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52 Cards in this Set

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John Snow

Father of modern epidemiology. 1854 London cholera epidemic


Langmuir, Alexander

Father of shoe leather epidemiology. Established the EIS. Contributions to disease surveillance domain.


D.a. Henderson

Initiated WHO global immunization program. Led global smallpox eradication initiative.


Janet Lane-Claypon

Pioneer of use of cohort and case control studies.

Study design

Austin Bradford-Hill

Grandfather of modern epidemiology. Demonstrated smoking - lung cancer association. Theories of association and causation. British doctors study.

Lung cancer


A hypothetical description of a complex entity or process.

Chronic disease

Disease characterized by a long natural history of frequent recurrence, multifactorial causation, usually a noncommunicable etiology

Risk factor epidemiology

Classic approach. Considers one factor at a time.

Non-modifiable risk factors

Inherent, genetic, individual level. Breast cancer gene

Modifiable risk factors

Environmental. Individual and societal level. Income.

Multiple risk factors

Black box model

Modern approach to chronic disease epidemiology

Multifactorial causation and mechanisms.

Genetic epidemiology

Study of the role of genetic factors and their interaction with environmental factors in the occurrence of disease in populations.

Genes considered as determinants of disease and susceptibility to the environment.

Social production of disease frameworks

Asserts that the primary determinant of population level disease risk (incidence) is to be found in the risk regime inhabiting a particular social address, which is a function of the material and social conditions of life.

What aspects of social structure place persons at risk for risk?

Infectious disease model

Specific organism -> specific disease

Chronic disease model

Multiple factors -> one or more diseases

Biopsychosocial model

Factor at multiple levels -> disease

HIV, individual behaviours and the global and national policies affecting the health of afflicted individuals.


The observed frequency of disease varies by the level of exposure. (dose dependence)


An exposure caused a disease, if without that exposure disease would not have occurred.

Within a population of exposed individuals, at least some cases would not have occurred if the exposure had not taken place.

Common cause

A cause shared by two effects

Common effect

An effect caused by two or more factors

Mediating factors

Intermediate variable which represents a step in the causal chain connecting exposure to disease.

Non causal associations

Chance association and bias


Confounding, selection bias and information bias are examples.

Confounding factor

Distorts the observed effect of an exposure by mixing an extraneous factor with the actual exposure.

Criteria for a confounder :

- Causes the disease

- Associated with exposure in the source population

- Not affected by the exposure ( which would be a mediating factor)

Sufficient cause

Can cause the disease without the effects of any other exposure.

Example: asbestos causes mesothelioma

Necessary cause

Must be present in all cases of the disease. Example: HIV and AIDS

Component cause

Contributes to sufficient cause.

Hill's causal criteria

Criteria for determining causality.

Considers strength of association, consistency of association, specificity, temporality, dose -response effect, plausibility, coherence, experimental support, and analogy.

Directed acyclic graphs (DAGs)

Causal and temporal pathways translated into diagrams. Can never form a cycle because we can't travel back in time. Outcome and exposure of interest, as well as pre and post exposure variables.


A group of people defined by personal traits (age, ethnicity, sex), place, and time

Target population

The group of individuals about whom inferences are to be made.

All young adults aged 18 years old living in BC in 2015

Source population

A group of individuals with the same exposure -disease relationship as the target population and who can be enumerated.

18 year olds enrolled in the BC MSP in 2015.

Study population

Group of individuals under observation, expected to have the same exposure - disease relationship as the source population.

Young adults graduating high school in BC who completed the survey.


How accurately the sample represents the entire population

Barriers include vague definition of target population, inability to sharply enumerate source population, issues with process for obtaining the study population from the source population (selection bias)


Population of individuals moving together through time.

At -risk

Describes the ability of a study individual to experience an endpoint of interest.

Person -time at risk

Each individual in a study contributes to the total person -time at risk.

Censored individuals

Did not experience the endpoint of interest while under follow up. Reasons can include loss to follow up, death, or scheduled end of follow up.

Closed cohort

Group of at - risk individuals followed over time. All individuals enter and exit the study at the same time.

Open cohort

Cohort in which individuals enter and exit the study at different times.


Incidence rate, mortality rate

A measure of a change in one quantity per unit of another quantity.

Average rate of change.


A type of ratio in which the numerator is included in the denominator.

p= a/(a+b)

Prevalence is a proportion.

May be instant or over an interval of time.


Disability adjusted life years. Measures the burden of disease.


Where YLL stands for years of life lost and YLD stands for years lived with disability.

International classification of diseases (ICD)

Numeric classification of diseases and conditions. Used for surveillance and reporting as well as insurance billing.

Person -time at risk

Total person -time at risk can be summed from all individuals if info is available.

Can be estimated by the area under a population decay curve or by calculating the population at mid-point multiplied by the time between enumerations (census)

Every person -moment of risk is assumed to be equal to any other person -moment of risk.


Agent or substance presumed to be causal of a disease or event

Exposure surrogate

Factor indicating exposure potential.



Exposure concentration at a given point in time


Length of time exposed

Cumulative exposure (dose)

Total amount of exposure = sum of all intensities X duration

Exposure lag

Exposure lags during some time window before the event does not have an effect