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rates ratios and proportions often measure...

dichotomous outcomes

rates, rations and proportions are what type of measures?

descriptive measures

rate is..

frequency of event in specific time period

what does finding risks for different subgroups allow for

allows identification of high risk groups and possible clues of causality

4 components of rate

numerator freq
denominator population time period multiplier  / how many 
ratio is...

relationship between numerator and denominator when they are unconnected quantities

proportion is...

numerator and denominator are always related
often shown as percent 
equations
rate ratio proportion 
rate X / delta t
ratio X / Y proportion X / Y+X 
Morbidity

any departure from well being

Mortality

any departure from actually living...aka death

morbidity measures are?
2types 
incidence and prevalence

incidence

number of new cases

prevalence

number of cases in population

Cumulative incidence is

proportion of population at risk that develops disease over specific peroid
denominator must be observed entire duration followup 
Cumulative incidence equation is

CI = number new cases dx during time
______________________ Pop at risk during same time 
Incidence rate is

same shit only with diff length of folow up times

Incidence rate equation

Numberof new cases in specific time
IR = __________________________ total person time of observation in pop at risk...huh 
Prevalence is

number of existing cases in entire pop

point prevalence is

number of ppl w/ dx at single point in time
_________________________ total number pop at that time 
period prevalence is

number ppl w/ disease at any point during time peroid
______________________________ number of persons in pop 
incidence and prevalence
think about it as... 
a bath tub....
incidence water going in prevelence water inside and death or recovery is how fast water leave and prevelance goes down 
Crude mortality rate is
CMR 
total number deaths from all causes per 1000 persons during specific time
______________________ total number persons at that time 
Age specific mortality rate is
ASMR 
total number of deaths from all causes in specific age group
___________________________ total number in that age group 
Cause specific mortality rate
CSMR 
deaths from specific cause
________________________ total pop that period 
case fatality
CF 
propensity of disease to cause death
number deaths from dx _____________________ # ppl w/ dx 
proportionate mortality
PM 
proportion of deaths from specific cause
deaths from dx _________________ total deaths 
Association measuring is

statistical relationship tween 2 or more variables

Exposure vs Outcome

exposure potential causal characteristics (behavior or tx)
outcome consequence of behavior or tx 
how do we measure association

risk ratio
odds ratio 
risk ratio is

risk of developing event in exposed individual to that of unexposed individual
cumulative incidence exposed ________________________ cumulative incidence unexposed 
risk ration of 1 means?
when does exposure show association? 
risk is equal in exposed and unexposed groups
if greater than 1 than exposure is associated NOTE TO REMEMBER for calculations with risk ratio recognize that total is for each group not whole study!!!! 
Odds ratio is..

ratio of number events and nonevents in cases to number of events and nonevents in control....
double positives * double negative __________________________ mixed * mixed 
OR greater than 1 means?
what about less? 
greater odds for event in exposed group higher
less event less liekly in exposed group 
Difference in descriptive and analytic epidemiology?

analytic tests predetermined hypotheses about association tween exposure and outcome variables

hypothesis serves as

framework for determining statistical significance

null hypothesis...

really how many times have we learned this now....
means no difference (for u morons out there) 
alternative hypothesis..

theres an association

When type 1 and type 2 errors?
wheres beta and alpha? ?]]when does power matter? 
I = P = positive
II = N = negative power matters when null is rejected truthfully 
what is P value and what used for

probability that effect as large as one seen in study could be from chance alone
used to determine conclusion of study 
how do sample size and P value relate?

inverse relationship
sample up, P down 
normal P is...

0.05

to determine if findings significant what do we do once we have P value?

use appropriate stat anal method
compare calc value to table value at specified P value IF calc value larger...data significant 
what 4 tools are used to measure effects of interventions on outcomes

relative risk reduction
absolute risk reduction number needed to treat number neede to harm 
relative risk reduction

extent to which exposure reduces a risk in comparison to unexposed
proportion of risk in untreated group... RRR= (Ru  Re) / Ru or 1 RR 
absolute risk reduction

simple...absolute value difference event rate of exposed and unexposed groups
ARR = Re  Ru 
NOTE

from what i understand these Re or Ru are cumulative incidence things

descriptive statistics vs inferential stats

D methods and procedures for summarizing and describing data
I methods used to make statements about the populations based on sample 
attribute is

specific value of variable
ex female for gender 
requirements of variables..

exhaustive
mutually exclusive 
Types of variable are

Nominal
Ordinal Interval Ratio Discrete vs continous Dependant vs independant 
What types of relationships can we have tween variables and what do they look like

Negative
Positive None Curvilinear  ex age vs intelligence 
True score theory

takes into account the two components involved in measurement
Observed score = true ability + random error 
random vs systematic error

random from factors that randomly effect measurement
not consistent effects add variability w/o changing average called noise Systematic affect measurement across sample positive or negative consistently called bias 
reliability vs validity

R repeatability or consistency
V best availible approximation of the truth 
Types of validity

External
Construct Internal Conclusion 
External validity

can we generalize this to other persons, places, times
get a random large sample to get this 
construct validity

are you using the correct instruments to measure what we are attempting to understand
are we executing this correctly design wise 
internal validity

do we see cause and effect
is this the true cause or its it something else thats causing it 
conclusion validity

to the results and findings match the conclusion given
are we reading the data correctly and taking it into account 
3 major characteristics of a variable

distribution
central tendency dispersion 
dispersion
how to measure it 
spread of values around the central tendency
range and standard deviation will show how certain scores relate to the mean of sample 
Statistical inference allows

decision making information about hypotheisiszed values of an unknown parameter

what kind of error is avoided and which can u not really help...

systematic error avoided since it can be eliminated
random error just kinda happens 
point estimates provide information on random error T/F

F they do not...

Confidence intervals

interval estimation associating a measure statistical variation with a point estimate
has two numerical values defining range of values covering parameter being estimated 
confidence interval better definition

range of values around point estimate tween upper and lower limits

how are precision and random error related

inversely
smaller random error more precise point estimate 
look at notes pages 34 37 cuz i dont know wtf is going on there...

do it

how do we see relationships tween indepenant variables, control variables and dependant variables

regression modelling!

Continous outcome
what kind of regression sued what association measure we get 
linear regression
regression coefficient 
categorical (dichotomus)
what kind associateion measure 
logistical
odds ratio 
time to event.....

cox regression
hazard ratio.... (thats not what i heard in drug lit....) 
What are third variable effects?
what are 3 types 
when other IV effect our results
Confounding Mediation Moderation 
Confounding

changes relationship related to both
different interpretations when ignored or included 
mediator

accounts for all or part of relationship
IV causes interveneing variable in turn causes DV differs conceptually from mediation confounder is not intermediate in causal sequence 
moderator

alters strength or direction of relationship
relationship is diff at diff lvls of moderator 
Medical utilization patterns
effectiveness of therapy depends on 
therapy appropriate
medication used as recommended 
suboptimal medication ultilization is

the point below which desired effect is unlikely to be achieved

Compliance

extent behavoir coincides medical advice

adhereance

patients failure consume medication according to directions

concordance

agreement tween pt and HCP regarding ultilization behavior

ISPOR does what...

defines medical compliance conformity to recommendation dosing, timing, freq

persistance

length of time taking medication in time...

What kinds of complaince are there

initial noncompliance
partial complinace compliance hypercompliance 
how can we measure complaince

direct measures directly observed therapy
indirect measures self report, provider esimates 
ethics

contemporary emphasis on rights of ppl take risks to save themselves

sumthing about IRBs and other ethical issues...

dont care
