Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3F Epidemiology FINAL > Landmark Epidemiological Studies > Flashcards

Landmark Epidemiological Studies Flashcards

1
Q

Framingham HEart Study

A

Originated to address non-infectious problems

-1940s-1950s cardiovascular disease became more prevalent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of study is Framingham Heart study

A

Prospective cohort study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The study population in Framingham heart study

A

5200 persons between 30-52 WITHOUT cardiovascular disease were examined and potential risk factors recorded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Later on in the Framingham Heart study

A
  • children and spouses were also given similar evaluation

- later on, an OMNI COHORT, reflected more diverse population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The Framingham heart study has produced _______ in leading medical journals

A

1200 articles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Generates in Framingham

A

3rd generation-grandchildren of original cohort

2nd group of Omni participants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Much of what we know about _____ come from Framingham

A

Risk factors for CVD

  • HTN, cholesterol, HDL/LDL, trigs, smoking, DM, physical inactivity
  • age, gender, psychosocial factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Framingham Heart study: relative risk for CHD for individual risk factors

A

Smoking had a greater relative risk for CHD

All between 1 and 2x relative risk

Measure of incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Framingham HEart Study: multiple risk factors

A

The more risk factors you have, the greater the odds of CHD

If you have all of the risk factors, you have a 14x odds ratio of having CHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HDL and LDL: Framingham

A

The lowest risk

  • least LDL and the highest HDL
  • RR is less than 1, its protective

Highest risk

  • lowest HDL and highest LDL
  • RR is 3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Framingham: DM and CHD

A

Among men and women, the number of deaths from CHD among diabetics was much higher

  • men: 2x deaths in DM
  • women: 4x as many deaths in DM

DM is a risk factor death and directly related to CHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Framingham Eye Study

A

2600 of the 4000 still living members 52-85 were given eye exam and looked at PREVALENCE of eye diseases in this population
-gave us some info on the conditions on this cohort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Framingham and dementia

A
  • although PREVALENCE is increasing due to longer living, INCIDENCE was found to have decreased. This is consistent with other recent studies
  • looked at 4 EPOCHS
  • incidence increasingly DECLINED in each epoch compared to baseline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Framingham and dementia: caveat

A
  • decrease in incidence of dementia was only seen in individuals with at least a high school diploma
  • the reduction in cardiovascular risk factors (except diabetes and obesity) may explain some, not all of the results
  • stable or decreased incidence of dementia has been noted in OTHER PARTS OF THE WORLD. Reason-improvements in living conditions, health care, eduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

BEaver Dam health outcomes study

A
  • PROSPECTIVE COHORT STUDY of health status and health related quality of life in adults
  • random sample of adults, inital age range 45-89; mean 64
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BEaver dam eye study

A
  • examined PREVALENCE AND INCIDENCE of AMD, cataract, DR, glaucoma and other eye diseases
  • 5000 people had baseline exams in early 90s
  • 5,10,15,20, and now 25 year follow up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Publications from beaver dam eye study

18
Q

Modifiable risk factors and Disease: beaver dam eye study

A

Doing link between modifiable risk factors and disease

  • cigarette smoking and both cataracts and AMD
  • lutein intake and lower risk of cataract

Systems developed to photograph cataracts and AMD, including a standardized scale

19
Q

Beaver dam and drusen

A

-connection between retinal drusen and RPE loss with progression to late stage AMD

Currently studying incidence of AMD in relation to

  • modifiable risk factors
  • glycooxidative stress
  • inflammation
  • atherosclerosis
20
Q

Nurses health study

A
  • ongoing PROSPECTIVE COHORT STUDY began in 70s-cardiovascular disease, cancer, DM, women’s health, lifestyle
  • RNs were selected to be followed prospectively
  • inital phase-122,000 nurses
  • every two years, follow up exam AND QUESTIONNAIRE FOR HEALTH RELATED TOPICS including smoking, hormone use, menopausal status, diet
21
Q

Women and physical activity: nurse study

A

The more physical activity women have, the less RR for DR

As physical activity increases, RR decreases
Physical activity is protective against DM, RR is below 0

22
Q

Baltimore eye survey

A
  • CROSS SECTIONAL study conducted from 1985-1988, residents of east Baltimore
  • 40+ age
  • 2400 BLACK, 2900 WHITE
  • all received glaucoma testing: tonometry, VF, stereo disc photography
  • first large-scale study to employ MODERN DIAGNOSTIC TECHNIQUES for glaucoma
23
Q

Firs large scale study to employing modern diagnostic techniques for glaucoma

A

Baltimore eye survey

24
Q

Baltimore eye study findings

A
  • risk factors for glaucoma looked at-race, age, IOP, HTN, DM (not a risk factor), family Hx
  • prevalence rates for POAG were 4-5X HIGHER IN BLACKS as compared with whites

Over the age of 80, blacks had 11% increase in POAG. It increases in whites but not nearly as much as in whites

Blacks had 2x prevalence of BLINDNESS AND VISUAL IMPAIRMENT than whites

25
Baltimore eye surgery and sex
No differences in sex
26
Blue mountains eye study
- CROSS SECTIONAL/COHORT STUDY of causes of age related vision loss conducted in 2 urban areas of Blue mountains region, near SYdney, Australia. - WENT DOOR TO DOOR and gave eye exams - 49-97 - 3600 participants
27
Blue mountains study and AMD/drusen
- smaller the drusen, the less severe it is (no Association with AMD) <63um - RR 3 for those with drusen >63um (3x risk) - >125um Soft drusen: none=no risk Distinct soft RR 4.6 Indistinct or reticular is more risky Location: <63um to 250um, higher risk of AMD Closer to the fovea center=risk much higher (over 11%). As you get right close to the fovea, it actually drops a little some reason Hyperpigmentation: no=no risk, no association, If present=RR 8x the risk
28
LA Latino Eye Study (LALES)
- POPULATION BASED ON CRESS SECTIONAL/COHORT STUDY - lived in and around LA county - average age 55 - 80% MEXICAN origina - baseline exam phase 200-2003, follow ups 2004-2008
29
LALES outcomes
- primary: PREVALENCE of visual impairment, blindness, cataract, glaucoma, DR, AMD - secondary: RISK FACTORS assocaited with eye disease, health related quality of life and vision related quality of life
30
Prevalence of types of DR among diabetics in LALES
As the patient has had diabetes longer, the prevelance of any type of DR climbs -DM over 15 years, DR prevalence is almost 80% in Latinos The long you have DM, the more likely you are to have DR
31
Mild NPDR and length of time with DM
Peaks at 5-9 years with DM, and then declines with duration of DM for some reason
32
Orinda study: school screening
- kids | - 1950s
33
Goal of the Orinda study
- the design the least expensive, least technical and most effective SCREENING PROGRAM for finding essentially all elementary school children with vision problems - study WORKED BACKWARDS-did a comprehensive eye exam to identify chidlren who needed professional attention, then evaluated 6 SCREENING PROTOCOLS that would best pick them up
34
Most effective technique of the Orinda study
- MODIFIED CLINICAL TECHNIQUE (MCT) - distance and near VA - distance and near CT - ret with lens rack - direct ophthalmoscope
35
Referral for VA: Orinda
20/40 or worse
36
Ret cut off for referral: orinda
+1.50 or more -0.50 or more myopia +/-1.00 DC ore mor eastigmatism +/-1.00 anisometropia
37
Distance CT referral: CT
Any tropia 5 EP 5XP 2 hyper
38
Near CT referral orinda
Any tropia 6 EP 10 XP 2 hyper
39
MCT results: orinda
96% sensitivity | 98% specificity
40
Other important findings of Orinda
- incidence of vision problems increases at rate of 1.6%/year - ages 5-7, 18% had vision problems - ages 13-15, 31% had vision problems
41
Importance of Orinda study
- performed by INTERDISCIPLINARY TEAM; ODs, OMD, stats, school psychologists, parents, teachers - those who had previous eye care more likely to be easily managed at follow up, even if they still failed the screening - MCT most economical screening programs INCLUDING COST OF NEEDING OD, WHEN TAKING INTO ACCOUNT COSTS TO THE COMMUNITY FOR OVER REFERRALS
42
Criticisms of the orinda study
- generalizability - MCT reliance on professionals - not diverse - limited evaluation of visual skills related to school performance - other studies have replaced it. Vision in preschoolers (VIP) study. Designed to identify high refractive error, strab in younger kids

3F Epidemiology FINAL (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions