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118 Cards in this Set
- Front
- Back
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John Snow
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Cholera
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Richard Doll
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Cigarette Smoking and Lung Cancer
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Hippocrates
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Lifestyle and environmental factors may affect human disease
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Bacon
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principles of inductive logic
philosophical basis for Public Health |
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Graunt
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London births & deaths
patterns of fertility, morbidity, and mortality |
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Lind
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1st Experimental Study (scurvy)
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Farr
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routine summary of death
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Lane-Claypon
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first historical cohort study (benefits of breast feeding)
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Doll & Hill
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First case-control study (cigarette & lung cancer)
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Association
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-characteristic of a cause
-a causal factor (X) must occur together with the putative effect (Y) |
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Direction
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-characteristic of a cause
-asymmetrical relationship -a change in the outcome is a result of a change in the antecedent factor |
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Time Order
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-must precede the effect
-distant cause -proximate cause |
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Host (Characteristic of Cause)
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-genetics, gender, age, immunity level, diet, behaviors, existing disease
-affects a person's susceptibility to disease |
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Environmental (Characteristic of Cause)
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determinants that are external to the individual and thereby encompass a wide range of natural, social, and economic events and conditions.
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Active Cause
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produces a change
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Passive Cause
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lack of preventative exposure
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Positive Cause
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presence of a causative exposure
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Negative Cause
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lack of a preventative exposure
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Risk Factors
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anything that increases your chance of getting a disease
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Agent
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-produces the disease
-parasites, bacteria, virus, chemical substance (smoking), food item (fat) |
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Divine retribution
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-imbalance in body humors caused by air, water, land, stars.
-spontaneous generation -sickness is a result of sin |
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Miasma
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disease is caused by poisonous air or gases
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Germ Theory of Disease
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-Henle-Koch Postulate
-microorganism must be ovserved in every case of disease. -microorganism must be isolated and grown in pure culture. -pure culture must, when inoculated into a susceptible animal, reproduce the disease. -microorganism must be observed in and recovered from the experimentally diseased animal. |
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Web of Causation
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-postulates the idea of multiple causes.
-explains chronic disease |
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Component Cause
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individual exposure that collectively produce disease
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Sufficient cause
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Minimal set of individual exposures that inevitably produce disease.
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Necessary Cause
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Required exposure for occurrence of disease and whose presence is always followed by the disease.
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Induction Period
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length of time from the action of causal component until disease initiation.
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Latent Period
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The interval from disease onset to detection.
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Temporality
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-causal interference criteria
-Essential -time sequence -exposure precedes development of disease by a period consistent with proposed biologic mechanism. -sufficient induction/latent period exists |
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Strength of Association
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-Causal Interference Criteria
-The stronger the association the more likely the exposure-disease relationship is causal. -valid if bias, confounding bias, and random error are eliminated. |
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Bias
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systematic error in the way that the study subjects were selected or the data were gathered.
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random error
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the probability that the observed results are due to "chance"
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Biological Gradient
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-Dose-Response
-Strength of Association increases with intensity or duration of exposure as predicted. |
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Consistency
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Other studies using different populations and methodology show similar results
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Plausibility
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there are known or postulated biological mechanisms that help explain exposure-disease relationship
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Coherence
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Association must not seriously conflict with what is already known about natural history or biology of disease
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Specificity
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-a specific exposure is associated with only one disease.
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analogy
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-evidence exists that similar exposures may have similar effects (heavy metals and toxic effects)
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Experiment
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natural experiments provide evidence for exposure-disease relationship
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Meta-analysis
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-statistical method of data pooling
-quantitative combination of results from published and unpublished research yielding an estimate of effect that has the benefit of combining larger numbers of observations. |
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Epidemiology
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The study of the distribution and determinants of disease frequency in human populations.
-Application of this study to control health problems |
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Distribution
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-Descriptive Epi
-patterns of disease within or across defined populations |
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Determinants
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-Analytic
-factors that influence the prevention, occurrence, control, and outcome of disease. |
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Population
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a group of people with a common characteristic.
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Fixed Population
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-permanent
-membership is usually based on a specific event. |
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Dynamic Population
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-membership reflects changing state or condition
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Specific Criteria
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-confirmed diagnosis of a disease
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Non-specific Criteria
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-probable diagnosis of a disease
-clinically compatible case that is epidemiologically linked to a confirmed one. |
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Prevalence
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The number of existing cases of a disease in a population at a given time.
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Incidence
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The number of new cases of disease that have developed in the population during a defined period.
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Cumulative Incidence
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-incidence risk
-measures the portion of individuals in the population who develop the disease within a defined period. |
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Incidence Density
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-incidence rate
-measures the rate of new cases per person per year |
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Crude Disease Rate
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estimate the actual disease frequency of a population
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Category-Specific Disease Rates
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-Stratification
-looking at different subgroups of the whole population (age, gender, race, etc.) |
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Adjusted Disease Rates
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computed in order to remove the effect of age or other factors from crude disease rates to allow meaningful comparisons across populations.
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Indirect Standardization
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Method when the numbers of deaths in the individual age groups are too small to yield reliable disease rates.
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Surveillance
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Ongoing collection and timely analysis, interpretation, and communication of health information for public health action.
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Timeliness
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To implement effective control measures
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Representation
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To provide accurate picture of the temporal trend of the disease
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Sensitivity
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To allow identification of individual persons with disease and to facilitate treatment, quarantine, or other appropriate control measures.
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Specificity
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To exclude persons not having the disease
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Survey
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structured and systematic gathering of information from a population sample to describe the population in quantitative terms.
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Notification
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reporting of certain disease or other health related conditions by a specific group, as specified by law, regulation, or agreement
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Registries
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Structured and systematic method for documenting and tracking persons over time.
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Passive Surveillance
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voluntary reporting of disease cases.
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Active Surveillance
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mandated reporting of disease cases.
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Population Sampling
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method by which subjects in a given population are selected as representatives of the entire population.
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Non-probability Sampling
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members of the population are selected in some non-random manner.
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Convenience Sampling
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method for selecting study subjects is convenient for study coordinator
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Judgement Sampling
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Method for selecting study subjects is based on investigator's perception that the sampled person will be representative of entire population.
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Quota Sampling
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method for selecting subjects based on subgroups in the population.
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Probability Sampling
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every member of the population has a non-zero probability of being included in the sample.
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Sampling Unit
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Subject for which information is collected.
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Sampling Frame
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any list of all the sampling units.
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Simple Random Sampling
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N subjects is randomly chosen without replacement from a population of N subjects and each subject has an equal chance of being chosen in the sample.
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Systematic Sampling
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nth name selection technique; select according to some pattern.
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Stratified Sampling
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used to ensure representation of specific subgroups of the population are in the overall sample.
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Cluster Sampling
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used when sampling unit is a cluster of subjects.
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Multistage Sampling
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Combination of other Sampling Schemes (primary sampling units, secondary sampling units, tertiary sampling units)
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Weighting
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Corrects for difference in the probability of selction due to non-response and non-coverage errors.
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screening
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Application of a test or procedure to separate asymptomatic, apparently healthy persons with a relatively high probability of having a given disease from those with a relatively low probability of having the disease.
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Reliable
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How closely do duplicate measurements of the same characteristic agree with each other?
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test-retest
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Agreement between responses on interview or questionaire given 2 times to the same person
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intra-observer
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agreement of given interpreter with self
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inter-observer
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agreement among different interpreters
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Kappa
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represents the extent to which agreement exists beyond that expected on the basis of chance when comparing discrete (or categorical) measures.
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Intraclass Correlation Coefficient
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measures the agreeement between replicate, continuous measures from the same person.
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Valid
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sensitive and specific
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sensitivity
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ability of a test to identify correctly all diseased persons among those who have the disease.
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Specificity
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the ability of the test to identify correctly all non-diseased persons among those who don't have the disease.
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Receiver Operating Curve
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Graphical tool for assessing the ability of a screening test to discriminate between healthy and diseased persons.
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Positive Predictive Value
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measures the proportion of TP among all positive test results
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Negative Predictive Value
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measures the proportion of TN among all negative test results
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Predictive Value of Test
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measures the screenings effectiveness
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volunteer bias
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occurs when those who choose not be be screened have a lower risk of disease or better diagnosis than those who choose not to be screened.
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lead time bias
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the interval between disease detection at time of screening and diagnosis when symptoms naturally occur.
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length bias
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the over-representation of screened cases with a long pre-symptomatic stage of disaeaes, and thus a more favorable diagnosis.
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case finding
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active detection of disease or of risk factors of disease in an individual under health care.
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risk assessment
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calculation of mortality risk or longevity through compiling the risk factors of an individual.
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Descriptive Studies
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characterize distribution of disease in population and describe the natural history of disease.
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analytic studies
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examine the causes of disease
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experimental study design
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investigator randomly allocates study participants to two or more groups
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quasi-experimental study design
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investigator assigns study participants to two or more groups.
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random selection
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-refers to how we select study participants.
-ensures the study sample is representative of the population of interest. |
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random assignment
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-refers to how we allocate study participants to treatment conditions.
-ensures treatment groups are equal. |
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Relative Risk
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-estimates the risk of developing the disease in the exposed population relative to those in the unexposed population.
-measures the strength of the exposure-disease relationship |
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Rate Difference
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-Difference between cumulative incidence in the exposed and unexposed populations.
-Estimates the excess risk of disease in the exposed population that is attributable to the exposure. |
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Population Risk/Rate Difference
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-the difference between cumulative incidence in the unexposed and total populations.
-estimates the excess risk of disease in total population that is attributable to the exposure. -determines which exposures have the most relevance to the health of a community. |
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Attributable Proportion
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the proportion of disease in the exposed population that is attributable to the exposure and can be eliminated if the exposure is eliminated.
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Observational Study
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studies causes, preventions, and treatment for diseases; investigator passively observes as nature takes its course.
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Cohort
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Examines multiple health effects of an exposure; subjects are defined according to their exposure levels and followed for disease occurrence.
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Case-Control
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Examines multiple health effects of an exposure; subjects are defined as cases and controls, and exposure histories are compiled.
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Cross Sectional
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Typically examines relationship between exposure and disease prevalence in a defined population at a single point in time.
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Observational Study
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studies causes, preventions, and treatment for diseases; investigator passively observes as nature takes its course.
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Cohort
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Examines multiple health effects of an exposure; subjects are defined according to their exposure levels and followed for disease occurrence.
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Case-Control
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Examines multiple health effects of an exposure; subjects are defined as cases and controls, and exposure histories are compiled.
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Cross Sectional
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Typically examines relationship between exposure and disease prevalence in a defined population at a single point in time.
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