Epidemiology

Front 1

Types of epidemiology

Back 1

descriptive, analytical, experimental, theoretical

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Epidemiology definition

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Study of determinant and dynamics of health in communities and population for the design and implementation of interventions that protect, maintain, and restore health well-being and productivity in individuals and populations

Front 3

community health vs public health

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public health is more organized gov’t run, whereas community health is often more grassroot efforts to do the same things

Front 4

social epidemiology

Back 4

the study of relations between social factors and disease in populations

Front 5

nutritional epidemiology

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to determine associations between dietary factors and the occurrence of specific diseases

Front 6

clinical epidemiology

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study of the variation in the outcome of illness and of the reasons for that variation; diagnosis, prognosis, treatment outcome uncertain for individual patients – use probability based on ‘population’ outcome

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nutritional epidemiology and ecologic study

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studying different regions or country and how nutritional differences affect disease prevelance (ex increased fat intake in US and increased breast cancer risk as compared to china). View relationship on an aggregate level, but drawbacks include the effect of other factors as well, genetics for ex

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evidence-based medicine

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formulate specific clinical question find best research evidence strength of evidence → prognosis and clinical decision

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Given a lot of research evidence, what do you look for when figuring out 'strength' of that evidence?

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statistical power-- want larger n, smaller CI (more precise)

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target population

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population you want to use results you generate on
-external validity

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source population (study population)

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population from which you draw your samples
internal validity. randomness is applied here at level of the study population

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sample

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want it so each subject has equal chance of being drawn, good representation of the population, non-zero, RANDOMIZED
-internal validity

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internal validity

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degree to which the study is correct for the sample of subjects being studied; paying attention to underlying conditions and making sure done accurately within the study population

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external validity

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degree to which the results of an observation hold true in other setting (generalizabllity); how well the results apply to the whole population

Front 15

confounding bias

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association of ‘extrinsic’ factor with outcome and exposure, independently ; known or unknown variable
that influences assessment of variable of interest on
outcome. ex of folic acid intake and colon CA prevention (influence of other factors need to be considered)

Front 16

ex of information bias

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Recall
Lead time
Length time
Diagnostic
Will Rogers phenomenon Family information

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ex of confouding bias

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Follow-up Attrition
Dilution

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ex of intervention bias

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Compliance
Proficiency
Contamination