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暴发调查设计:以急性戊型肝炎暴发为例

朱以敏 李亚欣 牟育彤 阚慧 张淼 范伟 李意杰 郑英杰

朱以敏, 李亚欣, 牟育彤, 阚慧, 张淼, 范伟, 李意杰, 郑英杰. 暴发调查设计:以急性戊型肝炎暴发为例[J]. 中华疾病控制杂志, 2020, 24(11): 1241-1245,1347. doi: 10.16462/j.cnki.zhjbkz.2020.11.001
引用本文: 朱以敏, 李亚欣, 牟育彤, 阚慧, 张淼, 范伟, 李意杰, 郑英杰. 暴发调查设计:以急性戊型肝炎暴发为例[J]. 中华疾病控制杂志, 2020, 24(11): 1241-1245,1347. doi: 10.16462/j.cnki.zhjbkz.2020.11.001
ZHU Yi-min, LI Ya-xin, MU Yu-tong, KAN Hui, ZHANG Miao, FAN Wei, LI Yi-jie, ZHENG Ying-jie. The designs for outbreak investigation: an example of acute hepatitis E outbreak[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(11): 1241-1245,1347. doi: 10.16462/j.cnki.zhjbkz.2020.11.001
Citation: ZHU Yi-min, LI Ya-xin, MU Yu-tong, KAN Hui, ZHANG Miao, FAN Wei, LI Yi-jie, ZHENG Ying-jie. The designs for outbreak investigation: an example of acute hepatitis E outbreak[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(11): 1241-1245,1347. doi: 10.16462/j.cnki.zhjbkz.2020.11.001

暴发调查设计:以急性戊型肝炎暴发为例

doi: 10.16462/j.cnki.zhjbkz.2020.11.001
基金项目: 

国家自然科学基金 81373065

国家自然科学基金 81773490

国家重点研发计划“生物安全关键技术研发”重点专项 2017YFC1200203

详细信息
    通讯作者:

    郑英杰,E-mail:yjzheng@fudan.edu.cn

  • 中图分类号: R181

The designs for outbreak investigation: an example of acute hepatitis E outbreak

Funds: 

National Natural Science Foundation of China 81373065

National Natural Science Foundation of China 81773490

The National Key Research and Development Program of China 2017YFC1200203

More Information
  • 摘要: 疾病暴发一旦确立,则意味着疾病(及其病因或疑似暴露)已经发生。暴发是疾病流行强度指标之一,虽然其本身不具备设计要素,但暴发调查可有多种设计选择。本文采用单次戊型肝炎暴发案例,调查并获得学生们对其设计类型判断的三个答案:横断面设计、病例对照设计和历史队列设计。借助因果思维和因果图,本文发现该案例并不满足或符合上述设计,即只有暴发确立型病例是已知的、可被测量两次;调查实施前暴露是未知的,暴露与结局间可混合存在着两种纵向测量时序。基于调查人群的代表性、暴发确立型病例的两次识别特征,可以将此案例视为横断面队列设计,即在假设的历史人群基础上对当前人群进行的横断面研究。对结局(和暴露)已然发生的情形,因果推断的准确性取决于其历史重建的正确性,应加强对这类基于历史重建的研究设计类型的认识。
  • 图  1  15名学生对戊肝暴发案例设计类型的答案

    注:CSS:横断面研究,CCS:病例对照研究,HCS:历史性队列研究;图中数字代表对应设计的答案数量。

    Figure  1.  Answers to the design type of hepatitis E outbreak by 15 students

    图  2  戊肝暴发及其测量过程

    注:A0和Y1分别代表暴露和戊肝的发生,Y2代表研究起点的戊肝感染情况,Y1*和Y2+△t*分别代表对Y1和Y2的测量,△t代表A2*和Y2+△t*间测量的时间差,可为负值和正值,但不可能为零。代表暴发确立的时间和研究起点。

    Figure  2.  Outbreak of hepatitis E and its measurement process

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出版历程
  • 收稿日期:  2020-06-18
  • 修回日期:  2020-09-04
  • 刊出日期:  2020-11-10

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