CH18 Oral Epidemiology Flashcards
A relatively low, but constant, level of occurrence of a disease in a particular geographic region.
*disease that is expected*
**************************
B) Endemic
The occurence of a disease in excess of normal in a specific community or region; usually occuring suddenly and spreading rapidly. Often called an “outbreak” of disease .
*****************
C) Epidemic
The study of the nature, cause, control, and determinants of the frequency and distribution of disease, disability, and death in human populations is referred to as ______.
It is the process of characterizing the distribution of disease and various related factors such as age, sex, race, socioeconomic status, time, place, person, and behavior.
********************
Epidemiology
The theory that a disease can be attributed to many factors is termed ________.
A) Multifactorial
B) Cause-and-effect
C) Dimensional
D) Naturalization
E) None of the above
A) Multifactorial
(Host = who, Agent = What, Environment = where)
The study of disease in a target population is called ________.
A) Etiology
B) Causality
C) Epidemiology
D) Naturalization
E) All of the above
C) Epidemiology
The rate of new cases of a disease or condition over a given period of time
*************************
Incidence
The study of the amount, distribution, determinants, and control of disease and health conditions among given populations
************************
Epidemiology
What publication is a compilation of cogent issues currently studied?
A) Mortality and Morbidity Weekly Report
B) Healthy People 2000
C) Call to Action
D) Healthy People 2010
E) None of the above
A) Mortality and Morbidity Weekly Report
A numerical expression of the number of all existing cases of a disease or condition measured at a given period of time
****************************
I) Prevalence
(All of the diseases)
The rate of new cases of a disease or condition over a given period of time
**************************
Incidence
The study of the cause(s) of disease
**************************
M) Etiology
Widespread outbreaks of a disease or condition that crosses international borders and affects several countries and continents.
************************8
Pandemic
Methods or systems used to monitor disease and morbidity in a population
********************************
P) Surveillance
Characteristics of an individual or population that may increase the likelihood of experiencing a given health problem
N) Risk factors
The ratio of the number of deaths from a given disease or condition
K) Mortality
A standardized method used to describe the status of an individual or group with respect to a given condition
F) Index
____ is the extent of disease, injury, or disability in a defined population.
*how many people have the disease*
************************
Morbidity
The theory of causation for a disease or condition
M) Etiology
Degree to which a research study measured what it was supposed to measure (internal) and can be generalized to the entire population (external)
E) Validity
These are often “adjusted” to make valid comparisons and detect trends
J) Disease rates
Change of the measurement made in error in a logical direction
Positive reversal
Caries is absent when DMF is measured the first time and is present when DMF is measured the second time, if the second measure is inaccurate
Change of diagnosis in an illogical direction over a period of time
Negative reversal
Caries is present when DMF is measured the first time and is absent when DMF is measured the second time
Monitors the burden of oral disease, utilization of the oral health care delivery system, and community water fluoridation in the nation and states
National Oral Health Surveillance System (NOHSS)
The prevention agenda for the United States is discussed in which publication?
A) Morbidity and Mortality Weekly Report
B) Healthy People 2020
C) Global Oral Data Bank
D) Prevention USA
E) None of the above
B) Healthy People 2020
Ten indicators identify the attainment of these objectives: physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to health care.
What source contains oral epidemiological data from around the world?
A) Prevention International
B) Federation Dentaire Internationale
C) Global Oral Data Bank
D) International Federation of Dental Hygienists
E) None of the above
C) Global Oral Data Bank
(From the WHO)
A risk marker is an attribute that is associated with the increased probability of disease but is not considered to have a causal role.
True
False
True
Risk is used to infer or suggest causality.
A risk indicator is a modifiable attribute that is known to be associated with a health condition.
True
False
False
Causality means that a particular exposure results in a particular outcome.
True
False
True
Observational studies can be conducted to infer causality.
True
False
True
Establishing risk is the same as establishing causality.
True
False
False
The multifactoral nature of disease that consists of the genetic or social factors of individuals that contribute to their susceptibility or resistance (i.e., tooth morphology, salivary flow) is the ______.
“who factor”
host
The multifactoral nature of disease that is the biologic or mechanical cause of the disease or condition (i.e., specific bacteria that cause dental caries or periodontal disease) is the ____.
“what factor”
******************************
agent
The multifactorial nature of disease that refers to the physical, social, sociocultural, sociopolitical, and economic circumstances that are required for the disease to thrive, survive, and spread (i.e., nutrition, sugar intake, and smoking) is referred to as the _____
“where factor”
************************
enviornment
Factors or events capable of bringing about change in health and make up a multifactorial approach to a disease or health condition are called _______.
Determinants
_____ is the concept that more than a single cause must be present for a disease or health condition to occur; multiple causation.
Multifactorial
************************
_______ is the elimination of an infectious disease agent through surveillance and containment; contrasted to control, which is to keep the disease at a minimum level so that it no longer poses a health problem.
Eradication
The ______ is the number of cases of the disease or condition in a population.
count
A ______ provides more information about the extent of the disease in a population; prevalence is expressed as a ______.
proportion; proportion
A _____ expresses the magnitude of one occurrence in relation to another
ratio
A ____ is an expression of disease in a population using a standardized denominator and including a time dimension; incidence is ____.
rate; rate
An _____ reports more detailed information than a count, proportion, or rate by providing a standardized measurement of the amount or severity of the disease or condition in a population.
index
What clinical measurement method uses a visual assessment that is quickly accomplished,as well as a tongue blade, mirror, and light.
Basic screening
The ________ is more thorough, uses instruments and light and is used with most indices.
epidemiologic evaluation
______ is accuracy of a measurement; measurement results are true or accurate.
Validity
________ is consistency or reproducibility of a measurement over time.
Reliability
______ is the ability to identify all screened individuals who actually have the disease; influences validity.
***************************
Sensitivity
_____ is the ability to identify only non-diseased individuals who actually do not have the disease; influences validity.
****************************
Specificity
__________ is the ability of a test to accurately measure a disease or condition.
Predictive value
_________ is an agreement among two or more examiners as they apply a test or index.
Inter-rater (examiner) reliability
________ is the consistency of a single examiner in the application of a test or instrument multiple times.
Intra-rater (examiner) reliability
______ is the standardization of examiners as they apply epidemiologic measurements.
Calibration
______ is a change of the measurement made in error in a logical direction.
Positive reversal
______ is a change of diagnosis in an illogical direction over a period of time
Negative reversal
Oral epidemiology reports use surveillance to identify ______, which are long term changes. This observation and monitoring is is an ongoing process.
trends
What are the two types of observation used in epidemiology reports?
Passive surveillance (voluntary reporting) and Active surveillance
The ________ monitors the burden of oral disease, utilization of the oral health care delivery system, and community water fluoridation in the nation and states.
National Oral Health Surveillance System (NOHSS)
What are the nine oral health indicatior used by the National Health Surveillance System?
- dental visits
- cleanings
- complete tooth loss
- loss of 6 or more teeth
- fluoridation status
- sealants
- caries experience
- untreated caries
- oral cancer
______-level surveys collect the data utilized by NOHSS.
state
The _____ publishes events of public health interest and importance to state and local health departments as quickly as possible.
MMWR
Morbidity and Mortality Weekly Report
The following are the Five Action Recommendations in the _________:
Change perceptions of oral health,
Overcome barriers to oral health
Build the science base
Increase oral health workforce diversity, capacity, and flexibility,
Increase collaborations
National Call to Action to Promote Oral Health
What organization manages the global oral health data bank?
WHO
Risk of disease, causes of disease, and effectiveness and efficacy of treatment modalities are the _________.
concepts of epidemiological studies
_____ is used to infer or suggest causality.
Risk
_____ must be in place to support causality, but the more that are present, the stronger the case for causality of a risk factor in relation to the disease or condition.
Criteria
What are the three attributes associated with disease?
risk factors, risk indicators, and risk markers.
SLIDE
Criteria for inferring causality from observational studies
- Strength of Association. The stronger the association between exposure and outcome, the greater is the likelihood of causation.
- Consistency of Association. If the association holds in a large number of studies (replication studies), it is more likely to be causal.
- Sensitivity of Association. If those who have the disease were exposed to the suspected causative factor, the factor is more likely to be causal.
•Specificity of Association. If absence of exposure is associated with absence of the disease outcome, the exposure is more likely to be causal.
•Time Relationship. If the exposure precedes the outcome, causality is more likely. This condition is considered to be absolute.
•Dose-Response Relationship. If the disease outcome increases as the degree of exposure increases, causality is more likely.
•Plausibility. If the association is congruent with current biological, medical, epidemiologic, and scientific knowledge, causality is more likely.
•Analogy. If the association is similar to other associations that have been shown to be causal, the transfer of knowledge can be used to support causality.
Levels of evidence to evidence-based practice
- Systematic review w/ meta analysis (looks at hundreds of similar studies and assesses)
- Systematic review w/o meta analysis (takes a few studies and writes a conclusions)
- One or more randomized controlled clinical trials (experiments)
- Well-designed cohort studies (ppl with similaries followed over time without a disease that are doing something to assess a risk like smoking; observational only)
- Well-designed case control studies (has a case and a control group, ppl with a disease(case) compared to a and a control group (not somkers)
- Cross-sectional studies w/o concurrent controls; uncontrolled experiments (shows one point in time)
- Case series
- Opinions of respected authorities, based on clinical experience; descriptive surveys; case reports, reports of expert committees
- Non-human (animal) research
Loosly controlled clinical trials that use a test to determine how an agent or treatment regimen works in everyday conditions is called an ________. It is conducted on a _______ community population with varying degrees of the disease or condition under study.
*this test is conducted after its efficacy has been established*
Effectiveness trial; broad
________ refers to the accuracy of the results of the study and is enhanced by controlling sources of error and extraneous variables. Factors that may affect its accuracy are the _____ and ______ of the study.
Extraneous factors: subject retention, compliance of study participants, data quality, appropriate methods
**********************
Internal validity; length; size
_______ refers to the accuracy of inferring (generalizing) the results from the sample to the population at large. It is affected by how well a sample represents the population; sampling must be precise for survey research.
Other factors that affect external validity are the _____ variable and ______.
**Jesse, check this card**
**********************
External Validity; dependent; pretests
A controlled clinical trial that conducts testing on a population susceptible to a disease or condition being studied to determine whether an agent or treatment regimen works is termed an ______.
Efficacy trial
(this comes first)
Criteria for ______ from observational studies are strength of association, consistency of association, sensitivity of association, specificity of association, time relationship, dose-response, plausibility, analogy.
inferring causality
______ is when every patient receives both treatments during an experiement.
Crossover design
______ is the break that is taken between the two treatments of a study in a crossover design.
washout period
