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BDS2 - PMHP > epidemiology > Flashcards

epidemiology Flashcards

1
Q

what is the definition of epidemiology

A

is the study of a population in order to determine the frequency and distribution of disease
- it helps in identifying risk factors for disease and determinant optimal treatment approached to clinical practice and preventive medicine

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2
Q

what was the starting point of epidemiology

A
  • John Snow broad street pump cholera epidemic, London, 1854

- one of the 1st recorded examples of epidemiology to investigate and manage of infectious disease

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3
Q

what is cholera

A
  • an infection in the small intestine caused by the bacterium vibe cholera
  • main symptoms are profuse, watery diarrhoea and vomitting
  • transmission occurs through drinking water or eating food contaminated
  • the severity of diarrhoea can lead to dehydration and even death
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4
Q

what happened in the investigation of the broad street pump

A
  • John snow was recording it and finding links between areas of infection
  • mapping the areas found that they were all near the pump
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5
Q

what was the intervention to the broad street pump epidemic

A
  • the pump handle was removed as intervention so people couldn’t use it anymore - a dramatic reduction in cases was seen
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6
Q

what are the major roles of epidemiology

A
  • monitor infectious disease and non infectious diseases
  • study natural history of disease
  • investigation of disease risk factors
  • health care needs assessment
  • development of preventive programmes
  • evaluation of interventions
  • health service planning
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7
Q

how is the flu monitored

A
  • stats are monitored weekly for the flu
  • it is an infectious disease
  • it is monitored to see if it is a pandemic or not
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8
Q

what is an example of a pandemic flu

A
  • swine flu

- affected young people as well as elderly people

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9
Q

how are non-infectious diseases monitored

A

yearly

- such as lung cancer

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10
Q

why are diseases studied

A
  • to determine if they are self limiting, chronic or fatal or unknown
  • oral cancer is an example of a fatal disease
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11
Q

what is an example of an unknown disease history

A
  • HPV

- it is known there is a link between it and oropharyngeal cancer but unsure of the link

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12
Q

what is considered in health care assessment for epidemiology

A
  • what care services are required by particular population groups
  • dependant on health status and demographics of population
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13
Q

what are development of preventive programmes based on

A
  • knowing risk factors of diseases and attempting to prevent exposure to these factors
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14
Q

what is an example of proportional prevention

A
  • childsmile

- meets needs of certain part of the population

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15
Q

what are the 3 types of epidemiological study

A
  • descriptive (observational)
  • analytic (observational)
  • intervention/experimental
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16
Q

what is descriptive epidemiology

A
  • measure of disease frequency
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17
Q

what is prevalence

A
  • a measurement of all individuals affected by the disease at a certain point in time
  • number of existing cases
  • number of affected individuals divided by total number of persons in population
  • estimates are obtained from cross-sectional studies of derived from registeries
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18
Q

what is prevalence used for

A
  • as an estimate of how common a condition is within a population is at a certain point of time
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19
Q

what does d3mft mean

A
  • decayed missing or filled teeth

- 3 means that it is decay into dentine so is substantial

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20
Q

what is incidence

A
  • a measurement of the number of new individuals who contracted a disease during a period of time
  • number of new cases or events during a specific period of time in a defined population
  • incidence estimates are obtained from longitudinal studies or derived from registries
  • always expressed as a fraction
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21
Q

what is the difference between oral cancer and oropharyngeal cancer

A
  • HPV is only present in oropharyngeal cancer
22
Q

what is the difference between prevalence and incidence

A
  • prevalence is at one point in time incidence is over a period of time
  • a chronic incurable condition like diabetes can have a low incidence but high prevalence because prevalence is the cumulative sum of the past year incidence rates
  • a short duration disease such as the common cold can have high incidence but low prevalence as many people get a cold a year but not many people may have it at one point in time
23
Q

what are the main variables of descriptive epidemiology

A
  • time
  • place
  • person
24
Q

what are the aims of descriptive epidemiology

A
  • identify changes in incidence or prevalence over time
    OR
  • determine incidence or prevalence of disease in different geographical areas
    OR
  • determine incidence/prevalence of disease in a group of individuals with different characteristics
25
Q

what is an example of a time and place study

A

“obesity trends in US adult population by US state, 1985-2003”

26
Q

what is the SIMD

A
  • Scottish index of multiple deprivation
  • 1-5
    5 is most deprived
27
Q

what are the advantages of a sample

A
  • reduces number of individuals to be sampled
  • reduces cost
  • higher response rate
  • higher quality of information collected
  • sample must e representative if population being investigated = aim is to avoid bias
28
Q

what are some sampling techniques

A
  • simple random sample = use of table of random numbers
  • systematic sample = individuals selected at regular intervals from list
  • stratified sample = ensures small sub-groups adequately represented
  • cluster sample = use of groups as sampling units
  • multi-stage sample = combines above techniques
29
Q

what are some errors and bias in survey methodology

A
  • sampling/selection bias
  • response bias/information bias
  • measurement error
  • observer variation
  • loss to follow up
30
Q

why is an index need

A
  • in order to measure disease you need an appropriate index

- measuring for the purposes of epidemiological studies different from recording disease for patient treatment purposes

31
Q

what are the properties of an ideal index

A
  • clear, unambiguous, not subjective
  • ideally correspond with clinically important stages of the disease
  • indicate treatment needed
  • within ability of examiners
  • reproducible
  • not time consuming
  • acceptable to patient
  • amendable to statistical analysis
  • allow comparison wit other studies
32
Q

what is the DMF index

A
  • 1st used in 1937
  • for adult teeth = 0-32 DMFT, 0-148 DMFTS (surfaces)
  • for children = e = extraction, at age 6 or over only score c,d or e
33
Q

what are the limitations of the dmf index

A
  • teeth extracted for reasons other than caries
  • influenced by access - inter proximal surfaces harder
  • difficulty in differentiating between fissure-sealants from restorations
  • influenced by past disease activity
  • threshold criteria for disease can vary
  • cannot be used for root caries
34
Q

how often are surveys done in the UK for children caries

A
  • every 10 years
  • small number of children
  • BASCD annual surveys organised locally around the UK
35
Q

what is the NDIP

A
  • national Dental inspection programme
  • Scottish epidemiological programme of children
  • renamed in 2002
  • cross-sectional descriptive dental surgery of school children
  • involve standard examination criteria and trained calibrated examiners
36
Q

what are the aims of NDIP

A
  • inform parents of their Childs dental health status (Basic NDIP)
  • advise Scottish government, NHS boards and other organisation of the oral diseases prevalence in children in their area (detailed NDIP)
37
Q

what are the target groups for NDIP

A
  • children in P1 and P7
  • basic inspection for all P1 and P& children every year
  • detailed inspection alternates each year between P1 and P7
  • NHS board can add additional year groups
38
Q

what is a basic NDIP

A
  • offered every child in P1 and P7 classes of local authority schools every year
  • proportion of school rolls inspected 85-90%
  • generates a letter to parent = overall state of dental heath of child, conveys degree of urgency with which appointment for attendance at dentist suggested for child
  • not a detailed inspection of each surface of each tooth
39
Q

what is a detailed NDIP

A
  • detailed inspection = more rigorous, calibration of examiners
  • records status of each tooth surface in accordance wit international epidemiological conventions
  • uses same clinical inspection criteria as SHBDEP
40
Q

what are the specific goals of detailed NDIP

A
  • to inspect a representative sample of the P1 or P7 LA school population in a year
  • to determine current levels of established tooth decay
  • to illustrate the impact of deprivation on the dental halt of 5 and 11 year olds children in Scotland
41
Q

what is calibration of epidemiology studies

A
  • number of children e.g. 10 are selected for calibration exercise
  • potential dental epidemiology examiners then all examine and chart each child
  • compare results = asses inter-observer variation
  • outlier dental examiners not able to participate in epidemiological programme
42
Q

what is the TF index

A
  • for fluorosis
  • TF 0 - TF 4
  • 0= good, 4= bad fluorosis
43
Q

what is dental fluorosis Scotland

A
  • not considered a public health problem
  • low impact to patient and profession
  • will be monitored through NDIP programme
44
Q

what is the IOTN

A
  • index of ortho treatment need
  • assess the needs and eligibility of children for NHS orthodontic treatment on dental health grounds
  • selects those children who will benefit most from treatment
45
Q

what is the DHC component to index of ortho treatment need

A
  • dental health component
  • has 5 grades
  • grade 1 = almost perfection
  • grade 5 = for severe dental problems
    = upper front teeth that protrude more than 9mm
46
Q

what is the aesthetic component of the index of ortho treatment need

A
  • scale of 10 colour photographs showing different levels of dental attractiveness
  • AC is used for border-line cases with Grade 3 DHC = if high AC score, then NHS treatment is permissible
  • 1 = perfect, 10= needs ortho
47
Q

what is the trend in adult dental health survey tooth loss

A
  • improvement in percentage of adults retaining natural teeth
  • in those ages under 45 years, total tooth loss is virtually a thing of the past
  • prediction for the future = % adults with no natural teeth expected to be in single figure in all groups up to 74 years old by 2028
48
Q

what are the plaque indices of periodontal disease

A
  • debris index = Green and Vermillion 1960

- plaque index = Silness and Loe 1964

49
Q

what are the gingivitis indices for periodontal disease

A
  • modified gingival index = Loe 1967

- loben index = loben 1986

50
Q

what are the periodontal indices for periodontal disease

A
  • basci periodontal examination (BPE)

BDS2 - PMHP (11 decks)

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