G.1 Introduction to Epidemiology

Question 1

What are the 8 star roles of a pharmacist?

Answer 1

• Caregiver
• Decision maker
• Communicator
• Manager
• Life-long learner
• Teacher
• Leader
• Researcher

Question 2

What are the 4 stages of decision making ?

Answer 2

1. Information gathering
2. Clinical reasoning
3. Clinical judgement
4. Decision

Question 3

What is evidence based medicine (EBM)?

Answer 3

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions amount the care of individual patients.
(making decisions about the care of individual patients)

Question 4

What is evidence based practice ?

Answer 4

Evidence based practice is the integration of best research evidence with clinical expertise and patient values.

Question 5

What is post-truth ?

Answer 5

Relaying to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.

Question 6

Put the different sections in hierarchy of evidence in the correct order: from ascending order

a. case report
b. Ideals, editorials, opinion
c. In vitro research
d. cohort study
e. case control studies
f. case series
g. randomised control double blind studies
h. systematic review and meta analyses
i. Animal research

Answer 6

c
i
b
a
f
e
d
g
h

Question 7

What is epidemiology?

Answer 7

The study of health and disease in population, looking at the distribution and determinants of health related states or events in specified populations and the application of this study to control of health problems

Question 8

What is the goal of epidemiology?

Answer 8

To assist the prevention and control of disease and the promotion of health by discovering the cause of disease and the way in which these causes can be modified

Question 9

What are the objectives of epidemiology?

Answer 9

1. Descriptive epidemiology
   (to determine the extent of disease found in population)
2. Etiological epidemiology
   (To identify the cause of disease and the relative risk factors)
3. Clinical epidemiology
   (To study the natural history and prognosis of disease)
4. Evaluative epidemiology
   (To evaluate the effects of interventions, and to estimate risks of specific disease)
5. Health services epidemiology
   (To evaluate both existing and newly developed prevention and therapeutic measures and modes of health care delivery)

Question 10

What are the epidemiological definitions of health and illness?

Answer 10

Health: disease absent
Illness: Disease present

Question 11

Prevalence

Answer 11

The number of people in the population with a disease or condition (Number of cases defined at one point in time)

Question 12

Incidence

Answer 12

The number of people who develop a disease or condition within a specified period of time (e.g number of students who have caught a cold from the start of the year)

Question 13

How is prevalence calculated ?

Answer 13

P= number of people with disease/ number of the whole population at risk

Question 14

How is cumulative incidence calculated ?

Answer 14

CI= number who develop disease/ number at risk over specified time

Question 15

How is incidence rate calculated?

Answer 15

I= number of people who develop disease/ person-time at risk (length of time during which person in population is at risk)

Question 16

What is risk?

Answer 16

Probability of an event (e.g. the probability that an individual will develop disease)

Question 17

What are examples of risk factors?

Answer 17

Associated with the increased chance of developing disease:

• social and economical conditions
• environmental exposures
• genetic factors
• individual lifestyle characteristics

Question 18

What is the difference between risk and odds ?

Answer 18

risk:
probability of disease

odd:
The probability of disease to the probability of not disease

Calculated by ppl with disease/ people without disease (probabilities rather than numbers)

Question 19

What is relative risk (RR) ?

Answer 19

The risk of developing disease in people who are exposed compared to the risk in people who are not exposed

RR= proportion who develop disease in exposed population/ proportion who develop disease in unexposed population

Question 20

What is odd ratio (OR)?

Answer 20

The odds of having a characteristic in people with a disease to the odds of the characteristics in those without disease

OD= odds of exposure in diseased people/ odds of exposure in disease free people

e.g exposure of certain characteristic may be the protective measure

Question 21

What are the requirement of individuals in a cohort study?

Answer 21

All subjects are disease free and time zero

Question 22

What research can be conducted form the cohort study?

Answer 22

What will happen

What has happened

Question 23

What are the strengths of a cohort study?

Answer 23

Can measure incidence 
Measurement of exposure precedes disease onset
Information bias minimised 
Cab examine multiple outcomes 
Rare exposures can be studied

Question 24

What are the weaknesses of a cohort study?

Answer 24

Time consuming and expensive
Problems with losses to follow up
Poor for rare diseases

Question 25

What does case control studies involve?

Answer 25

Group of people with disease and group of people without disease. Start with an outcome and trace back

All exposures have already happened at the initiation of case control study
Retrospective, the outcome of each subject is know by investigators

Question 26

What are the strengths of case control studies?

Answer 26

Relatively quick
Inexpensive
Can examine multiple cases
Good for rare disease

Question 27

What are the limitations of case controlled studies ?

Answer 27

Information bias

Poor for rare exposure

Question 28

What is a cross sectional study?

Answer 28

Determines exposure and event status at the same point in time

Question 29

What are the strengths of cross sectional study?

Answer 29

Measure disease and exposure at the same point in time
used to measure prevalence
Cheap and easy to conduct
useful to asses healthcare needs of population

Question 30

What are the limitations of cross sectional study?

Answer 30

Cannot determine causality
Cannot determine incidence
Cannot determine temporal (time) relationship
Cannot study rare outcome