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Year 2 LMAP > Epidemiology > Flashcards

Epidemiology Flashcards

1
Q

What is epidemiology?

A

‘the study of that which Is upon people’

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2
Q

What does endemic mean?

A

Diseases that reside within a population

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3
Q

What does epidemic mean?

A

Diseases that befall a population

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4
Q

How is epidemiology defined?

A

The study of the distribution and determinants of health-relates states or events in specified populations, and the application of this study to the control of health problems

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5
Q

Give a more succinct definition of epidemiology

A

How often disease in different groups of people and WHY

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6
Q

What are the three types of prevention?

A

Primary
Secondary
Tertiary

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7
Q

What is primary prevention?

A

The prevention of disease through the control of exposure to risk factors

before onset of disease

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8
Q

What is secondary prevention?

A

The application of available measures to detect early departures from health and to introduce appropriate treatment and interventions

slows progression

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9
Q

What is tertiary prevention?

A

The application of measures to reduce or eliminate long-term impairments and disabilities, minimising suffering caused by existing departures from good health and to promote the patient’s adjustments to their condition.

e.g. rehabilitation of someone who has had a stroke
enabling return to normal function

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10
Q

What does being good at epidemiology involve?

A 
Curiosity
Problem-solving
Numerical ability 
Critical thinking 
Communication 
Creativity
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11
Q

What are the three dimension of epidemiology?

A

Time
People
Place

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12
Q

What two things are often studied in epidemiology?

A

Exposures and Outcomes

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13
Q

What does the demographic transition model consist of?

A

5 stages of progression looking at birth rate, death rate and total population

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14
Q

What are the four stages of epidemiological transition?

A

Pestilence and famine
Receding pandemics
Degenerative man-made diseases
Delayed degenerative diseases and emerging infections

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15
Q

When was the era of pestilence of famine occurring the UK?

A

Pre-industrial revolution (up to 1800s)

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16
Q

What was associated with this period of pestilence and famine?

A

Urbanisation
Constraints on food supply
High birth rate and high mortality
Life expectancy low at birth

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17
Q

When was the era of receding pandemics occurring the UK

A

1800s - 1950

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18
Q

What was associated with this receding pandemics and famine?

A

Agricultural development improves nutrition

Life expectancy increases

Water, sanitation, hygiene

Vaccination emerges

High birth rate and decreasing deaths

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19
Q

When was the era of degenerative diseases occurring the UK?

A

1950 -2010s

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20
Q

What was associated with this degenerative and man-made disease period?

A

Lifestyle factors and NCDs predominate: Cancer and CVD

Environmental and global determinants drive obesity and other risk factors

Technology reduces need for physical labour

Addiction, violence and other issues emerge

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21
Q

When was the era of delayed degenerative diseases and emerging infections occurring the UK?

A

2010s onwards

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22
Q

What was associated with this degenerative and man-made disease period?

A

Health technology defer morbidity, albeit at increasing financial cost

Emerging zoonotic disease presents new threats

Inequalities within and between countries come to the fore

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23
Q

What determines which stage a country falls under?

A

Access to food, water, healthcare and sanitation

24
Q

What are the levels of evidence?

A

The pyramid

Systematic reviews and meta-analysis

Randomised control trials

Cohort Studies

Case-control studies

Case series, case reports

Editorial, Expert opinion

25
Q

What are the two types of research?

A

Quantitative research

Qualitative research

26
Q

What are the different types of epidemiological approach?

A

Descriptive

Analytic

27
Q

What does qualitative research often explore?

A

Underlying ideas and themes to inform research questions and possible future hypotheses

28
Q

How to does qualtitative research express findings?

A

In words

29
Q

What are the main pros and cons of qualitative research?

A

Relies on small numbers participants

Goes into substantial details

30
Q

When is qualitative research often used?

A

Earlier in the research process

31
Q

What are the three groups of conditions that affect DALYs?

A

Communicable disease

Non-communicable disease

Injuries

32
Q

Give 4 measures of frequency

A

Odds
Prevalence
Cumulative incidence
Incidence rate

33
Q

What are odds?

A

Ratio of a probability of an event to its complement

Number of people who have the disease divided by the number of people who don’t have the disease

34
Q

What is prevalence?

A

Proportion of individuals in a population who have the disease or attribute of interest at a specific timepoint

Number of people with the disease divided by the population

Always need to specify timepoint

Prevalence is measure with a percentage

Provides no information on new cases of a disease

35
Q

What is cumulative incidence?

A

Proportion of the population with a new event during a given time period

Number of new cases during the period of interest
divided by the number of disease-free individuals at the start of this time period

Need to be explicit about time period

36
Q

What does a cumulative incidence value of 0 mean?

A

There were no new cases during the study period

37
Q

What does a cumulative incidence value of 1 mean?

A

All individuals developed the disease during the time period

38
Q

What are other names for cumulative incidence?

A

Incidence proportion

Risk

39
Q

What must happen to calculate cumulative incidence?

A

Follow up from participants in study

At the same time

No new participants can join

No participants should leave

40
Q

What is incidence rate?

A

Number on new cases per unit of person time

The number of new cases during the follow up period divided by the total person-time by disease-free individuals

Can take values from 0 to infinity

Must mention unit of person time

Suitable for studies when people enter/leave study at different times

41
Q

What is person-time?

A

The total time a participant spends in the study

Can be expressed in various units hours-years

Ends when person acquires disease, dies or is lost to follow up

42
Q

What does standardisation allow us to do?

A

Make comparison

Adjusting for factors

43
Q

What are the two types of standardisation?

A

Direct Standardisation

Indirect Standardisation

44
Q

What does direct standardisation give you?

A

Comparable incidence e.g. 120 stroked per 100,000 a year

45
Q

What does indirect standardisation give you?

A

Gives a ration out of 100

46
Q

What does direct standardisation allow us to do?

A

Compare like-for-like between populations

E.g. look ate age-specific incidence in a standard population

47
Q

How would you conduct direct standardisation?

A

Step one: Calculate rate for each age bin

Step two: Add standard population to table

Step three: Rate x standard population divided by 100k to obtain expected count

Step 4: Take expected and divided by total population to get age-standardised incidence

48
Q

What is important to note about every stat?

A

Potentially hiding another fact

49
Q

A hospital has a seemingly high post-elective surgery 30 day mortality. What are the three possible explanations?

A

Unwanted variation - Hospital A is dangerous

Explained variation - e.g. the hospital does more high risk procedures

Statistical artefact - hospital is better at recording deaths (can be difficult to explain deaths outside of a hospital)

50
Q

How do you conduct indirect standardisation?

A

Use national statistics to calculate expected values

Calculate SMR

51
Q

What is the SMR?

A

Standard mortality ration

52
Q

How do you calculate SMR?

A

Dividing the observed count by the expected count

53
Q

What is SIR?

A

Standardised incidence ratio

54
Q

What is SHMI data?

A

Summary hospital mortality indicator data

55
Q

When is indirect standardisation useful?

A

When we only have high-level data about outcomes

We cannot make direct comparison

First step on a journey of enquiry

56
Q

What does the SHMI do?

A

indirect standardisation to produce ‘expected’ number of deaths by a series of adjustments taking into account the

volume of cases

blend of diagnoses

casemix adjustments for underling demography and health status variation of patients

57
Q

What doe SHMI values range from?

A

0.6 - 1.2

Year 2 LMAP (4 decks)

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