Unbiased Analysis of Today's Healthcare Issues

Lost in Translation? Types of Studies in the Economics and Medical Discipline

Written By: Jason Shafrin - Dec• 18•13

Statistics are statistics, but different disciplines use different terminology to refer to the same types of analysis.  A 2013 Institute of Medicine Report on cancer care lists a number of different study types (see below).  Whereas economists would refer to a study that examines  groups with and without an event or outcome as a “difference-in-difference” study, in the medical literature these are cohort studies.  Fortunately, there is some overlap.  Both economists and medical researchers have the same definition for a cross sectional study.


Experimental  study:  A  study  in  which  the  investigators  actively  intervene  to  test  a hypothesis.

  • Controlled trials are experimental studies in which a group receives the intervention of interest while one or more comparison groups receive an active comparator, a placebo, no intervention, or the standard of care, and the outcomes are compared. In head-to-head trials, two active treatments are compared.
  • In a randomized controlled trial (RCT), participants are randomly allocated to the experimental group or the comparison group. Cluster randomized trials are RCTs in which participants are randomly assigned to the intervention or comparison in groups (clusters) defined by a common feature, such as the same physician or health plan.

Observational  study:  A  study  in  which  investigators  simply  observe  the  course  of events.

  • In prospective observational studies, the exposure of interest is studied using data stored in registries, which can require years to accumulate the needed numbers of patients and outcomes.
  • In cohort studies, groups with certain characteristics or receiving certain interventions (e.g., premenopausal woman receiving chemotherapy for breast cancer) are monitored over time to observe an outcome of interest (e.g., loss of fertility).
  • In case-control studies, groups with and without an event or outcome are examined to see whether a past exposure or characteristic is more prevalent in one group than in the other.
  • In cross-sectional studies, the prevalence of an exposure of interest is associated with a condition (e.g., prevalence of hysterectomy in African American versus white women) and is measured at a specific time or time period.

Systematic review (SR): A scientific investigation that focuses on a specific question and  that  uses  explicit,  planned  scientific  methods  to  identify,  select,  assess,  and summarize  the  findings  of  similar  but  separate  studies.  It  may  or  may  not  include  a quantitative synthesis (meta-analysis) of the results from separate studies.

  • A meta-analysis is an SR that uses statistical methods to combine quantitatively the results of similar studies in an attempt to allow inferences to be made from the sample of studies and applied to the population of interest.


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