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122 Cards in this Set
- Front
- Back
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This describes what aspect of prevalence?
Describing health burden of a population Estimating frequency of an exposure Allocating health resources |
Usefulness
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These are not so useful for most studies of etiology
-Case must survive long enough to participate, or there must be truncated number of eligible case samples -Risk factors for rapidly fatal cases may be ≠ Risk factors for cases not so serious. Exceptions: -For condition with indefinite time of onset -Mental illness -Chronic illness This describes... These describe... |
Possible influences of differential survival
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Numerator: number of new cases
Denominator: population at risk Time: period during which cases accrue These are the elements of ... |
incidence rate
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describes rate of development of disease in group over a certain time period
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incidence
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Who is excluded from the incidence rate denominator?
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- Those who have already developed the disease
- those that cannot develop the disease -those who had disease conferring lifelong immunity -Those who are immunized |
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Full-time workers in a particular occupation fall under this category of populations at risk.
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Special populations
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How is time period designated for incidence?
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week, month, year, or multiyear
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For incidence, one must be able to specify date of onset for condition during time period. Some acute conditions are readily identifiable but others such as cancer is defined by..
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definitive diagnosis date
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This is known as the alternate form of incidence rate
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attack rate
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This is used when nature of event is such that population is observed for a short time period
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attack rate
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What is an example of when attack rate is used?
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Foodborne outbreaks such as salmonella
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What is the formula for Attack rate?
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Ill/(ill & well) x 100
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This is considered not a true rate because time is often uncertain or arbitrarily specified
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attack rate
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What are the uses of attack rate?
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Measures incidence of disease during acute infectious disease epidemics
- Incidence of conditions where risk is time-limited |
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-Hypertrophic pyloric stenosis
-Occurs mostly in first three months of life - Almost unheard of after six months of age These are incidence of condition where risk is _____ _______ |
Incidence of condition where risk is time limited
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Statement of probability.
Chance of developing a disease over a specified period. Conditional upon person not dying from other cause during that time period |
risk
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What is the scale for range of risk and what do these numbers entail?
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0 to 1. No risk to certainty of risk
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Cumulative incidence of particular disease is an estimate of _____
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risk
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Proportion of fixed population that becomes diseased during stated time period
No individuals can enter denominator after start of period Number includes only individuals in the fixed population Disease status must be determined for all in denominator |
cumulative incidence
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What are the problems with cumulative incidence
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-Dynamic population
-Geographic mobility - Loss to follow- up |
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What is the solution to problems with cumulative incidence
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use rates as indicator of risk
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When are rates used as an indicator of risk?
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When follow-up period is short and when rate of disease is relatively constant
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Multiplies average rate times duration of follow-up
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Estimate of small risks
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Differing observation time periods for individuals
Person-years of observation |
Incidence density
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What is the formula for incidence density?
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No. of new cases in time period/ total person-time of observation
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Prevalence of disease is proportional to...
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incidence rate times and duration of disease
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Why is prevalence more proportional to Incidence rate times than duration?
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Because Duration is short and Incidence rate times is high
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What are the three different types of rates?
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Crude rates, specific rates, and adjusted rates
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Summary rates based on:
Actual number of events in a population During a given time period |
Crude rates
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Useful measure of population growth
Index for geographic comparison |
Birth Rates
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Most used
Referred to as “fertility rate” |
general fertility
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For fertility rates, this is the number of live births reported in an area during given time interval
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the numerator
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What rate is being described?
Numerator - Number of live births reported in an area during given time interval Denominator - number of women aged 15 to 44 in that area (sometimes aged 15 to 49) Population size – at midpoint of year Multiplier – 1,000 women aged 15-44 |
Fertility rates
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What is the multiplier for fertility rates?
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1000
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_____ ______ _____ is defined as risk of dying during first year of life among infants born alive
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infant mortality rate
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True or False:
Infant mortality rates are higher in developed countries |
False
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Which race has the highest infant mortality rate?
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non-hispanic blacks
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What country has the highest infant mortality rate?
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U.S.
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What Rate is being described?
-Numerator: number of fetal deaths after 20 weeks gestation or more -Denominator: Number of live births plus fetal deaths after 20 weeks or more gestation -Multiplier-1,000 live births and fetal deaths |
Fetal mortality rate
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What rate is being described
28 weeks gestation x 1000 |
Late fetal death rate
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Fetal deaths > 20 weeks/number live births x 1,000
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Fetal death ratio
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Which race has the highest fetal mortality rate more than 20 weeks after gestation
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non-hispanic blacks
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What rate is being described below?
-Measures risk of dying among newborn infants age 0-27 days (under age of 28 days) in given year -Numerator: Number of deaths under 28 days of age -Denominator: number of live births -Multiplier - 1,000 live births |
Neonatal mortality rate
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What rate is being described?
-Measures risk of dying among older infants ( 28 days - 365 days after birth) during given year -Numerator: Number of deaths of older infants -Denominator: Number of live births - neonatal deaths -Multiplier- 1,000 live births (during a given year) |
Postneonatal mortality rate
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Rate being described below.
- Numerator= Period: Late fetal deaths (>28 weeks) plus infant deaths within seven days -Denominator= number of live births + number of late fetal deaths -Multiplier-- 1000 live births and fetal death rates |
Perinatal mortality rate
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What is being described?
-Numerator: Late fetal deaths (>28 weeks) plus infant deaths within seven days of birth -Denominator - number of live births -Multiplier - 1,000 live births |
Perinatal mortality ratio
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What type of rate is being described?
– refers to specific subgroup of population Better to compare rates of disease in a population Entire population, but for specific disease or cause of death Incidence and prevalence can be considered specific measures |
Specific rate
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What type of rate is being described?
refers to entire population Differences in rates may be due to systematic factors in population, not true differences due to: Age, sex, race |
Crude rate
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What is rate is being described?
Numerator: Mortality (or frequency of a given disease) Denominator: Population size at midpoint of time period Multiplier: 100,000 |
Cause-specific mortality rate
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What rate is being described?
Numerator: Mortality due to specific cause during period Denominator: Mortality due to all causes during same period Multiplier: 100 |
Proportional Mortality Ratio
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This rate gives the number of cases per age group of population (during specified time period)
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Age-specific rates
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No. of deaths among those 5-14 years/ No of persons aged 5-14 years (during time period)
Multiplier: 1000 |
age-specific rates
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summary measures of morbidity or mortality in population in which:
Statistical procedures have removed effect of composition differences in various groups in population Age – probably most important variable in morbidity and mortality |
adjusted rates
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What are the three methods for age-adjusted rates?
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-Direct method
-Indirect method -Refers to source of rates |
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Each age-specific rate multiplied by estimated no. in age group in “Standard Population”
Current standard population – pop. distribution in year 2000 |
Direct method of age-specific rate
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Used if age-specific rates of pop. for standardization are unknown or unstable (i.e., small population)
Apply disease rates from another standard population to structure of pop. of interest Expected number of cases /deaths in study population |
Indirect method of Age-adjusted rates
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Evaluation of result of indirect method
1. Construct standardized morbidity/mortality ratio 2. Compute mortality rate per 100,000 by Using expected number of deaths as numerator derived from standard population, not the observed number |
standardized mortality ratio
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-Amount and distribution of disease in a population
-Precedes analytical studies -Identify existing health problems -Reasons for high or low frequency in a specific population. |
Descriptive epidemiology
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-Determinants of disease
-Identify causes of disease |
Analytical Epidemiology
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The are objectives of what?
1. evaluate trends, make comparisons, monitor unknown diseases, identify emerging diseases 2. Provide basis for planning, provision, evaluation of health services, allocation of resources 3. Identify problems for analytical epidemiologic studies and suggest investigation areas |
Objectives of Descriptive epidemiology
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What descriptive epidemiology approach is being described?
-More useful when used in a proportion -May spur additional investigation |
case reports
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-Amount and distribution of disease in a population
-Precedes analytical studies -Identify existing health problems -Reasons for high or low frequency in a specific population. |
Descriptive epidemiology
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What approach of Descriptive epidemiology is being described?
-Many case reports -summary of many consecutive patient characteristics from a major clinical setting |
case series
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-Determinants of disease
-Identify causes of disease |
Analytical Epidemiology
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The are objectives of what?
1. evaluate trends, make comparisons, monitor unknown diseases, identify emerging diseases 2. Provide basis for planning, provision, evaluation of health services, allocation of resources 3. Identify problems for analytical epidemiologic studies and suggest investigation areas |
Objectives of Descriptive epidemiology
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What descriptive epidemiology approach is being described?
-More useful when used in a proportion -May spur additional investigation |
case reports
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What approach of Descriptive epidemiology is being described?
-Many case reports -summary of many consecutive patient characteristics from a major clinical setting |
case series
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What approach of descriptive epidemiology is being described
-Population surveys giving an estimate prevalence of disease or exposure -Gives time trends in prevalence or risk factors when repeated |
Cross-sectional studies
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Most important factor for any disease or illness
more variation than with any other personal attribute Trends fluctuate markedly |
Age
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What age has the greatest cause for unintentional injury mortality?
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1-44 yrs
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Greatest cause for mortality is marked by what age?
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greater than 45
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What is mortality for childhood?
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Developmental problems
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What approach of descriptive epidemiology is being described
-Population surveys giving an estimate prevalence of disease or exposure -Gives time trends in prevalence or risk factors when repeated |
Cross-sectional studies
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What approach of descriptive epidemiology is being described
-Population surveys giving an estimate prevalence of disease or exposure -Gives time trends in prevalence or risk factors when repeated |
Cross-sectional studies
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Most important factor for any disease or illness
more variation than with any other personal attribute Trends fluctuate markedly |
Age
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Most important factor for any disease or illness
more variation than with any other personal attribute Trends fluctuate markedly |
Age
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What age has the greatest cause for unintentional injury mortality?
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1-44 yrs
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What age has the greatest cause for unintentional injury mortality?
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1-44 yrs
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Greatest cause for mortality is marked by what age?
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greater than 45
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Greatest cause for mortality is marked by what age?
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greater than 45
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What is mortality for childhood?
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Developmental problems
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What is mortality for childhood?
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Developmental problems
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What is morbidity for childhood?
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Infectious diseases
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What is morbidity for childhood?
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Infectious diseases
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What is mortality for teenage?
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Accidents, violence, suicides
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What is mortality for teenage?
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Accidents, violence, suicides
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More than one peak incidence over lifetime ages
May indicate > 1 cause of disease |
multimodal incidence
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More than one peak incidence over lifetime ages
May indicate > 1 cause of disease |
multimodal incidence
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0-4 yr and 20-29 yrs
More interaction socially Change in immune status |
TB
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0-4 yr and 20-29 yrs
More interaction socially Change in immune status |
TB
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Mid-20s and early 70s
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Hodgkin's disease
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Mid-20s and early 70s
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Hodgkin's disease
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What is morbidity for childhood?
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Infectious diseases
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What is mortality for teenage?
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Accidents, violence, suicides
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More than one peak incidence over lifetime ages
May indicate > 1 cause of disease |
multimodal incidence
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0-4 yr and 20-29 yrs
More interaction socially Change in immune status |
TB
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this disease is prevalent in the Mid-20s and early 70s
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Hodgkin's disease
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Immune system decrease increased tissue susceptibility
Triggering of genetically-based disease Alzheimer’s |
biological clock
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which gender is higher in all causes of age-specific mortality?
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male
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major factor in sex-difference mortality in Denmark
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smoking
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Lower incidence premenopausal, higher postmenopausal
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"jogging female heart"
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Higher chronic disease morbidity than men
I.d., diabetes, hypertension, elevated cholesterol |
Economically disadvantaged women
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Immune system decrease increased tissue susceptibility
Triggering of genetically-based disease Alzheimer’s |
biological clock
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Immune system decrease increased tissue susceptibility
Triggering of genetically-based disease Alzheimer’s |
biological clock
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Immune system decrease increased tissue susceptibility
Triggering of genetically-based disease Alzheimer’s |
biological clock
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which gender is higher in all causes of age-specific mortality?
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male
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Immune system decrease increased tissue susceptibility
Triggering of genetically-based disease Alzheimer’s |
biological clock
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major factor in sex-difference mortality in Denmark
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smoking
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which gender is higher in all causes of age-specific mortality?
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male
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which gender is higher in all causes of age-specific mortality?
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male
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which gender is higher in all causes of age-specific mortality?
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male
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Lower incidence premenopausal, higher postmenopausal
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"jogging female heart"
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major factor in sex-difference mortality in Denmark
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smoking
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major factor in sex-difference mortality in Denmark
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smoking
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major factor in sex-difference mortality in Denmark
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smoking
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Lower incidence premenopausal, higher postmenopausal
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"jogging female heart"
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Higher chronic disease morbidity than men
I.d., diabetes, hypertension, elevated cholesterol |
Economically disadvantaged women
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Lower incidence premenopausal, higher postmenopausal
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"jogging female heart"
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Lower incidence premenopausal, higher postmenopausal
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"jogging female heart"
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Higher chronic disease morbidity than men
I.d., diabetes, hypertension, elevated cholesterol |
Economically disadvantaged women
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Higher chronic disease morbidity than men
I.d., diabetes, hypertension, elevated cholesterol |
Economically disadvantaged women
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Higher chronic disease morbidity than men
I.d., diabetes, hypertension, elevated cholesterol |
Economically disadvantaged women
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