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Poph192 > 14-21 lectures (progress test 2) > Flashcards

14-21 lectures (progress test 2) Flashcards

1
Q

what is epidemiology?

A

the study of the occurrence and distribution of health-related events, states or processes in specific populations

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2
Q

what is population health?

A

the health outcomes of a group of individuals including the distribution of such outcomes within a group

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3
Q

what does population health look at?

A

the big picture and the pattern of health impacts on a population

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4
Q

what does socioeconomic status show within population health?

A

as deprivation increases, so does the number of hospitalized people

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5
Q

what does the distribution of socioeconomic status show in NZ?

A

that the money rate affects the health of the Maori and Non-Maori

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6
Q

what are the 2 important patterns of health distribution in NZ?

A

ethnicity and socioeconomic

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7
Q

what is NZdep?

A

an area level of deprivation so the whole of NZ is divided into areas
each area has a different decile area and it includes everyone in NZ

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8
Q

what is absolute poverty?

A

an income level below which a minimum nutritionally adequate diet plus essential non-food requirements is not affordable

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9
Q

What is relative poverty?

A

the amount of income a person, family, or group needs to purchase a relative amount of basic necessities of life.

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10
Q

what identifies basic necessities?

A

they are identified relative to each society and economy

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11
Q

what is the trend between deprivation and health?

A

greater deprivation leads to poorer health

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12
Q

what are social determinants of health?

A

the conditions in which people are born, grow, live, work and age

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13
Q

what can population vary from?

A

a small group of people to a whole country

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14
Q

what can a public health model do?

A

-defines and measures a problem
-describes causes and consequences
-develops and evaluates interventions
-disseminates effective policy and practices

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15
Q

what are the 2 factors that are relative to the measure of occurrence?

A

prevalence
incidence

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16
Q

what is incidence sometimes referred to as?

A

cumulative incidence

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17
Q

what are the 2 segments that incidence is divided into?

A

incidence proportion
incidence rate

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18
Q

what is MEPTV?

A

Measure of occurrence
Exposure or outcome
Population
Time point
Value

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18
Q

what is prevalence?

A

the proportion of a population who have the disease at a point in time
its the existing cases within our desired population at a specific point of time

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19
Q

how do we calculate the prevalence?

A

the number of people with the disease at a given time
‘divided by’
the total number of people in the population at a given time

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19
Q

what do we report prevalence with?

A

MEPTV

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20
Q

what are 2 prevalence limitations?

A

difficult to assess the development of disease
Is influenced by the duration of the disease

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21
Q

what is incidence?

A

the occurrence of new cases of an outcome in a population in a specific period of follow-up

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22
Q

what is IP?

A

incidence proportion

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23
Q

what is IR?

A

incidence rate

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24
Q

what is the difference between IP and IR?

A

what we use as our denominator

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25
Q

what is incidence proportion?

A

the proportion of an outcome-free population that develops the outcome of interest in a specified time period

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26
Q

how do we calculate incidence proportion?

A

the number of people who develop the disease in a specified period
‘divided by’
number of people at risk of developing the disease at the start of the period

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27
Q

what do we need to consider in an incidence proportion?

A

if the people already have the condition as well as if the condition is something that they cannot develop

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28
Q

what are 2 limitations for incidence proportions?

A

-assumes a ‘closed’ population
-highly dependent on the time period

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29
Q

what is the incidence rate?

A

the rate at which new cases of the outcome of interest occurs in a population

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30
Q

how do we calculate the incidence rate?

A

number of people who develop the disease in a specified period
‘divided by’
number of person-years at risk of developing the disease

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30
Q

what are 3 reasons that someone might stop being at risk in an IR study?

A

-they become a case
-they are lost to follow-up
-follow-up time ends

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31
Q

how do we report IR?

A

we use MEPTV without the T

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31
Q

what are 2 limitations of the IR?

A

-person-time not available
-complex to calculate

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32
Q

what is the dumb down explanation of prevalence?

A

existing cases - distribution, burden

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33
Q

what is the dumbed-down explanation of IP?

A

new cases - risk

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33
Q

what is the dumbed-down explanation of IR?

A

new cases - speed

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34
Q

what do we need to consider when comparing populations?

A

-do the age structures differ?
-does the disease risk vary by age?

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34
Q

what is age standardisation?

A

the age structure differs and disease risk varies by age

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34
Q

what is descriptive epidemiology?

A

a person, place and time
also is observational

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35
Q

what is analytic epidemiology?

A

association (exposures and outcomes), causation, observational or intervention studies

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36
Q

what does a cross-sectional study measure?

A

exposures and/or outcomes at one point in time

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37
Q

what is a cross-sectional study used to describe?

A

prevalence, compare prevalence, generate hypothesis, plan

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38
Q

what is the GATE frame?

A

the population takes a sample and has exposure/comparison groups and is graphed into an outcome graph

38
Q

what are some limitations of a cross-sectional study?

A

-it’s temporal sequencing
-measures prevalence not incidence
-not good for studying rare outcomes or exposures
-not good for assessing variable and transient exposures or outcomes

39
Q

what do ecological studies do?

A

compare exposures and outcomes across groups not individuals

40
Q

what do individual level studies do?

A

look at it on a single persons status

41
Q

what do group level studies do?

A

look at groups of peoples status

42
Q

what are ecological studies used for?

A

-compare between populations
-assess population-level factors
-consider hypothesis

43
Q

what are some limitations for ecological studies?

A

-ecological fallacy
-cannot control for confounding
-cannot show causation

44
Q

How can we describe the fundamental characteristics and logic of analytical studies?

A

either using PECOT or GATE frames

45
Q

what is PECOT?

A

Population
Exposure
Comparison
Outcome
Time

46
Q

where does the GATE frame start?

A

at the source which is a population sample

47
Q

what is the source?

A

the population the sample is recruited from

48
Q

what is the sample?

A

the population included in the study

49
Q

what are measures of association used for?

A

to quantify data

50
Q

what is RR stand for?

A

relative risk

51
Q

what is relative risk?

A

how many times as likely is the exposed group to develop the outcome than the comparison group

52
Q

how do we calculate the relative risk?

A

incidence exposed
‘divided by’
incidence comparison

53
Q

what is risk difference?

A

the differences in incidences and this tells us how many extra/fewer cases of the outcome in the exposed group are attributable to the exposure

54
Q

what does exposure not change?

A

the occurrence of the outcome
so there are no association between exposure and outcome

55
Q

what is the null value?

A

when there is an equal occurrence in both groups so there is the same incidence of outcome

56
Q

what are cohort studies?

A

a is individuals are defined on the basis of the presence or absence of exposure to a suspected risk factor

57
Q

how do we get a cohort study?

A

-identify a source of the population
-recruit the sample that doesn’t have the desired outcome
-assess exposure to identify which groups participants belong in
-we follow up over time and observe whether they have developed the outcome

57
Q

what type of model is a cohort study?

A

analytic epidemiology

57
Q

what makes up the measures of occurance?

A

the incidence proportion and incidence rate

58
Q

how to calculate the risk ratio?

A

IPe
‘divided by’
IPc

58
Q

how to calculate the rate ratio?

A

IRe
‘divided by’
IRc

58
Q

how to calculate the risk difference?

A

IRe - IRc
IPe - IPc

58
Q

where does the exposed group come from in the cohort studies?

A

from the recruited sample

59
Q

why do we have to not have the sample population does not already have the desired outcome?

A

because they cant later see if they develop the outcome if they already have it

59
Q

where does the comparison group come from in the cohort studies?

A

from the general population

60
Q

what do we need to make sure in cohort studies?

A

that participants have been correctly classified as either exposed or comparison group

60
Q

why do we follow up people in cohort studies?

A

to see if they are still engaged and don’t become a loss of study

60
Q

what are 4 strengths of cohort studies?

A

-determined temporal sequence between exposure and outcomes
-can examine multiple outcomes from an exposure
-can calculate incidence
-good for studying rare exposures

61
Q

what are some limitations of cohort studies?

A

loss to follow up could lead to bias
the potential for missclassification of exposure/outcomes
they are not good for studying rare outcomes
they are also time consuming
can end up being very expensive

61
Q

where do perspective cohort studies start?

A

at the exposure

62
Q

strengths of historical studies?

A

less time consuming
less expensive
good for outcomes that take time to develop

62
Q

where do historical cohort studies start?

A

at the outcomes

62
Q

limitations of historical cohort studies?

A

they use existing data and we may not know about all the relative factors so it could lead to bias

63
Q

what are 3 things that case-controlled studys give?

A

-overveiw of design
-measure of association
-important points

63
Q

what are case controlled studys?

A

they identify people with outcomes and find people without outcomes.
they also compare exposures likelihood before hand (odds)

64
Q

what are the 5 steps of case controlled studies?

A

-identify source population
-identify people with outcome (cases)
-sample population without outcome from the same population
-measure exposure prior to outcome in cases and controls
-compare odds of exposure to calculate measure of association (odds ratio)

65
Q

how do we calculate odds of exposure in cases we used?

A

a/c

66
Q

how do we calculate the odds of exposure in controls we use?

A

b/d

66
Q

what does OR mean?

A

odds ratio

67
Q

what does odds ration mean?

A

is people with outcome are x times as likely to have had the exposure than people without the outcome.

68
Q

is OR and RR equal or not?

A

they are approximates

69
Q

do controls have outcomes?

A

nope

70
Q

what is case selection?

A

usually try to identify incident cases

71
Q

what do case-control studies represent?

A

the exposure distribution of people without the outcome in a source population
they must be capable of becoming a case

72
Q

what does RCTs mean?

A

randomised-controlled trials

73
Q

what type of epidemiology are RCTs?

A

analytic

73
Q

what does the R C T mean in an RCT?

A

Randomized-participants randomly allocated to groups
Controlled-there is a control (comparison) group
Trials-testing effect of treatments/interventions

74
Q

why do we allocate people to random groups in RCTs?

A

to make the intervention and comparison group as similar as possible
this is called exchangability

74
Q

what is a confounding factor?

A

something that is muddling up the effect we are seeing between the exposure and the outcome
it is a key threat to the validity

75
Q

what does exchangeability allow us to do?

A

to only look at the intervention and nothing else that may effect the outcome

76
Q

how do we eliminate confounding?

A

by randomizing
this applies to potential confounding factors (known) and unknown confounders

77
Q

what do we need to be able to have a suitable RCT?

A

a reasonable amount of participants

78
Q

what is randomisation?

A

the random allocation of participants either the intervention or controlled group

79
Q

what is random selection?

A

where people from the source population are randomly selected to participate in the study

80
Q

what is cluster randomisation?

A

this is where groups are randomized instead of individuals which is good if the intervention is better used among groups

81
Q

what is intention-to-treat anylysis?

A

preserves the benefits of randomization
participants are analyzed in the groups that they are randomized into regardless of weather they stuck to that group

82
Q

what is per-protocol?

A

which analyses to according to what they actually did so the benefits of randomization are lost and confounding is re-introduced

83
Q

2 types of benefits within randomization?

A

intention-to-treat
per-protocol

84
Q

what is blinding?

A

not knowing which participants are in the group and eliminating bias

85
Q

whats a way that bias can occur in RCTs?

A

a loss to follow up and non-adherance

86
Q

what are some strengths of RCTs?

A

randomisation
best way to test intervention
can calculate incidence
temporal sequence

87
Q

what are limitations of RCTs?

A

not all exposures are appropriate to be randomly allocated
harm of intervention

88
Q

what is another phrase for ‘harm of intervention’?

A

clinical equipoise

Poph192 (4 decks)

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