epidemiology and social determinants of health Flashcards
how is incidence reported
as a rate (denominator includes time)
are cohort studies prospective or retrospective?
prospective - we recruit people according to risk factor status (exposed or not-exposed) outcome happens after recruitment
what is the income where once you go past - life expectancy doesnt change much
$10000 per annum
what kind of studies can you get incidence from?
only from longitudinal studies
what are the 4 stages of health transition
age of infection and famine age of receding pandemics age of degenerative and man-made diseases age of delayed degenerative diseases
which study designs are observational?
case series, ecological, cross-sectional, case-control, cohort
what did the whitehall study find
that the lower in the work hierachy you are the greater the risk of death
what is the bonus of using 95% confidence intervals over p vales?
CI also provides an indication of the precision of the result
is case control studies prospective or retrospective
retrospective - we come in after disease has already occurred
how do you minimize confounding in the analysis of a study
restriction stratification - analysis of sub group multivariate analyses
what is intention to treat analysis
analyse results assuming that subjects remained in randomized group, regardless of cross over
what is number needed to harm
the number of people needed to undergo the intervention in order to harm one person (when interventions increase the risk/rate of outcome)
selection bias
systematic difference in characteristics of people selected for the study and those not selected
what are the 10 social determinants of health
AEFSSSSTUV the social gradient stress early start social exclusion work unemployment social support addiction food transport
a ROC indicates how well a test discriminates….
people with disease from people without disease
proximate risk factors for TB
- exposure - decreased IS - malnutrition - indoor air pollution - alcohol abuse - other disease - depression and stress
pros and cons of cross sectional studies
pros: relatively cheap and easy cons: need for representative sample, no temporal relationships (association only), weak evidence of causality
how does the social gradient determine health
life expectancy is shorter and disease is more common down the social ladder in each society
what are PPV and NPV dependent on
- sensitivity and specificity - underlying prevalence of the disease (lower prevalence = lower PPV)
hazard
special type of rate that is continuously updated as a longitudinal study progresses
what is confounding
the relationship between exposure and outcome may be influenced by exposure to a confounding factor related to the exposure
how do you try to reduce confounding in clinical trials
try and get treatment groups identical in all aspects other than the intervention
which study designs are interventional?
clinical trials
Risk
probability of disease occurring in a disease free population during a specified time period