epidemiology

Question 1

Examines the distribution of a disease in a population, and describes the features of its distribution in terms of person, place and time (PPT) —-

Answer 1

descriptive epidemiology
( what : health issue
who: person
where: place
when: time )

Question 2

Tests a specific hypothesis about the relationship of a disease to a possible cause.
It does so by conducting a study that measures the association of the exposure to the risk factor (or factors) to the disease of interest known as —

Answer 2

analytical epidemiology

Question 3

the key feature of analytic epidemiology is —-
different study design offer different ways of — an appropriate comparison groups. this impacts on the — of the study design

Answer 3

-comparison groups
- identifying
- strength

Question 4

When we measure frequency and distribution of disease, we need to take account of the —- of the population, we do this by incorporating a — in our measure
1- the numerator is the —
2- the demoniator is the —-

Answer 4

• size
• demonitaor
• event or count
• population at risk

Question 5

how important is the use of rates to healthcare planning :
( read)

Answer 5

Over a period of twelve months an accident and emergency department at a city hospital noted that the acute medical admissions for people over 65 had risen by 30% in the past year when there had been no change in the previous five years.

Question 6

1-who: person
the characertsics are:

Answer 6

-Age
-Sex
-Ethnicity
-Marital status
-Socio-economic status :
1-education,
2- occupation
3-income
-Behaviour / habits

Question 7

2- a place: where these include
1- are they — or —- as:
2- — effects as:
3- ——
4- relation to — exposure as:

Answer 7

• restricted or widespread as outbreak , epidemic , pandemic
• climate effect as temp and humidity
• urban/periurban /rural
• environmental exposure as water and food supply

Question 8

3- time: where
usually displayed on —-
1- vertical aka y axis usually shows the —
2- horizontal or x axis show the —-
- the —– is plotted over —
- graphs of disease occurrence over time are usually plotted as — or —

Answer 8

• graphically
• number or rate of cases
• time periods as years or months
• number or rate of cases is plotted over time
• line graphs or histograms

Question 9

change in disease over time can be :
1 — : related scattered cases
2—- : unusually increase in incidence
3- — seasonal chnage in condition or injury that conforms to regular seasonal pattern
4- —- recurrent alteration in occurrence , interval , or frequency of sieves but mo during a fixed period
5- —– long term changes over years or decades and can apply to both infectious and non infectious diseases

Answer 9

• sporadic
• epidemic ( not endemic )
• seasonality
• cyclic trend
• secular trends

Question 10

when we look for differences over time we need to ascertain whether they are due to:

Answer 10

1- chance/random error: Random variation will occur over time. We use statistical methods to measure how likely it is that variation has arisen b yhance.
2- artefact as:
- mistakes made in collecting or organizing the data
- changes in sensitivity or specificity of the surveillance system
- Changes in the perceptions of the public or the health care community about the importance of diagnosing and reporting a particular disease
3- a real difference :
True increases or decreases–actual changes in the frequency of the disease (or risk factor) in the population

Question 11

What is the most likely reason for changes in food poisoning rates:

Answer 11

1 – change is due to chance
2 – change is artefactual
3 – there has been a real increase in food poisoning rates

Question 12

crude mortality rate ( CMR) is —- over —-

Answer 12

(number of deaths during a specific period / number of persons at risk of dying during the same period ) x10 power n

Question 13

standardised mortality rate;
1-CMR cannot be used to compare two populations because they may have a —
2- When comparing mortality across two or more populations we must first remove (through standardization) —–
3- this can be accomplished through — and — standerization
4- also referred to as —

Answer 13

• different age and sex composition
• difference in age composition
• direct or indirect
  -adjust rate

Question 14

—- is used to avoid using crude mortality rate

Answer 14

standerised mortality rate

Question 15

The —— of rates eliminates the influence of different age distributions on the morbidity or mortality rates being compared

Answer 15

age-standardization

Question 16

infant mortality rate ( IMR) refers to :

Answer 16

(number of deaths in a year of children less than 1 year old / number of live births in the same year ) x1000
- Sensitive to socio-economic changes and to health care interventions
-Establishment of new medical centres in poor settings could lead to an increase in IMRs for a time because registration of births and deaths will be improved

Question 17

= The number of maternal deaths per 100,000 live births (from causes related to pregnancy and childbirth)

Answer 17

maternal mortality rate
(The rate of mothers dying from causes
associated with delivering babies, complications of pregnancy or childbirth.)

Question 18

1- —— and —– are a key outcome indicator of newborn care and directly reflect pre-natal, intrapartum, and neona­tal care.PMR includes still births in the denominator. NMR does not.
2- Post-neonatal mortality rates and infant mortality rates are —– associated with socio-economic conditions

Answer 18

• parinatal ( PMR) and neonatal mortality rate (NMR)
• inversely

Question 19

—– studies are usually descriptive. They measure person, place and time and generally do not include a comparison group.
—— of the cholera outbreaks in London are a classic example of how a cross sectional study can lead to hypothesis generation.

Answer 19

• cross sectional studies
• John Snow’s studies ( its an analytic study not descriptive )

Question 20

the 3 main analytic study designs are:

Answer 20

1- case control study
2- the cohort study

Question 21

Lung cancer increased significantly during the 20th century but its cause was unknown. Doll and Hill’s work linking lung cancer to smoking (1950) used a —–
they identify cases of — and matched w the ppl —— then looked back through time at smoking behaviour to see if smoking was more common among the cases than controls. It was, and more common among heavier smokers.
-Smoking was extremely prevalent, even in physicians, and many refused to believe that it could be a cause of cancer. It took ten years before smoking was accepted as an important cause of lung cancer.

Answer 21

• case control study
• cases of lung cancer
• ppl without lung cancer

Question 22

-Study of CVD among residents of Framingham, Massachusetts (1948 – ongoing)
-Much of the now-common knowledge concerning heart disease, such as the effects of diet, exercise, and common medications such as aspirin, is based on this longitudinal study.
-“I have often wondered what turn the subsequent course of history would have taken if modern methods for managing hypertension had been available in Roosevelt’s time.”
is all under —

Answer 22

cohort study

Question 23

I-SIS2 (Lancet 1988)
-International Study of -Infarct Survival
-Streptokinase and aspirin singularly and in combination
-Resulted in 53% reduction in mortality
are all under —

Answer 23

randomised controlled trails

Question 24

1—— is the most comprehensive worldwide observational epidemiological study to date.
2-it describes the —- and — from major diseases , — and – factors to health at global , national , and regional levels
3- Examining trends from 1990 to the present and making comparisons across populations enables understanding of the changing health challenges facing people across the world in the 21st century.

Answer 24

• global burden of disease study ( GBD)
• mortality and morbidity
• injuries and risk

Question 25

The Global Burden of Disease study has been key in helping us understand —-

Answer 25

-understand the disability and years of life lost due to the major health conditions
-Combines number of years of life lost (YLL) to premature death with time spent in less than full health (YLD). One DALY can be thought of as one lost healthy year of life.
- DALY - YLL + YLD

Question 26

in general , health outcomes are dependent on:

Answer 26

1-Biology and genetics (e.g. inherited conditions)
2-Public policy and regulation (e.g. vaccination campaigns)
3-Healthcare (e.g. timely treatment and diagnosis of disease)
4-(lifestyle) habits (e.g. smoking)
5-Social and environmental factors (e.g. poverty, exposure to crime, pollution)