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Poph192 > 29-36 lectures > Flashcards

29-36 lectures Flashcards

1
Q

what does a cause do?

A

causes an effect

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2
Q

what can outcomes have?

A

multiple outcomes

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3
Q

what is a cause?

A

an event, condition or characteristics that play an essential role in producing an occurrence of the disease

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4
Q

what can a causal pie model do?

A

used to see what exposers cause an outcome
together there exposures are sufficient to cause the outcome

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5
Q

what do we call a full pie?

A

a sufficient cause of the outcome

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6
Q

what is each exposure called?

A

a component of the sufficient cause
a component cause

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7
Q

how do we prevent a disease using a sufficient pie?

A

by removing exposures that are involved in multiple sufficent causes

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8
Q

what is a component cause?

A

necessary for the disease to occur
must be apart of every sufficient cause of the disease

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9
Q

how can we determine causation?

A

by considering if the association is a valid association
could the association that we are seeing be upto chance, bias or confounding

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10
Q

what happens if we have a valid association?

A

means it is not causal

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11
Q

what does BEST CDS mean?

A

Biological plausibility
Experimental evidence
Specificity
Temporal sequencing

Consistency
Dose-response relationship
Strength of association

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12
Q

what is biological plausibility?

A

if there is a plausable biological mechanism for the association, but epidemiology knowledge may precede knowledge on biological mechanisms

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13
Q

what is experimental evidence?

A

if there is evidence from human RCTs or animal experiments, however animal studies may not apply to humans

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14
Q

what is specificty?

A

if the exposure specificity associates with a particular outcome but not others, however it is quite common for exposures to be related to many outcomes

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15
Q

what is temporal sequencing?

A

seeing weather the exposure came before the outcome

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16
Q

what is consistancy?

A

if the finding are consistent with the findings from other studies, however there can be a number of reasons why studies might have different findings

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17
Q

what is dose-response relationship?

A

if the risk of the outcome changes with increasing or decreasing amounts of the exposure, but not all relationships are linear

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18
Q

what are strength of association?

A

the stronger the association, the less likely it is to be due to confounding or bias, however this is not always the case

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19
Q

what are the guildlines to see what is a causal relationship?

A

the BEST CDS

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20
Q

what is critical applause?

A

the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular content

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21
Q

what is the abstract?

A

provides a summary of the paper contents, a breif overveiw of the peice of work

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22
Q

what is the introduction?

A

provides beliefs story that has the aims of the study that are clearly stated
has the specific aim of the study
provides the backgrounsd to this research and what is already known on the subject

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23
Q

what is the methods?

A

used for others to carry outb the proces the same as the person that originally too the investigation
it contains the selection of participants, structure of the study, definition of exposures and outcomes measured

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24
Q

what is table 1?

A

usually the participants and their baseline characteristics

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25
Q

what are the results?

A

reporting of all the results in text, tables and figures
assessment of chance, bias and confounding

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26
Q

what is table 2?

A

usually results to interperate and relative risks

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27
Q

what is hazards risk the same as?

A

ratio risks

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28
Q

what is the discussion?

A

talks about the strength and challenges experience during the research study

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29
Q

what is concluision?

A

not always includes but usually outlines what this study adds to current knowledge, and where to from here
usually adds what the study adds to current knowledge

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30
Q

what is internal validity?

A

chance, bias, confounding

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31
Q

what is the reference?

A

list of research papers referred to in this paper

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32
Q

what are acknowledgements?

A

thanks contributors to the writing, research and funding of the research

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33
Q

what are conflicts of intrest?

A

identifies potential conflicts of interest

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34
Q

what are the 2 main types of reviews?

A

narritive and systematic

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35
Q

what are narritive reviews?

A

may be heavily influence by opinion

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36
Q

what are systematic reviews?

A

is replicable, transparent and systematic

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37
Q

why are systematic reviews done?

A

to collate evidence and synthesize thier results

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38
Q

what is needed in a protocol?

A

a specific clinical question
relevance of why we are doing this review
objectives of the study
a detailed search strategy

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39
Q

why do we combine results of a trial?

A

to generate an average result to apply a more precise outcome of the study

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40
Q

what is heterogeneity?

A

when something vaires across different groups
this is if the designs of the studies are too different

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41
Q

what is homogeneity?

A

when something is consistent across different groups
this is if the outcomes of the data are similar enough to combine to get an average result

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42
Q

what does sampling distribution give us?

A

where our true value might fall

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43
Q

why are forest plots called this?

A

because it looks likle a tree

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44
Q

what does the size of the dot in a forest plot mean?

A

the weight of the study

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45
Q

what are the lines of a forest plot mean?

A

the risk ratio and the lines represent the 95% confidence intervals

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46
Q

what is the width of the diamond in a forest plot mean?

A

the 95% confidence intervals

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47
Q

where is the null value in a forest plot?

A

the bottom of the plot

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48
Q

what is the limitations?

A

principal findings
limitations to the evidence
implications such as practice and research

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49
Q

what are challenges we face in the study?

A

getting a team of helpers
publication bias
poor quality trials/studies
heterogeneity

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50
Q

what are advantages we face in the study?

A

reproducibility
comprehensive
transparent limits
fill gaps in knowledge
forms basis for decisions

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51
Q

what is epidemiological surveillance?

A

an ongoing systematic collection, analysis interpretation and dissemination of data regarding a health event

52
Q

what are elements of surveillance?

A

data collection - analysis - interpretation - dissemination - action

53
Q

what is surveillance used for?

A

characterizing patterns of disease, detecting epidemics, further investigation, research, disease control programes, setting priorities, evaluation

54
Q

what are the 2 types of surveillance?

A

indicator-based
event-base

55
Q

what is passive surveillance?

A

is routine reporting of health data such as notifiable diseases, disease registries and hospital data
low cost, covers a wide area and data linkage

56
Q

what are the limitations of passive surveillance?

A

under-reporting

57
Q

what is active surveillance split into?

A

is split into serosurveillance and health survey

58
Q

what is serosurveillance?

A

is the monitoring of the presenc eor absence of specific substances in the blood serum of a population

59
Q

what is sentinal surveillance used for?

A

used for monitoring diseases or trend and detect outbreaks

60
Q

what are the 3 types of indicator-based surveillance?

A

active
passive
sentinal

61
Q

what is event-based surveillance?

A

organised monitoring of reports, media stories, rumours and other infomation about health events that could be a serious risk to public health

62
Q

what is dissemination?

A

those who need to know, newsletter, media and reports

63
Q

what is action?

A

when our data from our study is done and used to make a positive impact to people

64
Q

what is public health?

A

the science and art of preventing diseases prolonging life and promoting health through organised efforts of society

65
Q

what are the 3 levels of prevention?

A

primary, secondary and tertiary

66
Q

what is a primary prevention?

A

interventions that attempt to prevent disease from occuring

67
Q

what is a secondary prevention?

A

reducing impact of disease by shortening its duration, reducing severity or preventing recurrence

68
Q

what is tertiary prevention?

A

reducing the number or impact or complications, improving rehabilitation

69
Q

what are advantages for population/mass strategy?

A

radical, large potential for whole population, behaviourally appropriate

70
Q

what are disadvantages for population/mass strategy?

A

small benefits to individual, poor motivation of individuals, the benefit-risk ratio may be low for individuals

71
Q

what are advantages for high risk/individual strategy?

A

appropriate to individuals, individual motivation, clinicion motivation, favourable benefit-risk ratio for individuals

72
Q

what are the disadvantages for high risk/individual strategy?

A

need to identify individuals, might be against population norms, can be hard to sustain behavioural change

73
Q

what is the prevention paradox?

A

a large number of people at small risk may give rise to more cases of disease than the small number who are at high risk

74
Q

what is evidence-based practice a combination of?

A

patient values an choices, best available evidence, and clinical expertise

75
Q

what is conservation treatment?

A

doing nothing

76
Q

if good evidence is vital, what can be used otherwise?

A

-ineffective treatment can be used
-give treatments for which the harms outweigh the benefits
-fail to provide effective interventions
-new expensive treatments may be no better than older cheaper ones

77
Q

what makes it differcult to communicate the evidence?

A

-adverts backed by dubious scientific claims
-endorsements by prominent people
-scares and conspiracy theories
-the value that people place on individual stories may lead people to ignore objective evidence

78
Q

what is screening?

A

the widespread use of a simple test for a disease in an apparently healthy population

79
Q

what is a screening programme?

A

an organized system using a screening test among asypmathetic (healthy) people in the population to identify early cases of the disease in order to improve outcomes

80
Q

what is a screening test?

A

a usually relatively cheap and simple, used to test large numbers of apparently healthy people to identify individuals suspected of having early disease who will then go on to have further diagnostic test in that there is greater emphasis

81
Q

what is a screening test not?

A

a diagnostic test
a screening programme

82
Q

what is the aim of screening?

A

To limit the consequences of disease through early diagnosis and treatment
aims to improve outcomes

83
Q

what do we need to consider whe n deciding if a test is appropriate?

A

if the test is accurate, and if the test is acceptable and safe

84
Q

what 2 things do we measure accuracy with?

A

sensitivity and specificity

85
Q

what is sensitivity?

A

the proportion of people with the disease who test positive

86
Q

what is specificity?

A

the proportion of people without disease who test negative

87
Q

how do we test performance of sensitivity and specificity?

A

by using intrinsic properties of the test

88
Q

what is PPV?

A

positive prediction value

89
Q

what is a positive prediction value?

A

the proportion of people who test positive and have the disease

90
Q

what is NPV?

A

negative prediction value

91
Q

what is a negative prediction value?

A

the proportion of people who test negative and dont have the disease

92
Q

what is PVs?

A

prediction values

93
Q

what are prediction values?

A

are influenced by disease prevalence in the population of intrest, unlike sensitivity and specificity

94
Q

what are 3 benefits of screening programmes?

A

-potential for early detection and intervention
-reassurance (true negatives)
-improved health of population

95
Q

what are some harms of the screening programmes?

A

-increases in health inequities from unequal participation or treatment
-physical
-psycological
-financial

96
Q

what is screening biased towards?

A

detecting slowly developing disease that may never have required treatment

97
Q

what influences the spread of disease?

A

properties of the agent
sources of infection
biological resorviors
host factors
exposure variation
enviroment

98
Q

what are the 3 segments of the epidemiology triangle?

A

host, enviroment, agent

99
Q

what is the host?

A

descriptive epidemiology

100
Q

what is enviroment?

A

enviromental investigation

101
Q

what is an agent?

A

laboratory investigation

102
Q

what does a collection of host, enviroment and agent lead to?

A

different factors of disease

103
Q

what does host and enviroment lead to?

A

disease immunity

104
Q

what does host and agent lead to?

A

transmission

105
Q

what does agent and enviroment lead to?

A

disease survival

106
Q

what are examples of infectious agents?

A

bacteria, viruses, fungi, protozoa and helminths

107
Q

what is infection?

A

the entry ofn a microbiological agent into a higher order host and its multiplication with the host

108
Q

what is an infestation?

A

only on the external surface

109
Q

what is infectivity?

A

the ability of an organism to produce clinical symptoms and illness

110
Q

what is virulence?

A

the ability of an organism to produce serious disease

111
Q

what are some ways of transmission?

A

direct, indirect, airborne

112
Q

what is direct transmission?

A

touching or inhaling infectious secretions

113
Q

what is indirect transmission?

A

involves a vehicle
this splits into inanimate (bedding, clothes, utensils, food or water) and live (mosquitos, ticks)

114
Q

what is airborne transmission?

A

droplet nuclei = small particles

115
Q

what are outbreaks?

A

unexpected increase in the incidence of a disease

116
Q

what is an endemic?

A

constant presence of a disease or infectious agent within a geographical area or population

117
Q

what i holoendemic?

A

an intense disease all year round - children mainly infected, most adults immune

118
Q

what is hyperendemic?

A

intense disease with time periods of no transmission - persistant disease with all age infected

119
Q

what is a pandemic?

A

the disease affects a large number of people and crosses many international boundaries

120
Q

what is an endemic disease?

A

a constant present in a populatioon or region, with relatively low spread

121
Q

what is an epidemic disease?

A

the sudden increase in cases spreading through a large population

122
Q

what is a pandemic disease?

A

the sudden increase in cases across several countries, continents or the world

123
Q

what is a cluster?

A

a aggregation of relatively uncommon events or diseases in space and/or in time that are thought to be greater than could be expected by chance

124
Q

what are clusters usually?

A

rare non-infectious diseases

125
Q

why do we investigate outbreaks?

A

to stop and prevent any further illness, prevent further outbreaks from other similar sources, adress public concertns and involves the public in disease control, reduce direct and indirect costs, identify new mechanisms of transmission of known diseases, identify new or emerging disease agents

126
Q

what are the 3 components that outbreak investigation is broken down into?

A

analytic epidemiology component
enviromental component
laboratory component

127
Q

what are the 3 types of outbreaks?

A

common sources
propagated source (person to person)
mixed

Poph192 (4 decks)

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