Epidemiology

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What is epidemiology?

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The study of the causes and distribution of disease an health outcomes in a population.

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Epidemiologists...

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-overall public health
-screen for disease
-monitor risks of disease outbreaks
-generate studies of disease progression and relationships
-ultimately try to decipher disease causality and improve public health
-knowledge abotu disciplines such as clinical medicien, pathopsychology, statistics, social sciences, and public health.

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Epidemiological survailance..
(passive an active)

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passive- reporting cases from hospital
active- periodic health care facility visit

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Disease frequency measures...

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-Cumulative incidence
-incidence rate
-prevalence

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Cumulative incidence

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amount of new diseases that emerge in a population in a set time frame, i.e. risk of getting disease

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Incidence rate

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Amount of new diseases that emerge over time

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prevalence

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total number of disease cases occurring in a population at any one given time

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Cumulative incidence (calculation)

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# of new dease cases/ # in candidate population

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Incidence rate (calculation)

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# new disease cases/ person-time of pop. observation

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How is prevalance different from incidence?

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Prevalence is a slice through a population at a point of time determining who has the disease and who doesn't whereas incidence only looks at new cases

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What are factors that are increasing prevalence

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-migration of ill cases
-emigration of healthy person
-immigration of susceptible case on those wth that potential
-prolongation of life cases w/o cure
-increase in new case occurance

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Factors decreasing prevalence..

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-immigration of healthy people
-emigration of ill cases
-increased DR from diseases
-decrease in occurrence of new cases
-shorter disease duration
-death

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the comparisons of disease frequencies: the measures of association

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-relative risk
-risk difference

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Relative risk

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-captures strength of relationship b/w exposure and disease=freq. measure in exposed group/ freq. Unexp.
-tells how many times higher a lower disease is among exp. v unexp.
-more useful for etiological research

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Risk difference

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-absolute/excess risk of disease associated with exposure= freq. measure in exp. group- unexp. group. -This tells you the excess risk association with exposure

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Endemic

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A disease/ pathogen usually prevalent in a pop./region at all times

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Epidemic

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A suddenly occuring disease that exceeds in no. whats attributable to endemic diseases; excess of norm.

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Pandemic

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Widespread epidemic occuring widely through a region, country, etc.

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What are some Epidemiological approaches? (two)

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-Descriptive epidemiology
-analytic epidemiology

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Descriptive epidemiology

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examining the distribution of disease in pop. and observing the basic features of its distribution in terms of time, place, and person.
design- community health survey

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Analytic epidemiology

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Testing specific hypothesis about the relationship of a disease to a putative course, by conducting an epidemiologic study that relates exposure of interest to disease of interest.
design- cohort, case control

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causation criteria

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-temporal relationship
-strength of association
-biological plausibility
-replication of findings
-does-response isolation
-consideration of alternate explanations
-consistency with other knowledge