Does this study have to be community based or will hospital based prevalence be enough?
Dear Ms. Preeti,
Burden of a disease is estimated by either incidence (new cases only in a given time frame) or prevalence which includes both new and already existing cases as of today.
Incidence helps you the rate at which the disease is progressing in a given population.
The second question you want to think about whether you have access to a good hospital registry where each case is documented so you can go through the records.
If you don't have a disease registry, you can pool all the cases from all the hospitals in your community and get the total number of cases. You also have to know the population in age category in your community so you can use it for the denominator while you calculate the burden.
Chronic kidney disease is not common in the general population so I would not recommend population samples.
So to answer your question "what is the best study design" it is just collecting number of cases, it loosely fits into a cross-sectional but not quite. Case-control and cohort designs are used when you are also selecting the comparison groups (for case-control diseased vs. non-diseased and for cohort exposed vs. non-exposed at the time of subject selection). These are used when the objective of the study is to understand the relationship between the exposure and the disease. Since your objective is only counting numbers, the best way to do this is by using case registries or patient records. I hope this helps.
Preeti, have you also considered a qualitative assessment of the burden caused to the families of and children with kidney disease in regard to additional cost, time, access to services, social support, family stress, connection to others, exclusion etc?
Preeti,
When you say disease burden, are you looking at how prevalent the disease is (that's what it means in epidemiological sense). Or are you talking about impact of the disease on families in terms of financial and emotional/psychological burden? Please let me know because I am working on a grant looking to study depression and coping of having an autistic child.
Hello Preeti,
Adding to all the great answers. I believe that the best way to answer your question is to first assess or estimate the budget you have? Then, I would conduct a prospective study where I follow a large sample population for few years and then conduct my statistics. An important note to keep in mind is that if you are using a multi-logistic regression to correct for confounding variable, you should then report an odd's risk ratio (OR) not an incidence rate. A downside to prospective studies is that they are expensive, so if you have access to data and population sample from previous years, in this case I would conduct a retrospective study.
Dear Preeti,
it really is down to how much money you have and how much data you have access to. As discussed above it also depends on what you mean by burden of disease. The choice is essentially going to be between a cross sectional study (asking your population or a sample of yur population whether they have CKD at a given point in time), or a cohort study (following a population or a sample of the population over a period of time to look at how many new cases arise). If you are more interested in the burden associated with living with CKD (rather than the burden of CKD in the general population), there are other options. If you give a little more details, we may be able to help further
If you have more fund and time to spend opt for cohort design. If not, do a cross sectional survey in (geographical) area of your interest. Else opt for combining hospital registries data as Susie suggested. I will go for cross sectional survey with multistage sampling.
Thanks!
Our main problem is that CKD in the early stages is essentially silent. Children have vague symptomatology such as failure to thrive and unexplained anemia. Unfortunately it is not a practice to routinely check blood pressure in the pediatric population. Also most physicians start speculative antibiotics for unexplained fever even if the patient is not moribund and urine culture is rarely sent in such patients. Children who present to the hospital are usually in stage 4-5 when renal damage is already extensive. We have a national registry for these children (and adults) to which all pediatric nephrologists contribute.
Would you please specify your objectives so that appropriate epidemiological study designs could be suggested? The term burden is not well clear.
I also fee that objective is not clear. Are you searching for hidden cases or cases in early phase of pathology? or looking for evident cases only? Methodology depend on what do you want.
- Badges
- Science topic
- Similar topics
- Social Psychology
- Attitude