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Microbiology for Dentists > 30. Epidemiology > Flashcards

30. Epidemiology Flashcards

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1
Q

Define ‘epidemiology’

A
  • scientific method of studying disease in populations
  • study of distribution and determinants of disease frequency in human populations
  • in dentistry, includes measurement of dental disease in populations, evaluates effectiveness of treatment and assess needs/demands
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2
Q

3 components of epidemiology

A
  • distribution
  • frequency
  • determinants
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3
Q

What is distribution in epidemiology?

A
  • who is getting a disease?
  • where/when is it occurring?
  • are there patterns of disease?
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4
Q

What is frequency in epidemiology?

A
  • quantification of existence and occurance of disease
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5
Q

What is determinants in in epidemiology?

A
  • derived from data obtained from distribution and frequency
  • necessary to test an epidemiologic hypothesis
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6
Q

Process of epidemiology

A
  • a suspicion exists that a particular factor may be influencing occurrence of a disease (your suspicion may arise from clinical practice, observation, research)
  • formulation of a specific hypothesis
  • hypothesis is tested in epidemiological studies with comparison group
  • collect and analyse data to determine whether a statistical association exists
  • assess validity of any observed association by excluding alternative explanations like chance, bias, confounding etc
  • does statistical association suggest a causal relationship?
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7
Q

What is looked at to see if statistical association suggests a causal relationship?

A
  • magnitude of association
  • other studies
  • consistency of findings against other studies
  • biological credibility
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8
Q

Ways to measure disease

A
  • indices
  • standardisation
  • quantify it
  • indirectly - evaluation of effectiveness
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9
Q

A ‘gold standard’ measure of dental disease would be …

A
  • valid
  • reliable
  • objective
  • simple
  • reproducible
  • quantifiable
  • sensitive
  • accceptable
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10
Q

List descriptive study designs

A
  • observational
  • case-reports
  • case-series
  • cross-sectional
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11
Q

Give analytic study design

A
  • observational - case-control, cross-sectional
  • experimental - clinical trials
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12
Q

Give study designs from bottom to strongest methodology

A
  • animal and lab research
  • case reports/case series
  • case control studies
  • cohort studies
  • randomized controlled trials
  • systematic reviews
  • meta-analysis
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13
Q

Case-studies/case-series are used for …

A
  • highlighting interesting or novel cases/treatment
  • recognition of new disease/outcome
  • formulation of new hypotheses
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14
Q

Disadvantages of case studies/case series

A
  • cannot demonstrate valid statistical association
  • lack of appropriate comparison group can obscure a relationship or suggest an association where none exists
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15
Q

Define ‘case-report/case-series’

A

a report on a single patient or series of patients with an outcome of interest
- no control group required

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16
Q

What is a cross sectional study?

A
  • observation of a defined population at a single point in time (or time-interval)
  • exposure and outcome are determined simultaneously
17
Q

Cross sectional surveys are used for …

A
  • measuring prevalence of disease
  • look at potential risk factors or cause
18
Q

Disadvantages of cross sectional surveys

A
  • may establish association, NOT causality
  • confounders may be unequally distributed
  • group sizes may be unequal
  • recall bias
19
Q

What’s a cohort studies?

A
  • involves identification of two groups (cohorts) of patients
  • one which received the exposure of interest
  • one which did not
  • and following these cohorts forward to assess the outcome of interest
20
Q

Cohort studies are used for …

A
  • measures the incidence of disease
  • looking at causes of disease
  • determining prognosis
  • establishing timing and directionality of events
21
Q

Disadvantages of cohort studies

A
  • controls may be difficult to identify
  • exposure may be linked to hidden confounder
  • blinding is difficult
  • for rare diseases, large sample size is often necessary or a long follow up
22
Q

What is a case-control study?

A
  • a study which involves identifying patients who have the outcome of interest (case)
  • and patients without same outcome (controls)
  • looking back in time to see if they had the exposure of interest
23
Q

Case-control studies are used for …

A
  • looking at potential causes of disease
  • suitable for rare diseases
24
Q

Disadvantages of case-control studies

A
  • confounders
  • selection of controls may be difficult
  • recall and selection bias
  • difficult to establish time relationships between exposure to risk factor and development of disease
25
Q

Randomised Controlled Trials are used for …

A

evaluating the effectiveness of an intervention

26
Q

Disadvantages of randomised controlled trials

A
  • high costs
  • ethical issues
  • participant compliance
27
Q

How are randomised controlled trials random?

A
  • exposure status assigned by researcher preferably by random allocation
  • best way to reduce selection bias between 2 groups of participants
28
Q

Define ‘systematic reviews’

A
  • the evidence from a number of studies can be gathered together in one report
  • which pools and analyses all available data to assess the strength of evidence
29
Q

Why do a systematic review?

A
  • can end confusion
  • highlight where there isn’t enough evidence
  • yield new insights by combining findings from different studies
30
Q

Key features of a systematic review

A
  • needs to be an analysis of evidence not just a review
  • question needs to be defined precisely defining population and outcomes so studies included are appropriate and comparable
  • complete methods available detailing comprehensive searching for all evidence and author quality guidelines

Microbiology for Dentists (37 decks)

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