Clinical Epidemiology and Clinical Research — Pubrica

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In Brief

Clinical epidemiology aims at preventing, detecting and treating diseases in an efficient manner. John R Paul coined the term “clinical epidemiology” about fifty years ago. Clinical epidemiology focuses on medicines to improve health, especially in the present world, when individuals are encouraged to take care of their own health. Here, a population is chosen to study the health-related phenomena of different diseases. 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(Ehrenstein et al., 2017).

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

Clinical epidemiology studies three kinds of diseases:

a. 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. Geographical features, climate changes, poor living conditions such as dull houses, improper sewage systems and hazardous work conditions are other responsible factors for endemic disease. The example includes Malaria in Africa.

b. 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, spreading and introduction of the pathogen in a new geographical condition. An example includes Ebola fever in West Africa.

c. 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. An example includes Covid-19.

Clinical research is defined as “a careful study and an investigation in order to discover new facts and information”. Unbiased, reliable and valid measurements are required to carry out a clinical research programme. Clinical research addresses a specific question in an organized and objective manner(Magnin et al., 2019). The different types of clinical researches are described below.

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

2. 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.

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

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

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

6. Genetic studies: These studies aim to improve the prediction of disorders through identification and understanding of the relationship between genes and ill health. The different ways in which genes of an individual is more likely to develop a disorder is explored in this research domain. This, in turn, leads to the development of tailor-made treatments which are based on a person’s genetic make-up

7. Epidemiological studies: They seek to identify the patterns, causes and control of disorders in different groups of people. “Outpatient” clinical research requires that participants do not stay overnight at the treatment centre. “Inpatient” clinical research requires the participants to stay for at least one night in the hospital or research centre.

Conclusion

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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