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180 Lecture > Association to Causation > Flashcards

Association to Causation Flashcards

To memorize and study all about causation

1
Q

If we determined that an exposure is associated with a disease, the next question is _________________

A

whether the observed association reflects a causal relationship

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2
Q

In terms of disease etiology, in the case of animal studies and in vitro systems, the results may not be applicable to humans due to ____________________ and different environmental influences across species

A

genomic difference

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3
Q

True or False: Exposing humans to certain exposure is ethical

A

False, not ethical

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4
Q

As exposing humans to certain exposure is not ethical what is the best alternative?

A

Make observations in human populations by:
1. Unplanned or natural experiments
2. Observed populations predisposed to disease due to certain hazards

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5
Q

What are the etiological hazards for studying disease etiology?

A
  1. Occupational
  2. Environmental
  3. Genetic
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6
Q

What is the frequent sequence of studies in human populations? List them in order

A
  1. Clinical observations
  2. Available data
  3. Case-control studies
  4. Cohort studies
  5. randomized Trials
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7
Q

It is a part of studying disease etiology where its main goal is to review medical records and see if similar exposures are reported in other patients

A

Available Data

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8
Q

Perform association studies. The quicker way to do that is to document past
exposure in diagnosed patients through a case-control study. Cohort studies may be done next to see if initially healthy individuals with the exposure develop the disease.

A

Case-control studies and Cohort Studies

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9
Q

What is the quicker way to perform association studies?

A

Document past exposure in diagnosed patients through case-control studies.

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10
Q

What is done next to a case-control study?

A

Cohort study

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11
Q

It is ideal for beneficial or protective-against-disease exposures.

A

Randomized Control Trials (RCTs)

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11
Q

Part of studying disease etiology was not done to test potentially harmful exposures

A

Randomized Trials

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12
Q

In interpreting Associations we include the following:

A
  1. Case-control studies
  2. Cohort Studies
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13
Q

What are the types of associations?

A

(1) Causal and (2) Due to Confounding

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14
Q

True or False: Not knowing if an association is due to a causal relationship or not is important

A

False, Knowing

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15
Q

If __________________ or ______________ preventive measures will not work

A

Causal or Due to confounder

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16
Q

If cause, or there is a preventive measure against the identified exposure, disease incidence _____________

A

decrease

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17
Q

It is also called as waste of resources in terms of interpreting associations

A

no/minimal change in incidence

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18
Q

In direct causes of disease, what does it involve?

A

Factor, Disease

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19
Q

In Indirect cause of disease, it includes:

A

Factor, Step 1, Step 2, Disease

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20
Q

Necessary (-) factor disease _______ develops

A

Never

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21
Q

In Sufficient (+) factor disease __________ develops

A

Always

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22
Q

Give the process or diagram of Necessary and Sufficient

A

Factor A ——-> Disease

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23
Q

Necessary not Sufficient

A

Factor A
+
Factor B————–> Disease
+
Factor C

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24
Q

Sufficient, not necessary

A

Factor A————–> Disease
or
Factor B————–> Disease
or
Factor C—————>Disease

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25
Q

Not sufficient, not necessary

A

Factor A + Factor B ——> Disease
or
Factor C + Factor D ——> Disease
or
Factor E + Factor F ——-> Disease

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26
Q

What are the evidence for a causal relationship? Give all.

A
  1. Temporal relationship
  2. Strength of the Association
  3. Dose-response relationship
  4. Replication of the findings
  5. Biologic plausibility
  6. Consideration of alternate explanations
  7. Cessation of exposure
  8. Consistency with other knowledge
  9. Specificity of the association
27
Q

It is evidence for a causal relationship, where If a factor is believed to be the cause
of a disease, exposure to it must
occur before the disease develops

A

Temporal Relationship

28
Q

Temporal Relationship exemplified by __________ studies

A

Cohort

29
Q

True or False: The length of interval between exposure and disease is deemed optional

A

False, exposure and disease is important

30
Q

The stronger the association, the more likely it is that the relation is ___________.

A

Causal

31
Q

The stronger the association, the more likely it is that the relation is causal.

A

Strength of the Association

32
Q

As the dose of exposure increase, risk of disease____________

A

increases

33
Q

It refers to the dose of exposure and risk of disease and no disease may develop up to a certain level of exposure above this level, and disease may develop

A

Dose-Response Relationship

34
Q

If an association is observed, we would also expect it to be seen ______________ within subgroups of the population and in different
populations, unless there is a clear reason to expect different results.

A

consistently

35
Q

If an association is observed, we would also expect it to be seen consistently within subgroups of the population and in different
populations, unless there is a clear reason to expect different results.

A

Replication (of the findings)

36
Q

It refers to the coherence with the current body of biologic knowledg

A

Biologic Plausibility

37
Q

Evidence for a causal relationship, where all other explanations (other possible causes) have been investigated and
ruled out.

A

Consideration of Alternate Explanations (Confounding)

38
Q

Evidence for a causal relationship, if a factor is a cause of a disease

A

Cessation of Exposure

39
Q

In Cessation of Exposure as the risk of the disease decreases elimination of exposure __________

A

decreases

40
Q

Evidence for a causal relationship, if a relationship is causal, we would expect the findings to be consistent
with other data.

A

Consistency with other knowledge

41
Q

Evidence for a causal relationship, where it is identified to be the weakest basis for causality (disease occurrence à multi-factorial)

A

Specificity of the Association

42
Q

An association is specific when a certain exposure is associated with only one disease.

A

Specificity of the Association

43
Q

True or False: Any observational study will be perfect

A

False, never be perfect

44
Q

In observational study there can still be ________________ in the results drawn from the collected and analyzed data

A

Credibility

45
Q

In observation studies, these are need to be taken into account:

A
  1. biases
  2. Confounders
  3. Interactions
  4. Role of chance
46
Q

it refers to any systematic error in the design, conduct or analysis of a study that results in a mistaken estimate of an exposure’s effect on the risk of disease.

A

Bias

47
Q

Selection Bias occurs where there is a ____________ _______________ between the people who are included in a study and those who are not, or when study and
comparison groups are selected inappropriately or using different criteria.

A

systematic difference

48
Q

Occurs when there is a systematic difference between the
people who are included in a study and those who are not, or when study and comparison groups are selected inappropriately or using different criteria.

A

Selection Bias

49
Q

Selection Bias may result from:

A
  1. Disinterest among diseased or exposed individuals to join (vs volunteers)
  2. Low response rates
  3. Data collection is done through convenient channels (email, chat, via supervisor, etc)
  4. Participant loss to follow-up
50
Q

Selection bias affects the _______________ and _______________________ regarding the association of exposure and
outcome.

A

internal validity
legitimacy of inference

51
Q

Control of selection bias / Assessment of the effect of bias

A
  1. Use of clearly defined eligibility criteria
  2. Ensure high participation rates in all study groups
  3. Use external comparison
  4. Conduct sensitivity analysis
52
Q

It happens when information on the exposure and disease outcome are incorrect or à Misclassification Bias

A

Information Bias

53
Q

Information bias may result from:

A
  1. Limited sensitivity and specificity of diagnostic tests
  2. Wrong encoding of an individual’s disease outcome and/or exposure status (Interviewer
    bias)
  3. Enhanced recall among cases compared to control (Recall Bias)
  4. Reluctance to report an exposure due to attitude, belief, and/or perception (Reporting
    bias)
54
Q

It is the measurement error and resulting misclassification occurs to a greater extent in one group than another

A

Differential misclassification

55
Q

HIV Cases and Sexual Exposure are stigmatized topics is an example of what type of effect?

A

underestimation of the effect

56
Q

Recall bias: Women who had a baby with a malformation tend to remember (or report)
more mild infections that occurred during their pregnancies than mothers of infants
without malformations. What effect does the situation above show?

A

overestimation of the effect

57
Q

It is when measurement error and any resulting misclassification occur equally among comparison groups
(affects everyone in the study)

A

Non-differential misclassification

58
Q

Give ways on how to address misclassification bias

A
  1. Clearly define everything that is to be measured
  2. Ensure that the same instruments and methods are used in all study
    groups.
  3. Instruments or tests need to be standardized.
  4. Conduct validation (for accuracy, use of a gold standard) and repeatability (for
    precision) studies.
59
Q

Two types of measurement errors are?

A

Survey
Analytic Study

60
Q

What are the two types of Surveys?

A

Random and Systematic

61
Q

What are the two types of Analytic Study?

A
  1. Non-differential (same in all groups)
  2. Differential (different in different groups)
62
Q

In a Random study, what is the consequence or outcome?

A

There is no Bias in the mean but a lack of Precision

63
Q

In terms of the systematics survey, what is the consequence of the measurement error?

A

Biased Results

64
Q

Non-differential and Differential analytic studies are either ___________ or ___________.

A

Random or Scientific

65
Q

Non-differential random or systematic could be ______________

A

Bias to Null

66
Q

Differential in Random or Systematic could be __________________________

A

Bias towards or away from the null.

180 Lecture (1 decks)

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