGY AND 
 CLINICAL 
RESEARCH
An Academic presentation by
Dr. Nancy Agens, Head, Technical Operations, 
Pubrica  Group: www.pubrica.com
Email: [email protected]
Today's 
Discussion
Outlin In brief
e What is Done in Clinical Epidemiology
Three Kinds of Diseases in Clinical 
Epidemiology  Types of Clinical Research
Four Phases of Clinical 
Research  Conclusion
In 
Brief
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.
What is Done in Clinical 
Epidemiology
The image given below illustrates what is done in clinical epidemiology:
Figure 1: Distribution 
and  Determinants of 
Diseases  in Human 
Population
Contd
..
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
Contd
..
Figure 3: Illustrating  
Clinical Epidemiology  
Study Results of 
Patients  Suffering 
from Covid-19  in 
Wuhan, China
Contd
..
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.
Conclusio
n
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.
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