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COB Cumulative Final > Epidemiology > Flashcards

Epidemiology Flashcards

1
Q

Define epidemiology

A

a public health discipline basic science which studies the distribution and determinants of disease in populations to control disease and illness and promote health

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2
Q

What are the 3 primary groupings in epidemiology?

A

disease; exposure; population

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3
Q

Who is the father of epidemiology?

A

John Snow

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4
Q

In regards to distribution of disease, what is the frequency of disease occurrence?

A

not only counts but also counts in relation to size of the population

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5
Q

What 3 aspects do patterns of disease occurrence encompass?

A

person; place; time

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6
Q

In regards to distribution of disease, Who/where/when = ____ epidemiology

A

descriptive

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7
Q

In regards to determinants of disease, why/how = ____ epidemiology

A

analytic

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8
Q

New occurrences of an outcome or disease is called what?

A

incidence

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9
Q

Existing occurrences of an outcome/disease is called what?

A

prevalence

note: includes old and new cases, collectively

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10
Q

(new cases of the outcome)/(# persons at risk of the outcome) = ?

A

incidence

note: always subtract out those who already have the disease

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11
Q

What is the equation for incidence rate?

A

new cases/ person time (total net time people were at risk)

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12
Q

Occurrence of disease clearly in excess of normal expectancy is called what?

A

epidemic

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13
Q

an epidemic limited to a localized increase in the occurrence of disease is called what?

A

outbreak

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14
Q

define endemic

A

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

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15
Q

define pandemic

A

an epidemic occurring over a very wide area involving a large number of people

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16
Q

Explain difference between quantitative and qualitative research design

A 
quantitative = numbers 
qualitative = words
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17
Q

Explain difference between interventional and observational methodology

A

interventional = forced allocation to study groups

observational = no forced allocation to study groups

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18
Q

Explain the different phases of an interventional study

A

pre-clinical: bench research

phase 1: assess safety, small sample (20-80)

phase 2: assess safety and efficacy in diseased population, larger sample (100-300)

phase 3: primary focus is to assess efficacy, even larger sample (1000-3000)

Phase 4: post-marketing, long-term effects in large population

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19
Q

Define a single-blind interventional study

A

study subjects are not informed which intervention they are receiving but clinicians know

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20
Q

Define a double-blind interventional study

A

neither investigator nor study subjects are informed which intervention each subject is receiving

21
Q

Define an open label interventional study

A

everyone knows everything

22
Q

Inert treatments made to look identical in all ascents to the active treatment is called?

A

placebo

23
Q

What is a double-dummy treatment?

A

more than 1 placebo used

24
Q

What is the placebo-effect?

A

improvement in condition, by power of suggestion & due to the care being provided

25
Q

What is the hawthorne-effect?

A

desire of study subject to “please” investigators by reporting positive results, regardless of treatment allocation

26
Q

Group allocation in a cohort study is based on what?

A

exposure

27
Q

Group allocation in a case-control study is based on what?

A

disease

28
Q

What does a cross-sectional study examine?

A

the relationship between disease AND exposure

29
Q

What is absolute risk reduction (ARR)?

A

subtract risks of two groups

30
Q

What is relative risk reduction (RRR)?

A

ARR / Risk of unexposed

31
Q

What is the number needed to treat?

A

1 / ARR

32
Q

Interpret RR = 1.53

A

53% greater risk in the comparator group

33
Q

Interpret RR = 0.73

A

27% lower risk of the outcome

34
Q

When looking at the CI for ratios, if both values are on the same side of 1.0, is the data significant or not?

A

always significant

35
Q

How do you test for confounding?

A

calculate crude RR and then calculate adjusted RR which controls for confounder. if there is a 10-15% difference, confounding is present

36
Q

What is the purpose of controlling for confounding?

A

to get a more accurate estimate of the true association between exposure and disease

37
Q

In regards to study design, what are three ways you can control confounding?

A

randomization, restriction, matching

38
Q

In regards to analysis of data, what are 2 ways you can control confounding?

A

stratification, multivariate analysis

39
Q

A 3rd variable, that when present, modifies the magnitude of effect of an association by varying it within different levels of a 3rd variable is called what?

A

effect modification

40
Q

How is effect modification different from confounding?

A

comparing the crude estimate of the measure of association is not the only element used to evaluate the presence of effect modification, stream-specific estimates are compared directly to see if they are different. If the highest layer is 10-15% different than lowest layer, there is effect modification present

41
Q

How do artifactual associations arise?

A

from significant bias and/or extensive confounding

42
Q

How do non-causal associations occur?

A
  1. disease may cause exposure (RA leading to physical inactivity)
  2. disease and exposure are both associated with third factor (confounding)
43
Q

What are Hill’s guidelines?

A

strength, consistency, temporality, biologic gradient, plausibility

44
Q

Define True Positive

A

test is positive and patient does have disease (A box)

45
Q

Define True Negative

A

Test is negative and patient does not have disease (D box)

46
Q

Define False Positive

A

Test is positive but patient does not have disease

47
Q

Define False Negative

A

Test is negative but patient does have disease

48
Q

Sensitivity and specificity describe accuracy of ___ ___, while PPV and NPV predict accuracy of ____

A

test result; diagnosis

COB Cumulative Final (2 decks)

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