FPC2 Tutorial 2 The Use of Data Flashcards
Why is data important in medicine?
knowledge of data and how to present it to patients is a key skill in a world where the management of a patient is now centred around the patient, with the patient understanding what is happening to them and being involved in making decisions
It is impossible to provide good person centred care without being able to communicate risk and data to patients
What is general practice an interface between?
General practice is at the interface between the public on the one hand, and secondary (hospital) care on the other hand
severity of illness does not accurately parallel severity of __________
severity of illness does not accurately parallel severity of disease
What are the definitions of:
illness
disease
Disease – symptoms, signs – diagnosis. Bio-medical perspective
Illness – ideas, concerns, expectations – experience. Patients perspective
What are the 2 different kinds of factors affecting the uptake of care?
medical factors
non medical factors
What are some medical factors affecting the uptake of care?
new symptoms, visible symptoms, increasing severity, duration etc
What are some non medical factors affecting the uptake of care?
crisis, peer pressure “wife sent me”, patient beliefs, expectations, social class, economic, psychological, environmental, cultural, ethnic, age, gender, media etc
How does age/gender contact rates of a GP change?

What are some possible issues from the patient’s point of view to do with treatment?
Believes himself to be healthy
Is physically fit
Proud not to be using tablets
Both he and his wife associate all illnesses to do with the Heart with Ischaemic Heart Disease
If treatment is proposed, how would he feel better?
What are the 3 main aims of epidemiology?
Description - To describe the amount and distribution of disease in human populations.
Explanation - To elucidate the natural history and identify aetiological factors for disease usually by combining epidemiological data with data from other disciplines such as biochemistry, occupational health and genetics.
Disease control - To provide the basis on which preventive measures, public health practices and therapeutic strategies can be developed, implemented, monitored and evaluated for the purposes of disease control.
What does epidemiology compare and what does it detect?
It compares groups (study populations) in order to detect differences pointing to:
Aetiological clues (what causes the problem)
The scope for prevention
The identification of high risk or priority groups in society
Difference between clinical medicine and epidemiology?
Clinical medicine deals with the individual patient
Epidemiology deals with populations
What is the difference between incidence and prevalence?
Incidence - is the number of new cases of a disease in a population in a specified period of time
Prevalence - is the number of people in a population with a specific disease at a single point in time or in a defined period of time
What are some examples showing different incidences and prevelance?
Minor illnesses might have a high incidence but low prevalence e.g. a cold
Other illnesses might be chronic with low incidence but high prevalence i.e. diabetes
What is relative risk and how is it calculated?
This is the measure of the strength of an association between a suspected risk factor and the disease under study
Relative risk (RR) = incidence of disease in exposed group
incidence of disease in unexposed group
Some pictures showing how risk can be communicated

What are some sources of epidemiological data?
Include, but not restricted to:
Mortality data
Hospital and clinical activity statistics
Reproductive health statistics
Infectious disease statistics
Cancer statistics
Accident statistics
General practice morbidity statistics
Health and household surveys
Labour force surveys
Social security statistics
Drug misuse databases
Expenditure data from NHS
What is health literacy?
Health literacy is about people having the knowledge, skills, understanding and confidence to use health information, to be active partners in their care, and to navigate health and social care systems
Health literacy is being increasingly recognised as a significant health concern around the world
The Scottish Government has now published Making it Easy - A Health Literacy Action Plan for Scotland
What is the CHA2DS2-VASc score?
the CHA2DS2-VASc score, are clinical prediction rules for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), a common and serious heart arrhythmia associated with thromboembolic stroke. Such a score is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy
What are NOAC’s?
(novel oral anticoagulants)
These are newer drugs that do not require regular blood test monitoring like Warfarin
They are relatively expensive – see the table attached for the additional costs and the benefits gained
Patients will often have heard of them, and the lack of a need for monitoring often appeals to them
They are not easily reversed like Warfarin, which can be reversed with Vitamin K in the event of bleeding
used in the prevention of stroke for people with non-valvular AF

Is bleeding risk important to calculate?
yes - there is tools for this also
What are SIGN guidlines?
The guidelines are based on a systematic review of the scientific literature and are aimed at aiding the translation of new knowledge into action. The guidelines are intended to:
Help health and social care professionals and patients understand medical evidence and use it to make decisions about healthcare
Reduce unwarranted variations in practice and make sure patients get the best care available, no matter where they live
Improve healthcare across Scotland by focusing on patient-important outcomes
What are the different types of studies which can be carried out?
Descriptive studies
Cross-Sectional
case control studies
Cohort Studies
What are descriptive studies?
Descriptive studies attempt to describe the amount and distribution of a disease in a given population
This kind of study does not provide definitive conclusions about disease causation, but may give clues to possible risk factors and candidate aetiologies
Such studies are usually cheap, quick and give a valuable initial overview of a problem
