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2021 Epi Comps > History & Ethics > Flashcards

History & Ethics Flashcards

1
Q

Came out of trials of German officials in WWII; set foundation for regulation of human subjects research in US

A

Nuremberg Code (1947)

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2
Q

Voluntary participation, potential societal benefit, justified based on prior knowledge, don’t experiment when risks include disabling injury/death, hire trained & qualified staff, benefits outweigh risks, avoid undue harm/risk, implement systems to prevent risk/harm, participants can withdraw, stop experiments if continuation deemed dangerous

A

Tenants of Nuremberg Code

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3
Q

Conducted by US Public Health service; observed natural progression of untreated syphilis in 622 AA men in AL but marketed as free healthcare; lasted 40-years –> infected men not informed, funding lost for treatment but still continued, penicillin established in 1947 but not provided to participants

A

Tuskegee Syphilis Study (1932-1972)

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4
Q

Created in response to Tuskegee Study; created National Commission of Protection of Human Subjects of Biomedical & Behavioral Research –> formalized establishment & role of IRB

A

National Research Act (1974)

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5
Q

Created by National Commission for Protection of Human Subjects of Biomedical & Behavioral Research in response to Tuskegee Study (drafted at Belmont Conference 10 miles south of Baltimore); distinguished between medical treatment & research; 3 core principles = respect for persons (informed consent), beneficence (risk/benefit assessment), justice (selection of participants); crucial report underlying role of IRBs today

A

Belmont Report (1978)

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6
Q

Agreement/permission accompanied by full notice about care, treatment, or service that is subject of consent; patient apprised of nature, risks, & alternatives of medical procedure/treatment; patient either consents to or refuses treatment after receiving information

A

Informed Consent

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7
Q

Statement of study as research, explanation of purpose/duration/procedures, description of risks & benefits, disclosure of alternatives, statement on extent of confidentiality, discussion of compensation & safeguards/treatments for risks, contact information of study team, statement that participation is voluntary & can withdrawal at anytime; beneficence, justice, & respect for persons

A

Core Elements of Informed Consent

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8
Q

Non-exploitative research, protection of vulnerable populations, fair distribution of costs & benefits to research participants & benefitting population

A

Justice

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9
Q

Developed by World Medical Association following WWII; some overlap with Nuremberg Code but specifically for clinical research; additional tenets include duty to participant over society, ethics more important than laws, work must benefit population being studied, declare COIs, etc.

A

Declaration of Helsinki (1964, latest revision in 2013)

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10
Q

Built off Declaration of Helsinki; regulations & standards for IRBs –> assuring compliance by research institution, documentation of informed consent, criteria for establishment/operation/documentation of IRB, protection of vulnerable populations

A

Common Rule (1981, revised in 1991 & 2018)

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11
Q

Role to review & approve human subjects research (scientifically & ethically); composed of scientists, non-scientists, community members, & a non-affiliated party; review types include exempt, expedited, or full board

A

IRB

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12
Q

Enacted by Congress; 5 parts (4 regulating aspects of insurance & 1 focusing on protecting health information) –> restrictions on use of medical charts in research & increased focus on how privacy would be protected in studies

A

Health Insurance Portability & Accountability Act (1996)

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13
Q

Cervical cancer patient at JHU; cells used to establish immortal cell lines without her knowledge or consent; broadly disseminated to researchers & foundation of numerous ground-breaking projects

A

Henrietta Lacks

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14
Q

24-y/o healthy volunteer at JHU who inhaled experimental drug in asthma study & died of lung failure; study IRB approved but drug not FDA-approved; ICF only noted drop in BP as risk, didn’t note compound not FDA-approved, prior symptoms from other patients not reported to IRB; lead to suspension of Hopkins Medicine IRB

A

Ellen Roche (2001)

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15
Q

Developed early human & statistical census methods (life tables) that provided framework for modern demography; one of first experts in epidemiology

A

John Graunt (1662)

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16
Q

First clinical trial (treatise) for scurvy

A

James Lind (1754)

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17
Q

Established concept of competing risks (lives saved by eliminating small pox)

A

Daniel Bernoulli (1760)

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18
Q

Developed cowpox vaccine –> smallpox vaccine

A

Edward Jenner (1796)

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19
Q

Introduced SMR in annual report of Registrar General of GB to compare mortality & life expectancy across occupational groups (record cause of death in different groups)

A

William Farr (1840)

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20
Q

Identified source of cholera outbreak (contaminated water from Broad Street pump)

A

John Snow (1854)

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21
Q

Realized women were dying in childbirth because of contamination (doctors not washing hands between pathology & delivery)

A

Ignac Semmelweis (1860)

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22
Q

Involved in typhoid fever (ID are contagious); worked with John Snow cholera data & to protect London water supplies; nature, MOT, prevention

A

William Budd (1873)

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23
Q

Koch postulates, germ theory (anthrax causes disease), TB –> contributed to germ theory & causal relationships

A

Robert Koch (1870s)

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24
Q

Anthrax vaccines, rabies vaccines, germ theory of disease, pasteurization

A

Louis Pasteur (1885)

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25
Q

First connection of smoking with lung cancer (1950 case-control study); Bradford Hill criteria

A

Sir Austin Bradford Hill

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26
Q

1918

A

Foundation of Bloomberg School of Public Health

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27
Q

1919

A

Foundation of JHU Department of Epidemiology

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28
Q

Dean of Bloomberg 1916-1926; founder of JH School of Hygiene & Public Health (1918); bacteriologist & pathologist; discovered bacteria that causes gas gangrene (clostidium welchii); founding editor in chief of AJE

A

William H. Welch

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29
Q

Dean of Bloomberg 1926-1931; physiologist; pioneered use of heparin; worked closely with Welch to establish curriculum

A

William H. Howell

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30
Q

Dean of Bloomberg 1931-1934 & chair of epi 1919-1938; first resident lecturer at school of public health & first professor of epidemiology; studied poliomyelitis, influenza, diphtheria, & TB; “father of modern epi” (index case, life table methods, age cohorts, epi curve, SIR models); established Eastern Health District Research Area in Baltimore

A

Wade H. Frost

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31
Q

Dean of Bloomberg 1934-1937; expanded school’s MPH program

A

Allen W. Freeman

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32
Q

Dean of Bloomberg 1937-1946; professor of biostatistics (came up with “biostatistics”)

A

Lowell J. Reed

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33
Q

Dean of Bloomberg 1946-1967; focused on environmental medicine & chronic disease; founded Department of International Health (1961); promoted health aid in foreign policy

A

Ernest L. Stebbins

34
Q

Dean of Bloomberg 1967-1977; expanded health services research & integrated social/behavioral sciences; expanded student body; trained first EIS (1951)

A

John C. Hume

35
Q

Dean of Bloomberg 1977-1990; lead WHO efforts on smallpox eradication; first director of Office of Public Health Emergency Preparedness

A

Donald A. Henderson

36
Q

Dean of Bloomberg 1990-2005; known for work on vitamin A deficiency

A

Alfred Sommer

37
Q

Dean of Bloomberg 2005-2017; focused on cardiovascular & kidney disease

A

Michael J. Klag

38
Q

Dean of Bloomberg 2017-present; expert on trauma care systems

A

Ellen J. MacKenzie

39
Q

Chair of epi 1938-1954; first formally trained in epi; virologist; recommendation adding fluoride to drinking water; first polio lab

A

Kenneth Maxcy

40
Q

Chair of epi 1954-1970; established CDC’s Epidemic Intelligence Service & trained first class (1951); first president of MD Public Health Association; worked on incubation periods of different IDs, vaccination effectiveness against polio & influenza, harms of occupational radiation

A

Philip Sartwell

41
Q

Chair of epi 1970-1975; expanding epi to include chronic disease; father of “contemporary chronic disease epi”; worked on link between smoking & lung cancer; trained first EIS (1951)

A

Abraham Lilienfeld

42
Q

Chair of epi 1975-1993; epidemiology textbook; helped establish vision for Welch Center

A

Leon Gordis

43
Q

Interim chair of epi 1993-1994; focus on international health (disasters & wars)

A

Haroutune Armenian

44
Q

Chair of epi 1994-2008; focus on health risks of environmental pollutants; current chair of Clean Air Scientific Advisory Committee (EPA) & Tobacco Products Scientific Advisory Committee (FDA)

A

Jonathan Samet

45
Q

Chair of epi 2008-present; Inaugural Charles Armstrong Chair (2009); initial work on cancer & alcohol; started working on HIV/AIDS & STIs (1980s) in ALIVE & MACS; international collaborations with Thailand

A

David Celentano

46
Q

Professor in 1960s; micronutrient deficiency, TB, & CVD (ran first trials for BCG vaccine –> early use of cluster randomized design); known for engagement in community-based research & early cohort studies; Comstock Center

A

George Comstock

47
Q

Put vitamins forefront in nutrition

A

Elmer V. McCollum

48
Q

Professor; MACS & ALIVE studies; advocate for patients with HIV/AIDS; reinvigorated ID research

A

B. Frank Polk

49
Q

Faculty; contributed to elimination of polio in US; father of “shoe leather epi”; established EIS (1940s)

A

Alexander Langmuir

50
Q

Worked on lead poisoning in children & pioneered lead poisoning prevention guidelines

A

Emanuel Kaplan

51
Q

Mean age at death as summary measure to compare health conditions of sanitary districts in London

A

Sir Edwin Chadwick

52
Q

Chair of biostatistics; use of OR exposure to approximate OR disease in case-control studies (invariance of OR)

A

Jerome Cornfield

53
Q

Basis for Cox PH model to evaluate time-to-event analyses with censoring

A

Sir David R. Cox

54
Q

Regression fallacy

A

Milton Friedman

55
Q

Nonparametric estimation from incomplete observations –> intended to deal with problem of right censoring; take intervals as short & numerous as possible so each event occupies own interval

A

Paul Meier

56
Q

Mortality increases with age so areas with older populations will have higher mean age at death; direct & indirect standardization; use of standard populations

A

Francis G.P. Neison

57
Q

“When you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind”

A

William Thomson, 1st Baron Kelvin

58
Q

Regression to the mean (children’s height vs. height of parents); need to distinguish real change from expected change due to natural variation

A

Sir Francis Galton

59
Q

Baltimore City Health Commissioner 2019-present

A

Letitia Dzirasa

60
Q

Director of CDC

A

Rochelle Walensky

61
Q

Director of FDA

A

Janet Woodcock

62
Q

Director of WHO

A

Tadros Adhanom

63
Q

Director of NIH Allergy & Infectious Disease; chief medical advisor to president

A

Anthony Fauci

64
Q

Director of NIH

A

Francis Collins

65
Q

First female faculty (1932); beginning of racial disparity work

A

Miriam Brailey

66
Q

Established genetic epi program in 1979

A

Bernice Cohen

67
Q

Establishment of Framingham Cohort Study

A

1947

68
Q

Doll & Hill, smoking & lung cancer study

A

1950

69
Q

Cornfield, case-control study; Framingham/CVD

A

1951

70
Q

Pasteur, vaccines (rabies, anthrax)

A

1885

71
Q

Fleming, penicillin vaccine

A

1928

72
Q

Watson & Crick, DNA

A

1953

73
Q

Smallpox eradication

A

1980

74
Q

Salk, polio vaccine (inactivated)

A

1955

75
Q

Sabin, oral polio vaccine

A

1961

76
Q

Sanitary statistics, miasma vs. ID era, germ theory

A

19th Century Epi

77
Q

ID era, germ theory vs. chronic disease, black box/risk factors

A

20th Century Epi

78
Q

Statistician that demonstrated that mammography screening for breast cancer saves lives

A

Sam Shapiro

79
Q

Demonstrated HPV precedes cervical cancer in 95% cases

A

Keerti V. Shah

80
Q

Diagnosed first case of AIDS in India

A

Suniti Solomon

81
Q

Epi IDEAS diversity recognition award; first group from JHU to win award

A

2019

82
Q

Bloomberg Distinguished Professor of Epidemiology & Oncology; represents Department at school level to IDARE Efforts, chaired by Joel Bolling

A

Otis Brawley

2021 Epi Comps (5 decks)

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