Epi Block 1 Definitions

Front 1

Define Prevention

Back 1

Actions aimed to promote and preserve health; eradicating, eliminating, or minimizing the impact of injury, disease and disability.

Front 2

Primary Prevention

Back 2

Modifying Risk factors or Eliminating causes.

Phase: Before diseases is present

Strategy: Reduce or remove risk factors

Educate on health promotion

Front 3

Methods of primary prevention: Life Style

Back 3

Life Style --> Health Education

Exercise, Avoid tobacco, Limit Alcohol, safe Sex

Nutrition: Healthy diet, reducing salt, sugar and fat.

Promote Breastfeeding (helps develop immunity in a newborn)

Front 4

Methods of Primary Prevention: Enviroment

Back 4

Clean water, vector control

Adequate housing and good waste disposal

Environmental pollution and violence

Front 5

Methods of Primary Prevention: Specific Protection

Back 5

Supplements: Folic Acid in pregnancy (prevents neural tube defects)

Immunizations: to prevent infectious disease

Occupational safety

Automobile Safety

Front 6

Secondary Prevention

Back 6

Finding Disease in an asymptomatic person to improve prognosis

Phase: Disease present

Strategy: Diagnose the disease early

prompt treatment

Arrest disease process

Prevent disability

Front 7

Methods of Secondary Prevention: Early Diagnosis and treatment

Back 7

Screening test

- Pap Smears, Colonoscopy, Mammography

Regular Check ups

Front 8

Tertiary prevention

Back 8

Limiting complications and disability in symptomatic patients.

Phase: Disease present- clinical course after occurrence of disease

Strategy: Restore Normal/near normal functioning

Reduce fatalities and complications

Front 9

Methods of tertiary Preventions

Back 9

Disability limitation

Rehabilitation

Medical treatment/Therapy

Prosthetics

Physiotherapy

Front 10

What is the CDC involved in?

Back 10

Developing and applying prevention and education activities to improve the health of the people of the US.

1) Disease Prevention and control (especially infectious diseases)

2) Environmental health

3) Occupational Safety and Health

4) Health Promotion

Front 11

Descriptive Epidemiology measures?

Back 11

- The extent of certain "disease" (frequencies)

- Who, Where, and When is at risk (time, person place)

-The consequences of this "disease"

Front 12

Analytic epidemiology

Back 12

- What are the risk involves (determinants of disease)

= determinants of disease

Front 13

Why are Scatter Diagrams important?

Back 13

For initial exploration of the relationship between two quantitative variables

Front 14

Define Regression

Back 14

A mathematical model to describe the effects of one or more independent variables on a dependent variable.

Front 15

Linear Regression

Back 15

Effect of one Independent variable (X) on one independent variable (Y)

Front 16

Multiple Regression

Back 16

Effect of many independent variables on one dependent variable

Front 17

The Equation for the least squares regression line is:

Back 17

y = a + bx

where,

a= intercept

b= slope

Front 18

For a Mother who has a Body Mass Index of 40, what would be the predicted birth weight of the baby be?

given: a= 1.775 , b = 0.033

Back 18

Y= a + bx

Y= 1.775 + 0.033 (40)

Y= 3.096

Baby's birth weight is expected to be ~3.1 Kg

Front 19

Correlation coefficient

Back 19

A statistic that summarizes the size and direction of a relationship between 2 variables.

Front 20

Correlation coefficient vs regression

Back 20

correlation coefficient, r, measure the strength of the linear association between two variables, x and y

The regression line is a prediction equation that estimates the values of y for any given x

y = a + bx

Front 21

r takes values between -1 and + 1

Back 21

r = +1; Maximum or perfect positive correlation

r= -1; Maximum or perfect negative correlation

r= 0 represent no linear relationship between the two variables

r>0 implies a direct linear relationship

r <0 implies a inverse linear relationship

the closer comes to either +1 or -1, the stronger is the linear relationship.

Front 22

Coefficient of Determination r^2

Back 22

Another important measure of linear association between x and y (0 < r^2 < 1)

measures the proportion of the total variation in y which is explained by x

Front 23

Outliers

Back 23

impact r values, they are extreme values. Having a negative impact so we remove them, or re-do the study and get the data again

Front 24

correlation

Back 24

quantifies the degree to which two variables are related; it does not find the a best-fit line (that is regression)

Front 25

Linear regression

Back 25

what is the cause and what is the effect as the regression line is determined as the best way Y from X.

Front 26

Reasons for using a correlational study design

Back 26

-simple and easy to conduct

-cost effective

-time

-to discover new relationships that can later be explored using analytic studies.

Front 27

Name my descriptive studies (observational)

Back 27

Case Report

Case Series

Ecological/Correlational studies

Cross-sectional studies

Front 28

Name my analytic studies (observation)

Back 28

Case-control

Cohort

Front 29

Name my interventional analytic studies

Back 29

Randomized controlled trials

Cross over trials

Front 30

When do we do a case report?

Back 30

when we like to document unusual medical occurrences.

Front 31

Which report describes the experience of a single patient?

Back 31

Case Report

Front 32

When do we do a case series?

Back 32

Describes the experience of a group of patients with the same diagnosis (usually 5-10 people, but can be up to 100)

Front 33

What problems do we encounter with case reports and case series?

Back 33

-Often based on the experience of only one or a few patients.

- presence of a risk factor may only be coincidental

cannot test for the presence of a valid statistical association

THERE IS NO COMPARISON GROUP

Front 34

what is the other name of a cross sectional study?

Back 34

Prevalence Surveys

(exposure and disease are measured simultaneously)

Front 35

Examples of Cross sectional studies?

Back 35

Obesity and TV viewing

Alcohol and CHD

HTN and physical inactivity

Front 36

What are the benefits of cross-sectional studies?

Back 36

-Used to formulate a HYPOTHESIS

-Used to provide information on prevalence of disease and health outcomes

- Used to formulate hypothesis

Front 37

What problems do we encounter with cross sectional surveys?

Back 37

Surveys gather PREVALENCE, NOT INCIDENCE Data.

WE CANNOT TEST HYPOTHESIS, ONLY FORM ONE.

since we assessed both exposure and disease at the same time we don't know which came first.

Front 38

When do we do a correlational (ecological study) ?

Back 38

-Investigating a possible exposure-disease relationship

- use populations as unit of analysis

Front 39

What is Ecological Fallacy mean?

Back 39

Incorrectly assuming that an association on a population level reflect association on an individual level. (i.e.- Depression and Obesity)

Front 40

A state of complete physical, mental, and social well being is defined as what?

Back 40

Health

Front 41

The science concerned with safeguarding and improving the physical, mental and social well-being of the community as a whole is defined as ?

Back 41

Public health

Front 42

Define disease

Back 42

An abnormal condition of an individual that impairs physiological functioning

physiological/psychological dysfunction

Front 43

________ is a subjective state of the person who feels aware of not being well

Back 43

Illness

Front 44

Sickness is defined as what?

Back 44

a state of social dysfunction, i.e., a role that the individual assumes when ill

Front 45

Greater number of cases of a disease than expected in a given population is defined what?

Back 45

Epidemic

Front 46

____________ is a constant presence of a disease in particular locality, region, or people.

Back 46

Endemic

Front 47

Define Pandemic

Back 47

Epidemic that spreads though human populations across a large region, continent, or even worldwide

Front 48

Public Health focuses is which type of Prevention?

Back 48

Primary

Front 49

Difference between clinicians and epidemiologist?

Back 49

Clinicians are concerned with the health of an individual

Epidemiologist are concerned with collective health of the people in the community.

Front 50

Triad of Descriptive Epidemiology?

Back 50

Person, Time, Place

Front 51

What are the types of Descriptive Epidemiological Studies?

Back 51

Case Reports

Case Series

Correlation studies

Cross sectional studies = community health surveys.

We're observing the basic features of time, person, and place.

Front 52

What are the types of analtyical epidemiological studies?

Back 52

Cohort, Case control, Clinical Trial.

We're testing a hypothesis!

Front 53

Triad of Analytic Epidemiology

Back 53

Agent

Host Factors

Environment

Front 54

3 forms of disease transmissions with examples of each:

Back 54

Reservoir - I.e. Person, animal, soil, plant or a combination of these

Vector - Tick, Flea, mosquito (animate)

Vehicle- fomites, blood, food, and water (inanimate) that may indirectly transmit an infectious agent from a reservoir to a host.

Front 55

Dynamics of Disease transmission

Back 55

Source of Reservoir --> Modes of Transmission --> Susceptible host

The process of spread of a disease agent through a population

1) Who got it?

2) How did it spread?

Front 56

T or F: contaminated needles are a form of direct transmission?

Back 56

False

Front 57

Give 4 examples of how direct transmission can occur

Back 57

Direct contact

Contact with soil

inoculation in to skin or mucosa

Trans-placental (vertical)

Front 58

3 examples of indirect transmission?

Back 58

Vehicle Borne

Vector Borne

Airborne

Front 59

True or False: Descriptive studies can be used to prove an association between 2 variables?

Back 59

False- we can only form an hypothesis with descriptive data.

We need to analyze the date (analytical epi) only after that you can prove an association.

Front 60

Define surveillance & Name the 3 types

Back 60

Monitoring the progress of a disease in a community.

Active

Passive

sentinel

Front 61

What type of surveillance do we use during outbreaks to identify additional cases?

Back 61

Active Surveillance

(i.e.- Ebola)

Front 62

If a man comes in to the clinic and is diagnosed with HIV, and we report the case the health authorities what type of surveillance is this?

Back 62

Passive

Front 63

______________ is Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population

Back 63

Sentinel Surveillance

ex: WHO launches eradicate polio campaign by administering vaccinations

Front 64

the simplest and most frequently performed quantitative measure in epidemiology is

Back 64

COUNT

Front 65

Incidence formula

Back 65

# of new cases/ population at risk x 10^n

Front 66

Prevalence formula

Back 66

# of existing cases/ total population

Front 67

____________ measure the rate at which people without a disease develop the disease during a specific time period

Back 67

Incidence

Front 68

Incidence Density Formula

Back 68

# of new cases occurring in a given period

________________________________________ x 10 ^n

Total person-time of observation

Front 69

Incidence density is defined as

Back 69

the true incidence of disease at any given point in time.

Front 70

_____________________ is the proportion in the population who have a particular disease at given time.

Back 70

Prevalence Rate

Front 71

What type of study is incidence measured in?

What type of study is prevalence measured in ?

Back 71

Incidence is measured in a cohort study

Prevalence is measured in a cross-sectional study.

Front 72

T or F: Prevalence does not say anything about risk of developing a disease.

Back 72

True!

Front 73

True or False: Incidence tells us about the risk and how well the control measures are working.

Back 73

True.

Front 74

Incidence measures __________ duration while prevalence measures __________ duration.

Back 74

Incidence - short

Prevalence - long

Front 75

If you want to determine the cost of treating diabetics in your country-should you know incidence or prevalence?

Back 75

Prevalence

Front 76

If you want to know if anti-smoking legislation has resulted in fewer cases of lung cancer --should you know incidence or prevalence?

Back 76

Incidence (if it's working, the number of new cases should be going down!)

Front 77

what happens to incidence and prevalence if Behavioral risk factors are reduced in the population at large? (unsafe sex)

Back 77

Incidence decreases, and thus so will prevalence.

Front 78

what happens to incidence and prevalence if additional federal research dollars are targeted to a specific condition?

Back 78

No change in incidence or prevalence

Front 79

what happens to incidence and prevalence if a new chemotherapy tx is developed that reduces death from leukaemia but does not produce recovery. Which of the following will occur?

Back 79

Prevalence of the disease will increase

Front 80

Attack Rates is a variant of _________

Back 80

incidence rate

mainly used in epidemic situations

Front 81

Attack Rate formula

Back 81

Same as incidence formula:

new cases occurring in a given time period

__________________________________________ x 10^n

population at risk during the same time period

Front 82

Define secondary attack rate

Back 82

number of new cases among contact of known cases of a specific group

Front 83

Crude mortality definition and formula

Back 83

the proportion of population dying every year

all death during a calendar year

_______________________________ x 1,000

Population at midyear

it is actual measured rate for the whole pop.

Front 84

When comparing mortality Rates which formulas do we use

Back 84

Age-Specific mortality Rates

and Age-Adjusted Rates

Front 85

Infant mortality Rate formula

Back 85

Deaths infants under 1 yr old in a given year

_________________________________________ x 1000

Live Births in the same year

Front 86

Why is important to measure infant mortality rate?

Back 86

It is an important indicator of country's level of health & Development

Front 87

_________________ is the proportion of the overall mortality ascribed to a specific disease

Back 87

proportion mortality

Front 88

proportion mortality formula?

Back 88

Deaths assigned to the specific disease

_____________________________________ x 100

Total # of deaths from all causes during the same period

Front 89

_______________ is described as "deaths from a specific disease per number of persons with the disease"

Back 89

Case-fatality Rate

Front 90

Case fatality is used in ________ infectious diseases

Back 90

acute

Front 91

Solve: in a population of 100,000 people

20 people have lung cancer

and one year 18 people die from lung cancer

What is case fatality?

Back 91

0.9 or 90%

Front 92

Calculate Infant mortality Rates (IMR) if in 2013,

if 38, 910 infants died and 3.9 million children were born

Remember Infants are < than 1 yr old

Back 92

=38, 910/3.9 Million

= 9.95 per 1000

Front 93

Name the types of measures of association

and why do we do these test

Back 93

RR= Relative Risk

OR= Odds Ration

AR= Attributable Risk

ARP = Attributable proportion

to compare the risk between exposure and disease

Front 94

Relative Risk = RR

formula

Back 94

incidence rate of exposed group

_________________________________

Incidence rate of unexposed group

or

a/(a+b)

__________

c/(c+d)

Front 95

what measure the strength of association between factor and outcome?

Back 95

Relative Risk

Front 96

a risk ratio _______ indicates identical risk in the two groups.

a risk ratio _________ indicates that exposure gives an increased risk.

A risk ratio _____indicates protective factor against developing disease.

Back 96

1

>1

<1

Front 97

The Attributable Risk - AR

Back 97

the absolute effect of the exposure in those exposed vs not exposed

= the excess risk of the disease (the risk diffence)

AR= Ie - Io

Ie is incidence in the exposed

Io is incidence in unexposed

Front 98

the proportion of disease is attributable to exposure.

Back 98

attributable Proportion

Front 99

Formula for Attributable Proportion (ARP)

Back 99

Attributable Proportion (ARP)= AR/Ie

or

Incidence of Exposed- Incidence of unexposed

______________________________________________

Incidence of Exposed