Chapter 3 Flashcards
Single case or Small Series: Uses
Alert to new disease or resistant disease; alert to potential spread beyond initial area
Single case or Small Series: Advantages/Disadvantages
Useful for dramatic, unusual, and new conditions; requires alert clinicians and rapid ability to disseminate information
Statistics (“Vital Statistics”) & Reportable Diseases: Uses
Required by law— sometimes penalties imposed for noncompliance; births and deaths key to defining leading causes of disease; reportable disease may be helpful in identifying changes over time
Statistics (“Vital Statistics”) & Reportable Diseases: Advantages/Disadvantages
Vital statistics very complete because of social and financial consequences; reportable disease often relies on institutional reporting rather than individual clinicians; frequent delays in reporting data
Surveys— sampling: Uses
Drawing conclusions about overall population and subgroups from representative samples
Registries attempt to include all those with a disease in order to be representative of the population
Surveys— sampling: Advantages/Disadvantages
Well-conducted surveys allow inferences to be drawn about larger populations; frequent delays in reporting data
Difficult to include all potential patients in disease registries
Self-reporting: Uses
May help identify unrecognized or unusual events
Self-reporting: Advantages/Disadvantages
Useful when dramatic unusual events closely follow initial use of drug or vaccine; tends to be incomplete; difficult to evaluate meaning because of selective process of reporting
Sentinel monitoring: Uses
Early warnings or warning of previously unrecognized events
Sentinel monitoring: Advantages/Disadvantages
Can be used for “real-time” monitoring; requires considerable knowledge of patterns of disease and use of services to develop
Syndromic surveillance: Uses
May be able to detect unexpected and subtle changes, such as bioterrorism or new epidemic producing commonly occurring symptoms
Syndromic surveillance: Advantages/Disadvantages
May be used for early warning even when no disease is diagnosed; does not provide a diagnosis and may have false positives
Social media: Uses
Detect and monitor course of influenza epidemic
Social media: Advantages/Disadvantages
Potential for immediate data obtained from a large number of individuals
Accuracy and precision of the data for early and ongoing surveillance needs to be established
health-adjusted life expectancy (HALE)
Mobility—the ability to walk without assistance
Cognition—mental function, including memory
Self-care—activities of daily living: dressing, eating, bathing, & toilet use
Pain—regular pain that limits function
Mood—alteration in mood that limits function
Sensory organ function—impairment in vision or hearing that impairs function
under-5 mortality
the standard health status measure used by the World Health Organization (WHO) to summarize the health of children.
disability-adjusted life year (DALY)
compares a country’s performance to the country with the longest life expectancy
Health literacy
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
dread effect
is present with hazards that easily produce very visual and feared consequences.
unfamiliarity effect
Our degree of familiarity with a potential harm or a potential benefit can greatly influence how we perceive data and translate it for our own situation.
uncontrollability effect.
We often consider hazards that we perceive as in our control as less threatening than ones that we perceive as out of our control.
Discounting
a quantitative process in which we give greater emphasis or weight to events that are expected to occur in the immediate future compared to events that are expected to occur in the distant future
decision maker
may be an individual; a health professional; or an organization, such as a nonprofit, a corporation, or a government agency.
inform of decision approach
implies that the clinician has all the essential information and can make decisions that are in the patient’s best interest. The role of the clinician is then merely to inform the patient of what needs to be done and to prescribe the treatment, or write the orders.
informed consent
rests on the principle that ultimately, patients need to give their permission or consent before major interventions, such as surgery, radia- tion, or chemotherapy, can be undertaken. Informed consent may be written, spoken, or implied. Clinically, informed consent implies that individuals have the right to know what will be done, why it will be done, and what the known benefits and harms are.
shared decision-making
In this approach, the clinician’s job is to provide information to the patient with which he or she can make a decision.
