Epi Final

Front 1

Analyzing data

Back 1

1. Determine the magnitude of association - use measures of association and impact

2. Rule out the role of chance in the results by doing confidence intervals and hypothesis testing

3. Rule out confounding by restriction or statistical adjustment for potential confounders

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2 main study designs

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1. Experimental

2. Non-experimental (observational)

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Experimental study design

Back 3

Intentional manipulation of the subjects

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Observational study design

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Lack of manipulation, a.k.a. non-experimental

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Goals of Epidemiology

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1. Maintain an accurate picture of disease incidence and prevalence in a population

2. Find and evaluate risk factors and correlates of a disease (i.e. agent, host, environmental interactions) - etiology

3. Prevent future disease, reduce incidence/prevalence - disease control

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Ecological study

Back 6

Correlational, population is unit of study

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Cross-sectional

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Prevalence, individuals are unit of study

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Case-control

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Case-reference, individuals are unit of study

Front 9

Cohort

Back 9

Follow-up, individuals are unit of study

Front 10

Randomized controlled trials

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Clinical trials, patients are unit of study

Front 11

Field trials

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Healthy people are unit of study

Front 12

Community trials

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Community intervention studies, communities are unit of study

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Cross-sectional studies

Back 13

-Compares the prevalence of a disease between exposed and unexposed groups

-Data are collected on individuals in a population (or a sample of a population) about their current disease status and their previous exposure

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Case vs. Control

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Case - people with disease

Control - people without disease

Front 15

Target population

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Population that you intend to generalize your findings to

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Three major goals of epidemiology

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1. Distribution

2. Determinants

3. Control

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Epidemiology - definition

Back 17

The 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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Epidemic - definition

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An inc. in the number of cases over past experience for a given population, time, and place

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Endemic - definition

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Normal level of disease in a given population at a given time

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Pandemic - definition

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When an outbreak crosses international borders at a given time

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Epidemiologist - definition

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An investigator who studies the occurrence of disease or other health related conditions or events in defined populations. The control of disease in populations is often also considered to be a task of the epidemiologist

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Surveillance - definition

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The ongoing systematic collection, analysis, and interpretation of outcome-specific data closely integrated with timely dissemination of these data to those who are responsible for preventing and controlling disease or injury

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Outbreak investigation steps

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1. Define the epidemic

2. Examine the distribution of cases

3. Look for the combination of relevant variables

4. Develop hypothesis

5. Test hypothesis

6. Recommend control measures

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Epidemiological triad

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1. Host

2. Agent

3. Environment

Front 25

4 uses of epidemiology

Back 25

1. Establish CAUSATION

2. Study the NATURAL HISTORY of a disease

3. DESCRIBE the health status of a population

4. EVALUATE the impact of interventions to prevent disease or injury in a population and EVALUATE the impact of treatment on groups of patients

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Factors that inc. prevalence

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1. Fatality rate of disease

2. Duration of illness

3. Incidence rate

4. Migration (dynamic population)

5. Reporting

6. Treatment

7. Diagnostics

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Relative risk (RR)

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Risk = (the chances of something happening) / (the chances of all things happening)

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4 properties of relative risk (RR)

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1. Ranges from 0 to infinity (i.e. cannot be negative)

2. If RR = 1 then there is no association

3. If RR > 1 then there is a positive association

4. If RR < 1 then there is a negative association

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Odds ratio (OR)

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Odds = (the chances of something happening) / (the chances of it not happening)

Front 30

3 properties of odds ratio (OR)

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1. Regardless of how the data are sampled, the OR will remain the same

2. It has similar properties to the RR in terms of range, magnitude, and statistical significance

3. Under the conditions of a rare disease, the odds ratio will be a decent approximation to the "true" relative risk

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2 measures used to quantify the distribution of disease occurrences

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1.

2.

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3 goals in analyzing epidemiological data

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1.

2.

3.

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Essentials of a good surveillance system

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1. Collection of useful data

2. Analysis and interpretation of data

3. Dissemination of information and analyses back to people involved in control activities

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3 types of surveillance

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1. Passive

2. Active

3. Sentinel

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5 goals of a surveillance system

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1. To recognize cases or clusters of cases to trigger control activities

2. To assess public health impact of disease and measure disease treatment

3. To demonstrate need for communicable disease programs and resources and allocation of resources

4. To monitor effectiveness of control measures

5. To identify high risk populations or geographical areas

6. To develop hypotheses about risk factors for disease acquisition and transmission

7. To recognize multi-state clusters and outbreaks to trigger control activities

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Reports or surveillance data

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1. Physicians

2. Hospital epidemiologist

3. Laboratories

4. Nurses

5. ICP - infection control practitioners

6. Other sources - NP, PA, PT, dentist