Epidemiology Exam 1

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study of the distribution and determinants of diseases in human populations

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epidemiology

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study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems

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epidemiology

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distribution of disease

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descriptive epidemiology

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determinants of disease

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analytic epidemiology

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deals with individuals isolated from their environment

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clinical medicine

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deals with populations of people in their natural environments

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epidemiology

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exists because disease is NOT randomly distributed

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epidemiology

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father of western medicine

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hippocrates

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founder of "vital statistics"

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john graunt

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he used "social arithmetics"

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john graunt

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he was the first to use quantitative methods for epidemiology

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john graunt

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john graunt observed that this population had a higher mortality rate in youth

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males

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john graunt observed that ________ dwellers had higher mortality rates than __________ dwellers

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city, country

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he demonstrated the mode of cholera transmission 30 years before Robert Koch identified the causative agents

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john snow

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he used modern epidemiology to study cholera outbreaks in London

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john snow

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he studied the relationship between water supply and outbreak

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john snow

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he devised the antecedant for ICD

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william farr

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standard nomenclature and classification system for epidemiology

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international classification of disease (ICD)

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he invented the standardized mortality rate

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william farr

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mode of transmission for cholera

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fecal contamination of water

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type of experiment used to determine the mode of transmission for cholera

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natural experiment

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two important steps in the investigation of an outbreak

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1. taking immediate control measures
2. reporting findings

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type of statistics that organizes and summarizes information in a clear and effective way

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descriptive statistics

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type of statistics that includes graphs, charts, and tables

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descriptive statistics

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type of statistics that includes averages and percentiles

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descriptive statistics

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type of statistics that uses a sample to make inferences about a population

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inferential statistics

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all of the individuals, items, or data under consideration in a statistical study

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population

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that part of the population from which information is collected

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sample

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he developed the vaccine for polio

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jonas salk

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type of study done to create the polio vaccine

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inferential study

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quantitative indices that describe the center of distribution

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mean, median, mode

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most commonly used measure of central tendency

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mean

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number that divides the bottom 50% of the data from the top 50%

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median

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data value(s) that occurs most frequently in a data set

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mode

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least useful measure of central tendency

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mode

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measure used if the data is normally distributed

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mean

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distribution with high variability or non-normal distribution

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nonparametric

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measure that is influenced by all observed values and is sensitive to outliers

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mean

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measure that depends only on values in the middle of the data set and is robust

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median

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measure that ignores all values except the ones with the highest frequency

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mode

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measures the variation in a data set by determining how far the data values are from the mean

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standard deviation

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total area under a normal curve

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1

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this curve extends indefinitely in both directions, approaching the horizontal axis

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normal curve

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curve that is symmetric about the mean

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normal curve

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percent of data that lies between +/- 1 standard deviation

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68

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percent of data that lies between +/- 2 standard deviation

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95

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percent of data that lies between +/- 3 standard deviation

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99

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square of the standard deviation

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variance

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measure used only with parametric data

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variance

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most powerful measure of variability with normally distributed data

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confidence intervals

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confidence interval typically used

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95%

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determines the accuracy of the estimate of the population mean

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confidence interval

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states how confident we are that the population mean lies within the stated interval

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confidence interval

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parametric statistics used with normal distribution

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z and t tests, analysis of variance

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statistics used if you are not sure that the population is normally distributed

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nonparametric

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nonparametric study to determine if two characteristics of a population are dependent

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chi squared independence test

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stage of disease where prevention and protection from disease occur

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stage 1 (susceptibility)

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stage of disease where prevention of progression of disease occurs

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stage 2 (presymptomatic disease)

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stage of disease where treatment of disease occurs

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stage 3 and 4 (clinical disease, disability/recovery)

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stage 1 of disease

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stage of susceptibility

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stage 2 of disease

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stage of presymptomatic disease

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stage 3 of disease

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stage of clinical disease

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stage 4 of disease

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stage of disability/recovery

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stage of disease where risk factors are present

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stage 1 (susceptibility)

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stage of disease where there is no manifestation of disease, but pathogenic stages have started to occur

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stage 2 (presymptomatic disease)

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transition point between presymptomatic disease and symptomatic disease

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clinical horizon

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stage of disease where there are recognizable signs and symptoms

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stage 3 (clinical disease)

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stage of disease where there is a residual defect of short or long duration

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stage 4 (disability)

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stage of disease that includes primary prevention

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stage 1 (susceptibility)

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stage of disease that includes secondary prevention

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stage 2 (presymptomatic)

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stage of disease that includes tertiary prevention

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stage 3 and 4 (clinical disease, disability/recovery)

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type of prevention that includes general health promotion

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primary

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type of prevention that includes specific protective measures (immunization, sanitation, protection against injury)

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primary

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type of prevention that includes early detection and prompt treatment

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secondary

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type of prevention that includes attempting to cure disease or slow its progression

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secondary

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type of prevention that includes limitation of disability and rehab

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tertiary

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constant presence of disease within a given geographical area

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endemic

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usual presence of disease

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endemic

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occurrence of disease in excess of normal expectancy within a geographical area

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epidemic

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a state of altered responsiveness to a specific substance through immunization or natural infection

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specific immunity

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disease causing factors that include specific immunity and affect susceptibility to disease

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host factors

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disease causing factor that includes personality

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host factor

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disease causing factor that includes influence exposure and sometimes indirectly affect susceptibility

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environmental factors

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three types of environment that affect disease

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1. biological
2. social
3. physical

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standardized approach to looking at demographics of a population

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population pyramid

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periodic counts of the population

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census

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frequency of US census

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10 years

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provides a denominator for calculations of incidence and prevalence

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census

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must be stated on death certificate

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cause of death

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percentage of deaths that involve autopsy

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15%

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reason why autopsy data is not useful

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not random

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data that includes reports of notifiable diseases

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morbidity data

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compliance in reporting disease varies with this

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disease

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these types of diseases are more likely to be reported

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rare

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authority in reporting disease lies here

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with individual state

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time allowed for reporting diseases after it's discovery

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72 hours

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when reporting disease, patients are identified to prevent this

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multiple reports

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reported disease is not anonymous until it reaches this

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CDC

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number of years an individual is expected to live

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life expectancy

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gender with greater life expectancy, generally

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women

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greatest impact on life expectancy in the US includes this

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increasing survival in infancy and early childhood

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least progress on life expectancy in the US

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extending human lifespan

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number of new cases of a disease in a population over a period of time

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incidence

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probability that a non-diseased individual will develop a specific disease during a specified period of time

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incidence

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number of new cases / population at risk

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incidence rate

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population without disease at the mid year

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population at risk

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number of individuals who have a particular disease at a given time

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prevalence

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number of existing cases / population at risk

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prevalence rate

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summary rates based on the actual number of events in a population over a given time period

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crude rates

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refers to a particular subgroup of the population defined, for example, in terms of race, age, or sex, or for an entire population but specific for a single cause of illness or death

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specific rates

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leading causes of death in the US (all ages)

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heart disease, cancer, stroke

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leading causes of death in young people in the US

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accidents, homicides, suicides

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summary measures of the rate of morbidity or mortality in a population in which statistical procedures have been applied to remove the effect of differences in composition of the carious populations

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adjusted rates

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variable for which adjustment is most often required because of its marked effect on morbidity and mortality

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age

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studies that determine the amount and distribution of a disease within a population by person, place, and time

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descriptive studies

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studies that focus on determinants of disease or reasons for high or low frequency in a specific group

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analytic studies

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identifies non-random variations in the distribution of disease to enable an investigator to generate testable hypothesis regarding etiology

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descriptive epidemiology

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reveals the patterns of disease occurrence in human populations

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descriptive epidemiology

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legionnaire's disease affects this type of age group mainly

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elderly

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measles, mumps, and rubella affects this age group mainly

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young

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encephalitis affects this age group mainly

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infants

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gender with higher mortality

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male

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gender with higher morbidity

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female

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TB has a higher rate in individuals in this socio-economic status

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homeless

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these two marital status has the lowest mortality and morbidity

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married, single

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these two marital status have greates mortality and morbidity

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divorced, widowed

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diseases that depend on specific environmental conditions

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place diseases

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diseases that show a marked difference between tropical and temperate regions

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place diseases

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trends that are long term variations

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secular trends

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trends that are annual or seasonal

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cyclical trends

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studies used to determine disease rates and ID risk factors

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analytic studies

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study that compares cases and controls

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retrospective

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study that looks at past exposures for possible risk factors

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retrospective

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analytic study that is less expensive, faster, and depends on reliable medical records and patient recall

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retrospective

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cohort study

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prospective

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study where all subjects are disease free at the start of the study

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prospective

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study where subjects are divided into groups based on exposure to risk factor and followed up to see who develops disease

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prospective

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analytical study that is longer, more expensive, and provides incidence rates

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prospective

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ratio of incidence rates of those exposed to those not exposed

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relative risk

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estimate of reative risk

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odds ratio

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situation where relative risk is >1.0

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risk factor

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situation where relative risk is =1.0

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no risk

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situation where relative risk is <1.0

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protective

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causal relationship with spurious association and false association that occurs by chance or through bias

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artifactual association

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causal relationship with indirect association and where factor and disease are both related to a common underlying condition

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indirect association

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causal relationship in which the disease is caused by the risk factor

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causal association

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3 criteria required for screening tests

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quick, inexpensive, not invasive

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presumptive identification of unrecognized disease or defect by the application of tests, applied rapidly to sort out apparently well persons who probably have a disease from those who probably do not

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screening

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group identified by screening that are presumed free of disease

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negatives

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group identified by screening that require further diagnostic testing

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positives