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Epidemiology > Ch. 3 Epidemiology > Flashcards

Ch. 3 Epidemiology Flashcards

1
Q

Define the classic concept of epidemiology

A

epidemiology derives from the Greek word
epidemic: epi- (among, upon), -demos- (population, people) and –
logos (scientific study)

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2
Q

Whats today’s definition of epidemiology

A

a science that:
 Studies the frequency and distribution of diseases in human
populations.
 Determines the causes of diseases.
 Characterizes the mechanisms of disease progression.
 Determines the factors (biological and social) influencing diseases

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3
Q

What was the beginning of epidemiology?

A

Hippocrates wrote a treatise called On
Airs, Waters and Places around 400 BC.
- defined Relationships between the living conditions of populations
(diet, fluid intake, exercise) and their health status.

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4
Q 
In Spain (XVI century) the term “epidemiology” appears,
for the first time...
A

in a study of a plague

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5
Q

whos involved with

“Germ Theory“ (2)

A

Louis Pasteur 1860s

Robert Koch 1870s

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6
Q

Who’s involved with miasmic theory of infection?

A
  • The Ancients Greeks: The Origin of the Theory

- The Middle Ages: Corruption of the Air

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7
Q

What is the ancient greeks origin of the theory? (3)

A

-Hippocrates believed that bad air was the main cause of pestilence.
-Vitruvius: warned of the dangers of various kinds of bad air (exhalations
from marshes, pestilential air, and unhealthy vapors).
-Galen: traced individual susceptibility to the balance of humors in the
body.

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8
Q

What is the middle ages corruption of the air? (@)

A

-Explanation of plague contagion during the Middle Ages and into the
Renaissance.
-Medieval writers referred to “corruption of the air”, “pestilential air” or
“putrefaction of the air”, NOT “miasma”.

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9
Q

The Chambers 21st Century Dictionary dates the word “miasma” to the
17th century. It is a Latin term derived from the Greek word for ….

A

pollution

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10
Q

Who popularized the word miasm/miasma? when?

A
  1. De noxiis paludum effluviss (Of the poisonous effluvia of malaria), a
    work of Giovanni Mari Lancisi
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11
Q

During the germ theory period, ___________ were used to explain many diseases, including tuberculosis,
malaria and cholera.

A

microorganisms

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12
Q

________ theory was maintained through the middle of the nineteenth century

A

miasmic

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13
Q

who believed miasma was the main cause of cholera.

A

Dr. William Farr

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14
Q

Who argued that miasm could not be the cause of cholera?

A

Charles Earl Johnson

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15
Q

The history of germ theory (just to read while studying)

A

Microorganisms were used to explain many diseases, including tuberculosis,
malaria and cholera.
Miasmic theory was maintained through the middle of the nineteenth century.
Dr. William Farr believed miasma was the main cause of cholera.
Charles Earl Johnson argued that miasm could not be the cause of this disease.
An influential 1849 essay by British physician John Snow entitled On the
Mode of Communication of Cholera argued that cholera was water-borne. Germ theory was further developed by Louis Pasteur in the 1860s
and Robert Koch in the 1870s.

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16
Q

Who suggested cholera was water borne?

A

An influential 1849 essay by British physician John Snow entitled On the
Mode of Communication of Cholera argued that cholera was water-borne.

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17
Q

Who further developed germ theory from John Snow?

A

-louis pasteur & robert koch

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18
Q

What established epidemiology as the science of infectious diseases?

A

-Advances in the field of microbiology (Pasteur, Koch, etc.)

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19
Q

Scurvy was studied by…?

A

James lind

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20
Q

What defined the beginning of modern epidemiology ?

A

(1943): the social aspects

of disease are more important than its causal agent.

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21
Q

The first school of hygiene (public health today) in the world was
created in…

A

England

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22
Q

What important studies were conducted by the 2nd half of the twentieth century? (2)

A
  • Experimental study on water fluoridation.

- Framingham studied risk factors for cardiovascular disease.

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23
Q

When and where was the cholera epidemic?

A

London, 1854

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24
Q

_____ described and solved this cholera outbreak 30 years ____ (before/after?) the discovery
of the microorganism causing the
disease (________)

A
  • John Snow
  • Before
  • Vibrio Cholerae
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25
Q

How did john snow solve the cholera epidemic?

A
  • Quantitative method

- looked at water supply for those affected and noticed the disparity

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26
Q

What is the main goal of epidemiology? (2)

A

-To achieve the best possible health status in the
community
- Improve the health of the whole population

27
Q

How does epidemiology differ from clinical medicine? (2)

A

-It considers the disease as a group phenomenon.
-Is different than in clinical medicine that treats each patient
individually

28
Q

What are the intermediate objectives of epidemiology? (3)

A
  1. diagnosis of the health of a population
  2. study the origin of the disease progression
  3. evaluate different health actions
29
Q

What are the health indicators of a population? (6)

A

 Morbidity and mortality
 Demographic indicators (life expectancy, births, deaths …)
 Indicators of environmental conditions (water supply, number of
occupants per dwelling …)
 Indicators of nutrition (calories and protein consumption per person,
milk consumption in children …)
 Indicators of resources and health activities (health expenditure
per capita per year, number of hospital beds, number of doctors per
100,000 inhabitants)
 Economic and social indicators (average income per family, literacy
rate, unemployment rate …)

30
Q

How can we study the origin of disease progression? (3)

A

 Establish probabilities and risks: Predict the likelihood that a person will suffer a disease (risk) with the study of a sample of
individuals that is representative of the general population.

 Searching for “causes”.

 Identification of new syndromes and clinical manifestations

31
Q

How can we evaluate different health actions?

A

 Evaluation of diagnostic methods: Economic cost, reliability,
validity, acceptance by the population.
 Evaluation of treatments: Efficacy of treatment, administration
mode, acceptance by the population, control of side (unwanted)
effects.
 Evaluation of health services

32
Q

What is the epidemiological method? (5)

A
  1. Observing the phenomenon (usually a disease).
    What is it?, Who is affected?, When is it?, Where is it?
  2. Counting cases or events. Tabulation (sorting and
    ordering) and quantification of the observed data.
    To have all the information organized.
    To quantify frequency and distribution.
  3. Developing a hypothesis.
    It must be “reasonable“; should not be arbitrary and should not be in contradiction
    with established facts.
    It is an orderly scientific sequence applied to health problems.
  4. Testing the hypothesis.
    For ethical reasons, many hypotheses can not be subjected to
    experimentation, statistical analysis is used to accept or reject the hypothesis.
  5. Report/conclusions: accept or reject the
    hypotheses.
33
Q

Define descriptive epidemiology (2)

A

Stop in the first 2 or 3 steps of the epidemiological method:

  • observation,
  • measurement
  • presentation of hypotheses

describes the general characteristics of the distribution of
disease, particularly in relation to person, place and time.

34
Q

Define analytic epidemiology (2)

A
  • continue to the end of all 5 epidemiological methods

- tests a specific hypothesis about a potential exposure and an outcome of interest. Risk factor-Outcome relationship

35
Q

Define population

A

set of all elements
that meet certain properties
where a particular phenomenon
is studied

36
Q

Define health sciences

A

a set of individuals in

which you want to study something

37
Q

What is the population object, goal or reference/target population?

A

population that you want to study

38
Q

What is the origin population/study population?

A

The population that is actually sampled.

-is experimentally accessible and can be measured

39
Q

When there is no selection bias, what happens ?

A

-Target population matches study population

40
Q

Define sample

A

the part of the population that is going to be studied

41
Q

What are the different sampling techniques?

A

1- Convenience sample: volunteers, people who attend a consultation…Does this system have problems?
2- Random sampling: the best procedure to get a representative sample of the population

42
Q

Define estimation

A

Attempt to determine the true value of a variable in a

population from the study of a sample.

43
Q

Estimation involves…

A

calculating the range that
will include the population value with a certain degree
of confidence.

44
Q

Define confidence interval

A

provides a range of values contains the population parameter of interest.

-gives an estimated range of values which is likely to include an unknown
population parameter

45
Q

the narrower the confidence interval…

A

the better the precision of the estimation

46
Q

How can you change the width of the confidence interval? (3)

A
  1. Increasing sample size
  2. Decreasing the measurement error.
  3. Varying the risk of error you are willing to accept.
47
Q

What does increasing the sample size do to the width of the confidence interval?

A

More precision = narrower

But from a certain sample size, to achieve minimal gains in precision, large increases in the sample are needed.

48
Q

What does Varying the risk of error you are willing to accept do to the width of the confidence interval?

A

higher confidence interval = bigger range

lower confidence interval = smaller range

49
Q

define variable

A

characteristic that is being

measured or observed

50
Q

What are the types of variables? (2)

A
  • Qualitative/categorical variables

- Quantitative variables

51
Q

What are the types of qualitative/categorical variables? (3)

A
  • ordinal scales
  • nominal/categorical scales
  • dichotomous
52
Q

What are the types of quantitative variables? (2)

A
  • discrete variables

- continuous variables

53
Q

What is a qualitative / categorical variable? (2)

A

-are those that
are described in terms of presence or absence of an attribute
-If you cannot add it…it’s qualitative

54
Q

What is a quantitative variable?

A

measured on a

numeric or quantitative scale

55
Q

What is an ordinal scale? (2)

A
  • qualitative variable
  • rank amongst the categories within a range
    ex. staging of tumors, socioeconomic status, “Strongly agree, agree, neutral, disagree, etc”
56
Q

What is nominal/categorical scale? (2)

A
  • qualitative variables
  • categories cannot be ordered
    ex. gender, blood group, presence/abscence of disease, symptom, risk factor
57
Q

What is dichotomous scale? (2)

A
  • qualitative variables
  • can only take 2 values
    ex. can be ordinal (rich vs poor) or nominal (gender)
58
Q

What is a discrete variable? (3)

A
  • quantitative variable
  • can only be an integer
  • result of counting process

ex. # of hospital admissions, # of children

59
Q

What is a continuous variable? (3)

A
  • quantitative variable
  • any numerical value with decimals
  • result of a measure
    ex. weight, height, blood cholesterol
60
Q

What is a dependent variable?

A

variable being affected by independent variable

61
Q

What is an independent variable?

A

a variable that does not depend on that of another

62
Q

What type of variables are measured in epidemioloigal studies? (person) (7)

A
  • age
  • gender
  • social class
  • occupation
  • ethnicity
  • religion
  • marital status
63
Q

What variables are always collected /measured in all epdemiological studies? (4)

A

Age
gender
location
time (of study and duration of schedule - ex. for seasonal flu)

Epidemiology (6 decks)

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