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Introduction to Epidemiology > Lecture 2 & 3 Intro to Epidemiology > Flashcards

Lecture 2 & 3 Intro to Epidemiology Flashcards

1
Q

Epidemiology

A

Public health discipline basic science which studies
-Distribution
-Determinants
in specified populations

Figuring out what causes disease and who gets it

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2
Q

Distribution of Disease

A

Frequencies and Patterns of disease

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3
Q

Disease Frequency

A

Part of Distribution of Disease
Not only counts but also counts in relation to size of population
-Comparisons between populations possible

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4
Q

Disease Patterns

A 
Part of distribution of disease
Encompasses:
-Person
-Place
-Time
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5
Q

Descriptive Epidemiology

A

Who
When
Where
The 3 W’s

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6
Q

Determinants of Disease

A

AKA Risk Factors or Associations

Can be positive (associated with reduction, prevention) or negative (increase, promotion)

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7
Q

Ex negative risk factor

A

smoking and lung cancer

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8
Q

Ex positive risk factor

A

breast cancer and breastfeeding

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9
Q

Analytic Epidemiology

A

Why and How

Determinants of Disease

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10
Q

Objectives of Epidemiology

A

Study natural course of disease
Determine the extent of disease
Identify patterns and trends in disease
Identify the causes of disease
Evaluate the effectiveness of measures that protect and treat disease
Assist in developing public health policy

IN POPULATIONS

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11
Q

Father of Epidemiology

A

John Snow

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12
Q

John Snow

A

Father of Epidemiology
Observed people dying in community, wanted to know why, finally figured out it was water supply, took pump off and disease decreased.

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13
Q

Last pandemic

A

2009 H1N1 (Influenza A)

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14
Q

Last pandemic before H1H1

A

1918

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15
Q

What does basic science study?

A

Cells, tissues, animals

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16
Q

What does clinical study?

A

Sick patients

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17
Q

What does public health study?

A

Populations or communities

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18
Q

Basic science research goals

A

Understanding disease mechanism and effects of substances

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19
Q

Clinical research goals

A

Improving diagnosis and treatment of disease

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20
Q

Public health research goals

A

Prevention of disease and promotion of health in the population

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21
Q

Basic science examples

A

Pharmacology, Microbiology, Biochemistry

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22
Q

Clinical science examples

A

Internal Medicine, Health Policy & Management

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23
Q

Dr source of data

A

History and physical exams

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24
Q

Epidemiologist source of data

A

Surveillance and descriptive epidemiology

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25
Q

Dr assessment

A

Differential diagnosis

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26
Q

Epi assessment

A

Inference

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27
Q

Dr Hypothesis testing

A

Diagnostic studies

28
Q

Epi Hypothesis testing

A

Analytical Epidemiology

29
Q

Dr Action

A

Treatment

30
Q

Epi Action

A

Community Intervention

31
Q

Epidemiological Assumptions

A
  • Disease occurrence is NOT random
  • Systematic investigation of different populations can identify associations, causal and preventive factors
  • Making comparisons is the cornerstone of systematic epi investigations.
32
Q

What is the cornerstone of systematic epidemiological investigations?

A

Making comparisions

33
Q

6 core functions of epidemiology

A
  1. Public Health surveillance
  2. Field investigation
  3. Analytic studies
  4. Evaluation
  5. Linkages
  6. Policy development
34
Q

Public health surveillance

A

Core Function of epi
count, track and record
To portray the ongoing patterns of desease occurrence so that investigation, control and prevention measures can be applied

35
Q

Field investigation

A

Core Function of epi
ask questions and look for what they have in common
To determine source or vehicle of disease or to simply learn more about the natural history, clinical spectrum, descriptive epidemiology and risk factors of a disease

36
Q

Analytic studies

A

Core function of epi
start setting up comparison groups, do assumptions hold true?
To advance the information (hypotheses) generated by descriptive epidemiology techniques
**Hallmark is use of comparison group

37
Q

Evaluation

A

Core Function of epi
Figure out what you are looking at data wise
Evaluate findings
To determine, as systematically and objectively as possible, the relevance, effectiveness, efficiency and impact of activities with respect to established goals

38
Q

Linkages

A

Core Function of epi

Talking. When you figure out what cause is, do something!

39
Q

Policy Development

A 
Core Function of epi
If public health related event that needs policy to change, start it!
To collaborate (link) with other professionals
40
Q

Examples of policy development by epi

A

Helmet laws, smoking bans

41
Q

Public health surveillance examples

A

Reportable diseases registry (pertussis, meningitis)

42
Q

Field investigation examples

A

Ground beef as source of o157:H7
Eggs as source of salmonella
*initial investigation of “SARS” before it was named and known

43
Q

Hallmark of an analytic study is

A

the use of a comparison group

44
Q

Key skills for Analytic studies

A

Design, conduct, analysis, interpretation and communication of research study processes and data

45
Q

Linkage examples

A 
Laboratory specialists
Sanitarians
Physicians
Federal, state and regional governments
Communities
46
Q

Definition of Epidemiology ends with…

A

“…and the application of this study to the control of health problems.”

Core function of epi, policy development

47
Q

The Epidemiological Approach

A

describing groups and events by:

  • Counting
  • Dividing
  • Comparing
48
Q

Counting

A

Counting cases/health events and describing them in terms of person, place and time
-Case and study population definitions a key function

49
Q

Dividing

A

Dividing the # of cases by an appropriate denominator to calculate rates, ratios and proportions

50
Q

Comparing

A

Comparing rates over time for different groups of people

51
Q

2 Categories of Studies

A
  1. Observational (descriptive, analytical)

2. Experimental (interventional aka clinical)

52
Q

Observational Studies

A

Descriptive

Analytical

53
Q

Experimental Studies

A

Interventional aka Clinical

54
Q

Types of Analytical Studies

A

Case-Control
Cohort
Experimental - Pre Clinical - Phase 1 - 2 - 3 - 4

55
Q

Population

A

All individuals making up a common group; from which a sample (smaller set) can be obtained, if desired.
**Don’t confuse with ‘study population’, which is the final group of individuals selected for study

56
Q

Sample

A

A subset or portion of the full, complete population (representatives)
-useful when studying the complete population is not feasible

57
Q

Ways to acquire a sample

A

Random number generator (computer)
Pre-defined sample (every 3rd patient, everyone admitted on weekends)
Convenience sample

58
Q

Inferential Statistics

A

Inferences (conclusions) made about random data relative to a sample

59
Q

Generalizability

A

Inferential statistics transposed from the sample to the full population

60
Q

Epidemic

A

Occurrence of disease clearly in excess of normal expectancy

  • Community/Period clearly defined
  • Goal is to capture disease as early as possible
61
Q

Endemic

A

The constant presence of a disease within a given area or population in excess of normal levels in other areas
Ex. Malaria in UK

62
Q

Outbreak

A

aka Upsurge/cluster

An epidemic limited to a localized increase in the occurrence of disease

63
Q

Pandemic

A

An epidemic occurring over a very wide area involving a large number of people
*Many times multi-region or multi-national

64
Q

Primary Prevention

A

Preventing or halting a disease before it occurs or becomes established

65
Q

Example of Primary Prevention

A

Low dose aspirin in prevention of cardiovascular disease in women

66
Q

Secondary Prevention

A

Interrupts the disease process before it becomes symptomatic or prevents it from progressing or recurring

Introduction to Epidemiology (4 decks)

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