1.

In the nested case-control study, cases of a disease that occur in a defined cohort are
identified and, for each, a specified number of matched controls is selected from among those
in the cohort who have not developed the disease by the time of disease occurrence in the
case. For many research questions, the nested case-control design potentially offers
impressive reductions in costs and efforts of data collection and analysis compared with the
full cohort approach, with relatively minor loss in statistical efficiency. The nested case-control
design is particularly advantageous for studies of biologic precursors of disease. To advance
its prevention research agenda, NIH might be encouraged to maintain a registry of new and
existing cohorts, with an inventory of data collected for each; to foster the development of
specimen banks; and to serve as a clearinghouse for information about optimal storage
conditions for various types of specimens. Ernster VL

2. The National Center for Health Statistics (NCHS), the Federal agency responsible for use
of the International Statistical Classification of Diseases and Related Health Problems,
10th revision (ICD-10) in the United States, has developed a clinical modification of the
classification for morbidity purposes. The ICD-10 is used to code and classify mortality
data from death certificates, having replaced ICD-9 for this purpose as of January 1,
1999. ICD-10-CM is the replacement for ICD-9-CM, volumes 1 and 2, effective October
1, 2015.

The ICD-10 is copyrighted by the World Health Organization (WHO), which owns
and publishes the classification. WHO has authorized the development of an adaptation
of ICD-10 for use in the United States for U.S. government purposes. As agreed, all
modifications to the ICD-10 must conform to WHO conventions for the ICD. ICD-10-CM
was developed following a thorough evaluation by a Technical Advisory Panel and
extensive additional consultation with physician groups, clinical coders, and others to
assure clinical accuracy and utility.

The entire draft of the Tabular List of ICD-10-CM, and the preliminary crosswalk
between ICD-9-CM and ICD-10-CM were made available on the NCHS website for public
comment. The public comment period ran from December 1997 through February 1998.
The American Hospital Association and the American Health Information Management
Association conducted a field test for ICD-10-CM in the summer of 2003, report [PDF –
1.8 MB]. All comments and suggestions from the open comment period and the field test
were reviewed, and additional modifications to ICD-10-CM were made based on these
comments and suggestions. Additionally, new concepts have been added to ICD-10-CM
based on the established update process for ICD-9-CM (the ICD-9-CM Coordination and
Maintenance Committee) and the World Health Organization’s ICD-10 (the Update and
Revision Committee). This represents ICD-9-CM modifications from 2003-2011 and ICD-
10 modifications from 2002-2010.
The clinical modification represents a significant improvement over ICD-9-CM
and ICD-10. Specific improvements include: the addition of information relevant to
 ambulatory and managed care encounters; expanded injury codes; the creation of
combination diagnosis/symptom codes to reduce the number of codes needed to fully
describe a condition; the addition of sixth and seventh characters; incorporation of
common 4th and 5th digit subclassifications; laterality; and greater specificity in code
assignment. The new structure will allow further expansion than was possible with ICD-9-
CM. https://www.cdc.gov/nchs/icd/icd10cm.htm
3. Rasio risiko (Hazard Ratio (HR)) adalah rasio dari fungsi risiko satu individu dengan fungsi
risiko dari individu lain.
4. In its simplest form, the hazard ratio can be interpreted as the chance of an event
occurring in the treatment arm divided by the chance of the event occurring in the control
arm, or vice versa, of a study. The resolution of these endpoints are usually depicted
using Kaplan–Meier survival curves. These curves relate the proportion of each group
where the endpoint has not been reached. The endpoint could be any dependent
variable associated with the covariate (independent variable), e.g. death, remission of
disease or contraction of disease. The curve represents the odds of an endpoint having
occurred at each point in time (the hazard). The hazard ratio is simply the relationship
between the instantaneous hazards in the two groups and represents, in a single
number, the magnitude of distance between the Kaplan–Meier plots.[5][page needed]
Hazard ratios do not reflect a time unit of the study. The difference between
hazard-based and time-based measures is akin to the difference between the odds of
winning a race and the margin of victory.[1] When a study reports one hazard ratio per
time period, it is assumed that differezce between groups was proportional. Hazard ratios
become meaningless when this assumption of proportionality is not met.
If the proportional hazard assumption holds, a hazard ratio of one means
equivalence in the hazard rate of the two groups, whereas a hazard ratio other than one
indicates difference in hazard rates between groups. The researcher indicates the
probability of this sample difference being due to chance by reporting
the probability associated with some test statistic. For instance, the from the Cox-model
or the log-rank test might then be used to assess the significance of any differences
observed in these survival curves.
Conventionally, probabilities lower than 0.05 are considered significant and
researchers provide a 95% confidence interval for the hazard ratio, e.g. derived from
the standard deviation of the Cox-model regression coefficient, i.e. Statistically
significant hazard ratios cannot include unity (one) in their confidence intervals.

5.