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POPH192 > Lecture 17-18!! > Flashcards

Lecture 17-18!! Flashcards

1
Q

Epidemiology definition decreiptive part and analytic part

A
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2
Q

Descriptive epidemiology features

A

• ‘Person, place and time’
• Observational
• What • Who • Where • When

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3
Q

The public health model

A
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4
Q

Analytic epidemiology features

A

• Associations: exposures and outcomes
• Causation
• Observational or intervention studies
• Why

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5
Q

Examples of descriptive epidemiology

A

Cross-sectional and ecological studies

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6
Q

Example of analytic epidemiology

A

Cohort studies
Case-control studies
Randomised-controlled trials

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7
Q

What is a cross-sectional study?

A

Measures exposures and/or outcomes at one point in time

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8
Q

What do we mean by a ‘point in time?’ - CSS

A

A particular date
( 18 August 2023)

A specific event
(visit to doctor, retirement)

A specific period of time
(in the past 12 months)

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9
Q

S ome examples of cross-sectional studies

A

New Zealand Health Survey
Census of Populations and Dwellings
Youth 2000 National Youth Health and Wellbeing Survey Series

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10
Q

What do cross-sectional studies measure?

A

Prevalence: the proportion of a defined population who have a disease at a point in time

Prevalence =

number of people with disease at a given point in time
______________________________________________________________________
total number of people in the population at that point in time

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11
Q

P revalence is affected by

A

incidence AND duration

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12
Q

What will decrease prevelance

A
  • death or recovery
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13
Q

Cross-sectional studies can be used to____

A
  • Describe prevelance (What is the prevalence of osteoarthritis in NZ? )
  • Compare prevalence (What is the prevalence of osteoarthritis in NZ for people of different ages? | Has the prevalence of smoking changed over time among high school students? )
  • To generate hypotheses (Which factors are associated with low back pain among nurses?)
    -To plan ( Population of Nelson-Tasman- Marlborough)
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14
Q

Cross - sectional studies: what they measure, what they are used for

A
  • Measure exposures and/or outcomes at one point in time
  • Measure prevalence (affected by incidence and duration)
  • Used to:
    describe prevalence
    compare prevalence
    generate hypotheses
    plan (e.g. health service delivery)
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15
Q
A
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16
Q

Cross sectional needs to be around

A

EXACTLY AT THE POINT OF ASSESMEMT
- at the SEPCFIC point in time!!!!!!

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17
Q

Limitations of cross-sectional studies

A

Temporal sequencing - (Exposure and outcome were assessed at the same time - which came first the chicken or the egg)

Measures prevalence not incidence

Not good for studying rare outcomes or exposures

Not good for assessing variable and transient exposures or outcomes

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18
Q

Limitations of cross-sectional studies - Not good for assessing variable and transient exposures or outcomes - examples of transient / variable and why their hard to measure

A
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19
Q

Pros of cross sectional studies

A

• Can assess multiple exposures and outcomes • Depends on your research question
• Prevalence, and distribution of prevalence in the population
• Stable exposures and outcomes
• Hypothesis generating
• Can be less expensive than some other study designs • Relatively quick

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20
Q

What do ecological studies do?

A

Compare exposures and outcomes across GROUPS not individuals

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21
Q

Individual level studies vs group level studies

A

Yes

22
Q

What are ecological studies used for?

A

• To compare between populations
• To assess population level factors
• To consider hypotheses

23
Q

Examples of ecological studies

A
24
Q

L imitations of ecological studies

A
  • Ecological fallacy (…derives from ascribing to individuals the characteristics of the group - can’t describe characteristics of the group towards an individual in the group)
  • cannot control for confounding
  • cannot show causation
25
Q

Advantages of ecological studies

A

• Depends on the research question
• Population level exposures
• Consideration of hypotheses

• Data is often routinely collected
• May be relatively easy to do
• May be relatively inexpensive

26
Q

Cross-sectional studies - summary

A

Assess prevalence
Temporal sequence
Not good for rare, variable or transient exposures or outcomes

27
Q

Ecological studies - summary

A

Group level not individual level
Every data point is a population (not individual people)
Ecological fallacy

28
Q

Measures of association

A
29
Q

Guts of analytic epidemiology

A
30
Q

How do we compare groups?

A

Through analytic study designs

Cross-sectional & Ecological
Cohort
Case-control
Randomised controlled trial

31
Q

Fu ndamental characteristics and logic of analytical study designs can be described using ..

A

PECOT
GATE

32
Q

PECOT and GATE describe…

A

Fu ndamental characteristics and logic of analytical study designs

33
Q

What is PECOT?

A
34
Q

The GATE frame

A
35
Q

Source vs sample population

A
36
Q

In ___ epidemiology we want to _____________ exposure ______ or _______ the _______ of the ________

A

In analytic epidemiology we want to quantify the degree to which an exposure increases or decreases the occurrence of the outcome

37
Q

How many times as likely is the exposed group to develop the outcome than the comparison group?

A

Ratio of the incidences
- relative risk

38
Q

What is the relative risk

A

Ratio of the incidences

Incidence of the exposed
__________________________
Incidence of the comparison

39
Q

What is the null value - relative risk

A

Exposed and comparison have the same incidence of outcome
- equal occurrence of outcome in both groups
- Exposure doesn’t change occurrence of outcome, so no association between exposure and outcome

40
Q

When the ratios are different for incidence in relative risk - risk factor vs protective factor

A
  • Greater incidence of outcome in exposed group
  • Greater occurrence of outcome in exposed group
  • If outcome is bad, exposure is potentially a risk factor for the outcome
  • Greater incidence of outcome in comparison group
  • Greater occurrence of outcome in comparison group
  • If outcome is bad, exposure is potentially a protective factor for the outcome
41
Q
A

The (Exposed Group) were (Value) as likely to develop (Outcome) compared to (Comparison Group)

(Same interpretation if using incidence proportion or incidence rate)

42
Q

4 factors needed to interoperable relative risk

A
  • exposed group
  • value
  • outcome
  • comparison group
43
Q

How to calculate risk difference or attributable risk

A

Incidence of exposed - incidence of control

(Differences in the incidences)

(How many extra/fewer cases of the outcome in the exposed group are attributable to the exposure)

44
Q

Risk difference (RD/AR)

A
45
Q

Interpreting the risk difference

A

There were (value) extra/ fewer (outcome) in (exposed group) compared to (comparison group)

(Report differently for incidence proportion and incidence rate)

46
Q

Difference in interpreting the risk difference for proportion vs rate

A
47
Q

Relative risk vs risk difference

A

Relative Risk
- Clues to aetiology (causes)
- Strength of association

Risk Difference
- Impact of exposure
- Impact of removing exposure

48
Q

Relative risk vs risk difference

A

Relative Risk
- Clues to aetiology (causes)
- Strength of association

Risk Difference
- Impact of exposure
- Impact of removing exposure

49
Q

PECOT/GATE
- what does it do?

A

Makes explicit the logic of comparing
Describes key components of a study
Can use GATE to calculate measures of occurrence and association

50
Q

Measures of association - difference between what RR and RD measure

A

POPH192 (28 decks)

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