Phealth Research And Practice Midterm

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surveillance

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the ongoing collection and timely analysis, interpretation, and communication of health information for public health action

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case definition

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includes person being affected, place, and time

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epidemic

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the occurrance in a community or region of cases of an illness, specific health related behavior, or other health related events clearly in excess of normal expectancy

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pandemic

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an epidemic occurring worldwide

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epidemiology

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concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability, and mortality in populations

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distribution

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occurrence of diseases and other health outcomes varies in populations, with some subgroups of the population being more affected than others

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determinant

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any factor that brings about change in a health condition or other defined characteristic

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exposure

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contact with a disease causing factor or the amount of the factor that impinges upon a group or individuals

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outcomes

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all the possible results that may stem from exposure to a causal factor

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quantification

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counting of cases of illness or other health outcomes

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descriptive epidemiology

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studies that are concerned with characterizing the amount and distribution of health and disease within a population

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analytic epidemiology

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examines causal hypotheses regarding the association between exposures and health conditions

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dose-response relationship

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the observation that the effects of a poison are related to the strength of its dose

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epidemiologic transition

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shift from causes related to infectious and communicable diseases to causes associated with chronic, degenerative diseases

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demographic transition

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shift from high birth rates and death rates to lower birth rates and death rates

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risk

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probability that an event will occur (that an individual will become ill)

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risk factor

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exposure that is associated with a disease, morbidity, mortality, or adverse health outcome

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HIPAA

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health insurance portability and accountability act of 1996, protects personal information contained in health records

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vital events

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deaths, births, marriages, divorces, and fetal deaths

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registry

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centralized database for collection of information about a disease

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maternal mortality

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maternal deaths that result from causes associated with pregnancy

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infant mortality rate

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number of deaths of infants under 1 year/number of live births

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fetal mortality

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number of fetal deaths after 20 weeks of gestation/number of live births+number of fetal deaths after 20 weeks of gestation

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crude birth rate

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number of live births in a given period/population size at middle of that period

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general fertility rate

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number of live births within a year/number of women aged 15-44 years at the midpoint of the year

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perinatal mortality rate (takes in to account late fetal deaths and deaths among newborns)

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number of late fetal deaths after 28 weeks or more gestation+infant deaths within 7 days of birth/number of live births+number of late fetal deaths

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bar chart

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frequency of categories of a categorical variable (ex yes/no)

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continuous variable

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could have infinite number of values along a continuum

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incidence

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the occurrence of new disease or mortality within a defined period of observation in a specified population

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incidence rate

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number of new cases that occur during a time period/number of individuals in population at risk

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prevalence

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number of existing cases of disease or health condition, or deaths in a population at some designated time

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point prevalence

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all cases of a disease, health condition, or deaths that exist at a particular point in time relative to a specific population from which cases are derived

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period prevalence

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all cases of a disease within a period of time

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lifetime prevalence

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cases diagnosed at any time during the person's lifetime

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crude rate

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has not been modified to take account of any of the factors (ex demographic makeup)

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reference population

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the population from which cases of a disease have been taken

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case fatality rate

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number of deaths due to disease x/number of cases of disease x

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proportional mortality ratio

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mortality due to a specific cause during a period of time/mortality due to all causes during the same time period

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cause specific rate

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mortality (or frequency of a given disease)/population size at midpoint of time period

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age specific rate

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number of cases of disease per age group of the population during the specified time period

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adjusted rate

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statistical procedures have been applied to permit fair comparisons across populations by removing the effect of differences in the composition of various populations

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case reports

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accounts of a single occurrence of a noteworthy health related incident or small collection of such events

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cross sectional study

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examines relationship between diseases and other variables of interest as they exist in a defined population at one particular time

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person variables

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age, sex, race, socioeconomic status

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health disparities

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difference in the occurrence of diseases and adverse health conditions in the population

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place variables

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international, national (ex regional or urban-rural comparisons), and localized

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secular trends

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gradual changes in the frequency of diseases over long time periods

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cyclic trends

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increases and decreases in the frequency of a disease or other phenomenon over a period of several years or within a year

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point epidemic

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response of a group of people circumscribed in place to a common source of infection, contamination, or other etiologic factor

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clustering

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a closely grouped series of events or cases of a disease or other health-related phenomena with well defined distribution patterns in relation to a time or place or both

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association

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linkage between or among variables

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positive association

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as value of one variable increases, so does the value of the other variable (positive r)

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negative association

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when value of one variable increases, the value of the other variable decreases (negative r)

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correlation coefficient (r)

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measure of the strength of association, ranges from -1 to 1

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no association

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variables are unrelated, r=0

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linear increasing graph

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positive association

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inverse linear graph

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negative association

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circular shape of graph

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no association

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curved graph

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relationship is nonlinear (not necessarily no correlation)

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dose response curve

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type of correlative association between an exposure and effect

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threshold

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lowest dose a which a particular response occurs

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multimodal curve

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has several peaks in the frequency of a conditions (could be caused by change in immune status or lifestyle of host)

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mode

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category in a frequency distribution that has the highest frequency of cases

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latency

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time period between initial exposure and a measurable response

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epidemic curve

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a graphic plotting of the distribution of cases by time of onset

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contingency table

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tabulates data according to two dimensions

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method of difference

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a situation in which all of the factors in two or more domains are the same except for a single factor

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method of concomitant variation

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frequency of an outcome increases with the frequency of exposure to a factor

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operationalization

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process of defining measurement procedures for the variables used in a study

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hill's criteria of causality

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strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment, analogy

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multiple causality

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diseases that involve more than one causal factor

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point estimate

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single value chosen to represent the population parameter

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confidence interval estimate

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range of values that with a certain degree of probability contain the population parameter

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power

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the ability of a study to demonstrate an association if one exists

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population parameters

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incidence rate, prevalence, proportion, odds ratio, relative risk

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retrospective

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obtaining information about exposures that occurred in the past

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ecologic study

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the units of analysis are populations or groups of people rather than individuals

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ecologic comparison

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assessment of the association between exposure rates during the same time period

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ecologic correlation

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association between two variables measured at the group level

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ecologic fallacy

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erroneous inference that may occur because an association observed between variables on an aggregate level does not necessarily represent or reflect the association that exists at an individual level

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case-control study

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subjects are defined on the basis of the presence or absence of an outcome of interest, small sample sizes, low prevalence conditions, rapid results

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odds ratio

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measure of the association between frequency of exposure and frequency of outcome used in case control studies (greater than 1 means positive association)

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cohort

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population group, or subset thereof, that is followed over a period of time

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prospective cohort study

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subjects classified according to exposure to a factor of interest and then observed over time

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retrospective cohort study

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makes use of historical data to determine exposure level at some baseline in the past

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relative risk

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ratio of the incidence rate of a disease or health outcome in an exposed group to the incidence rate of the disease or condition in a nonexposed group

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attributable risk

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the difference between the incidence rate of a disease in the exposed group and the incidence rate in the nonexposed group

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population risk difference

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difference between rate of disease in nonexposed segment of population and overall rate in population

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intervention study

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investigation involving intentional change in some aspect of the status of the subjects

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randomized controlled trial

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subjects in a population are randomly allocated into groups (study/control) to receive or not to receive an experimental preventative of therapeutic intervention

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prophylactic trial

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tests preventative measures

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therapeutic trial

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evaluates new treatment methods

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clinical trial

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involves administration of a test regimen to humans to evaluate efficacy and safety

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crossover design

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participants may be switched between treatment groups

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community intervention

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designed for purpose of educational and behavioral changes at the population level

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quasi-experimental study

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investigator manipulates the study factor but does not assign individual subjects randomly to the exposed and nonexposed groups

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program evaluation

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determination of whether the program meets stated goals and is justified economically

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external validity

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one's ability to generalize from the results of the study to an external population

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sampling error

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values (statistics) obtained for a sample differ from the values (parameters) of the parent population

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internal validity

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degree to which the study has used methodologically sound procedures

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hawthorne effect

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participant's behavioral changes as a result of their knowledge of being in a study

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recall bias

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cases may remember an exposure more clearly than controls

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selection bias

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distortions that result from procedures used to select subjects and from factors that influence participation in the study

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confounding

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distortion of a measure of the effect of an exposure on an outcome due to the association of the exposure with other factors that influence the occurrence of the outcome

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infectious disease

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illness due to a specific infectious agent or its toxic products

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epidemiologic triangle

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model used to describe the etiology of infectious disease, includes agent, hose, and environment

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environment

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domain in which disease causing agents may exist, survive, or originate

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incubation period

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time interval between invasion by an infectious agent and the appearance of the first sign of symptom of the disease

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subclinical

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infection does not show obvious clinical signs or symptoms

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generation time

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time interval between lodgement of an infectious agent in a host and the maximal communicability of the host

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index case

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denotes first case of a disease to come to the attention of authorities

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categories of significant infectious diseases

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STDs, foodborne diseases, waterborne diseases, vactor borne, vaccine-preventable, zoonotic, emerging infections, bioterrorism-related