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Introduction to Epidemiology > Epi Midterm Review > Flashcards

Epi Midterm Review Flashcards

1
Q

Objectives of Epi

A 
Distribution
-frequencies
-patterns
Determinants
-risk factors
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2
Q

John Snow

A

Father of Epi

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3
Q

3 Assumptions made by Epi

A
  1. Disease not random
  2. Investigation can lead to association, causes and prevention
  3. Making comparisons is cornerstone
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4
Q

6 Core Functions

A 
Public Health surveillance
Field investigation
Analytic studies
Evaluation
Linkages
Policy development
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5
Q

Population vs. Sample

A

Population is all ind making up common group from which a sample can be obtained

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6
Q

Generalizability

A

Inferential statistics transposed from sample to full population

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7
Q

Inferential Stats

A

Inferences made about random data relative to a sample

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8
Q

Epidemic

A

Occurrence of disease clearly in excess of normal expectance

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9
Q

Outbreak

A

AKA upsurge/cluster

An epidemic linked to a localized increase in occurrence of disease

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10
Q

Pandemic

A

Epidemic occurring over very wide area, large number of people

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11
Q

Endemic

A

Constant presence of a disease within given area or population in excess of normal levels in other areas

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12
Q

Cluster

A

AKA outbreak

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13
Q

2 Main stages of disease prevention

A

Primary - preventing disease

Secondary - Interrupts disease process

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14
Q

MeSH

A

Medical Subject Headings

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15
Q

Boolean terms

A

AND, OR, NOT

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16
Q

CONSORT

A

Clinical trial checklist

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17
Q

STROBE

A

Observational trial checklist

cohort, case-control, cross-sectional

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18
Q

STARD

A

Diagnostic study checklist

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19
Q

PRISMA

A

Systematic reviews/Meta-analyses checklist

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20
Q

3 Characteristics of data

A
  1. Magnitude
  2. Interval
  3. Rational Zero
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21
Q

Magnitude

A

Bigger is more, lower is less

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22
Q

Interval

A

Equal, even spacing

Ex. time

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23
Q

Nominal Data

A

No magnitude, No interval
Non-ranked categories
Ex. Sex, race, handed-ness

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24
Q

Ordinal Data

A

Magnitude, No interval
Categories, ranking something
Ex. Pain scale

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25
Q

Interval Data

A

Magnitude and Interval

Ex. height, weight, age, income, days until surgery

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26
Q

Mean

A

Average

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27
Q

Median

A

Value that divides group values into half

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28
Q

Mode

A

Most frequently occurring value

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29
Q

Variation

A

Difference between max and min

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30
Q

Spread or dispersion of data

A 
Variance
Standard Deviation (square root of variance)
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31
Q

Graph Types

A 
Pyramid
Stacked
Pie
Line Graph - trend
Scatter plot
Box plot
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32
Q

Null Hypothesis

A

H0

Study hypothesis that states no true difference between groups being compared

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33
Q

Alternative Hypothesis

A

H1

Hypothesis states there IS a true difference

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34
Q

P Score

A

Want less than 0.05 (5%) so it is a statistically significant result. NOT by chance

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35
Q

P < .05

A

Statistically significant, result is not by chance

Reject null hypothesis

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36
Q

Type 1 Error

A

(alpha)
Rejecting null hypothesis when it is actually true
False positive

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37
Q

Type 2 Error

A

(beta)

NOT rejecting null hypothesis when it is actually false. There is a real diff but you don’t reject H0

38
Q

Power

A

Ability of a study to find difference in study if it was there

39
Q

Sample size

A

Larger increases power. More likely to find a difference if it is there

40
Q

Sensitivity

A

Box A

Proportion of time that a test is positive in pt that does have disease

41
Q

Specificity

A

Box D

How well test can detect absence of disease when in fact disease is absent

42
Q

Diagnostic Accuracy

A

Proportion of time a pt is correctly identified as either having a disease or not having disease

43
Q

Positive Likelihood Ratio

A

LR+
Probability of positive test in presence of disease
Sensitivity/1-Specificity

44
Q

PPV

A

How accurately a positive test predicts presence of disease

45
Q

Validity

A

Ability to accurately discern between those that have disease and those that don’t

46
Q

Internal validity

A

Extent to which results accurately reflect the true situation of study population

47
Q

External validity

A

Extent results are applicable to other, non studied populations

48
Q

Reliability

A

=Reproducibility

49
Q

3 factors necessary to compare dz frequencies in diff popultions

A

number of people affected by disease
Size of the source population
Length of time population followed

50
Q

Ratios

A

Division of 2 unrelated numbers

51
Q

Risk

A

AKA : Attack rate, incidence, cumulative incidence

52
Q

Common measure of disease frequency

A 
Mortality rate
Death rate
Survival rate
Live birth rate
Fertility rate
53
Q

Absolute Difference

A

Subtracting differences

54
Q

ARR

A

How much is difference in risk attributed to your exposure

55
Q

Observational

A

designs considered natural
Observe outcomes
Useful for unethical study designs

56
Q

Experimental

A

Intervention
Can demonstrate causation
Investigator selects interventions

57
Q

Advantages of Clinical

A

Cause precedes effect - shows causation

Only design used by FDA for new drug/device

58
Q

Disadvantages of Clinical

A

Cost
Time
Ethical
Generalizability

59
Q

Simple study design

A

Subjects randomized once

Usually to test one hypothesis

60
Q

Factorial study design

A

Randomized at least twice
Multiple hypotheses
Disadv: risk of drop out, restricts generalizability

61
Q

Parallel Study design

A

groups concurrently and parallel

NOT cross-over

62
Q

Cross-over study design

A

Groups serve as own control
1 person multiple data pts
Wash out period to reset to normal

63
Q

Direct Endpoints

A

Most clinically relevant, publishable

Ex death, stroke, hospitalization

64
Q

Surrogate Markers

A

Number that is associated with bad outcome VS direct endpts

Ex. cholesterol, BP

65
Q

Blocked randomization

A

Make sure group is equal
1:1, 2:1, etc
ensures balance within each group

66
Q

Stratified randomization

A

Ensures balance by known confounding variable

ex. age, gender, disease severity

67
Q

Placebo/Dummy

A

Inert treatments

30-50%

68
Q

Hawthorne Effect

A

Desire of study subject to please investigator

69
Q

Double Dummy

A

more than one placebo

70
Q

Run in/Lead in phase

A

ALL study subjects given one or more placebos for initial therapy to determine baseline of disease

71
Q

4 Principles of Bioethics

A
  1. Autonomy
  2. Beneficience
  3. Justice
  4. Nonmaleficence
72
Q

Autonomy

A

self rule/determination

ex. not in place is mental capacity, age

73
Q

Beneficiance

A

Benefit/do good for patient

74
Q

Justice

A

Equal fair treatment regardless of pt characteristics

75
Q

Nonmaleficence

A

Do no harm

  • withhold info
  • lie
76
Q

Consent

A

Agree to participate

Legal age

77
Q

Assent

A

Not able to consent, legal guardian must consent

78
Q

Belmont Report

A

1978

  1. Respect for persons
  2. Beneficiene
  3. Justice
79
Q

IRB

A

Protect human subjects before study

OHRD is law above IRB, could mean jail

80
Q

DSMB

A

Data safety and Monitoring Board
Assess for undue risk or benefit AFTER study starts
Can stop study early

81
Q

Equipoise

A

Genuine confidence that an intervention may be worthwhile in order to use it in humans
-principal people who argue against placebo use

82
Q

Full Board IRB

A

ALL drug trials

Interventional trials with more than minimal/no risk to pts

83
Q

Expedited IRB

A

Minimal risk and no pt identifiers

84
Q

Exempt IRB

A

No pt identifiers, low/no risk, enviro, use of existing data/specimens

85
Q

Kappa Statistic

A

Agreement between evaluators
+1 perfectly agree
-1 exactly opposite

86
Q

Kappa Interpretation

A

.8-1 excellent
.6-.8 good
.4-.6 fair
0-.4 poor

87
Q

Positive Post Hoc

A

If sub groups are pre-defined and NOT fishing

88
Q

3 Factors for Sample Size

A
  1. Anticipated difference between groups
  2. Background rate of outcome
  3. Alpha and Beta (power)
89
Q

Ways to Handle Drop outs

A
  1. Include them anyway
  2. Ignore them
  3. Treat them as “as treated” - move subject
90
Q

Improving Adherence

A

Frequent follow ups
Treatment reminders
Med blister packs, dosage containers

Introduction to Epidemiology (4 decks)

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