Miettinen O S
Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
J Clin Epidemiol. 1988;41(8):709-13. doi: 10.1016/0895-4356(88)90154-0.
The fundamentals of epidemiologic study design have remained a matter of confusion. Most authors still see the main design options to consist of the "cohort" study and the "case-control" study, augmented by the "cross-sectional" study. Others regard these as options only with respect to the perceived "directionality" dimension of design decisions. Few have come to appreciate that, realistically, there are no options as to directionality in the usual sense of "following forward" vs "investigating backward", or in the related sense of "inferential reasoning" being "from cause to effect" vs "from effect to cause". Related to this, few appreciate that the perceived duality of options constituted by "sampling by exposure" and "sampling by outcome" is, similarly, but an illusion. Old illusions like these confound the discernment of even those who, today, strive to deconfound the fundamentals of epidemiologic study design.
流行病学研究设计的基本原理一直令人困惑。大多数作者仍然认为主要的设计选项包括“队列”研究和“病例对照”研究，并辅以“横断面”研究。其他人则认为这些只是在设计决策的“方向性”维度方面的选项。很少有人认识到，实际上，在“向前追踪”与“向后调查”这种通常意义上的方向性，或者在“因果推断推理”是“从因到果”还是“从果到因”这种相关意义上，并没有选择的余地。与此相关的是，很少有人认识到由“按暴露抽样”和“按结果抽样”构成的选项二元性同样只是一种错觉。诸如此类的旧有错觉甚至困扰着当今那些努力理清流行病学研究设计基本原理的人。
