新发病例:新发生还是新发现

New cases are they incident or newly discovered

新发病例是流行病学的一个基本概念,通常用作人群疾病发生频率指标的分子计数。然而,关于新发病例的确切定义仍不清楚。基于疾病的自然史,结合事件-状态概念,本文重新定义病例相关概念,并将其与传统概念进行了比较。研究发现,传统流行病学研究中所谓的新发病例实际上为首次发现病例,包括新发现病例和可被识别的新发生病例(疾病启动)。现实世界中,新发生病例通常很难测量,并且与疾病自然史和冰山现象一起,可能会影响疾病频率测量和因果推断的准确性。正确理解病例相关概念的含义及其之间的差异有助于合理地解释流行病学的研究结果。

New case is a basic concept in epidemiology and often serves as the numerator for the indexes of the frequency of disease in a population.However,the exact definition of new case is still unclear.Based on the natural history of disease combined with the concept of event-state,this article redefines case-related concepts and compares them with traditional concepts.The study found that the socalled new cases in traditional epidemiological studies are actually the cases firstly discovered,including newly discovered cases and identifiable newly incident cases(disease initiation).In the real world,new cases are often difficult to measure,and together with the continuous process of disease development and iceberg phenomenon,those may affect the accuracy of disease frequency measurement and causal inference.A correct understanding of the meaning of case-related concepts,the meanings they reflect,and the differences between them help to rationally interpret the results of epidemiological research.