H&S, CM, MDM Flashcards
Definition and importance of global health
Global health is an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide
Global health emphasizes transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of population based prevention with individual-level clinical care
Global burden of disease, population health, and how it is measured
Cardiovascular disease is largest cause of death in the world
Methods of measurement- death rate (must consider age of death and life expectancy), disability adjusted life years, infant mortality, underweight infancy
Describe principle causes of morbidity and mortality and how health risks vary by gender and income across global regions
Causes- respiratory infection, ischemic heart disease, stroke, HIV, diarheal diseases (noncommunicable disease
Gender- males experience more death across all world region; exception: women are affected more by communicable disease (HIV) in Africa
Wealthy- lowest years living lost, and years living with disability
Compare the changing global epidemiology of communicable and non-communicable disease
Western, higher income countires have more non-communicable than communicable diseases
Discuss the obstacles to global disease prevention and care.
critical shortages and maldistribution of health care workers, 1:10,000 doctor to patient ratio in sub-saharan Africa
Identify and describe the roles of major players in global health: WHO, USG Global Health Initiative (PEPFAR, PMI, GAVI), Global Fund, Gates Foundation, and local ministries of health.
International agencies (fund/direction)- WHO, UNICEF, Global Fund
Government agencies- USG, USAID
NGO’s- Gates foundation
Discuss ethics and moral responsibility of care and research in global health
Western ethics focuses on an individual patient to clinician relationship
But the 4 principles (justice, autonomy, nonmalefiscence beneficence) can extended and adapted to a variety of cultures
To describe the relationship between the randomized clinical trial design and assessing effects of treatment.
To state and apply the issues of sampling in an RCT, including methods of randomization, intention to treat analysis, blinding, etc.
To compare and contrast efficacy and effectiveness.
To summarize ethical issues in evaluating treatment.
Randomization balances unknown and unmeasured confounding variables
Outcome is valid when chance and bias are taken into account and deemed not to have a major impact on the result
To state and apply the issues of sampling in an RCT, including methods of randomization, intention to treat analysis, blinding, etc.
Randomization minimizes chance
Intention to treat analysis- all patients should be analyzed in the group to which they were assigned
Blinding- patients and assessors should not know what treatment patient was given
To compare and contrast efficacy and effectiveness
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To summarize ethical issues in evaluating treatment
re-exposure to disease of interest, placebo
To describe and understand the junctures where bias can occur in each study type.
Biases affecting external validity
1) Publication Bias (positive over negative)
2) Spectrum Bias (heterogeneity of study subgroups or inadequacy of number of subgroups)
Biases affecting internal validity also called systematic error: difference between what study is measuring and what it was designed to measure
1) Selection Bias- must be inferred, and can’t adjust for in data analysis, could be caused by lack of follow-up
2) Missclassification Bias
3) Confounding Bias
Ethical issues in bias
reporting results/giving opinions/disclosure- how doctors view one remedy may influence self-reporting
Association of funding with a pro-industry result
