Lecture 2 Flashcards
is the study of the distribution of disease and determinants of disease frequency in populations
(is the study of causes of disease)
epidemology
to control health problems and improve health at the population level
goal of epidemiology
“counting” the causes and determining variables of morbidity and mortality
operationally
ID factors that are “causes” and are potentially modifiable;
guiding and evaluating interventions to improve public health
operationally
clinical and research concerns:
_1_good or bad; chemical, biological, physical, psychological, educational
2=good or bad; disease, cure, improved attitude, longer life, better quality of life
1 = exposure
2=outcome
we generally know either the exposure or the outcome and we want to __ the other
measure
past achievements of epidemiology and oral health
water fluoridation and dental caries
fluoridated toothpaste and decrease in dental caries
smoking as a risk factor for oral cancer
developmental enamel defects
fluorosis, enamel hypoplasia,
the usual occurrence of a disease in a given population
endemic
a meaningful increase in the occurrence of a disease in a give population
epidemic
spread of a disease across a large region or worldwide
pandemic
exposure of interest
independent variable
outcome of interest
dependent variable
- suspicion of an E to D relationship
- hypothesis formation
- test E to D hypothesis
- rule out alternative explanations
epidemiological reasoning
epidemiology is fundamentally concerned with
populations - measuring distribution of disease in populations and the factors associated with those distributions
__ is an identifiable relation between an exposure and a disease
association
3 questions in casual inference;
1=how do we look for a cause?
2=what is the cause?
3=how do we decide if there is enough evidence to act on a cause?
1 = methodological question
2= ontological question
3= ethical question
an event, condition, or characteristic that preceded the disease and without which the disease would not have occurred at all or would have not occurred until some later time
cause
\+strength of the association \+does-response relationship \+temporal sequence \+biologic credibility \+consistency of fingings across studies
criteria for assessing causality
criteria for assessing causality: is there a strong E - D relationship
strength of the association
criteria for assessing causality: does risk increase with increased exposure
dose-response relationship
criteria for assessing causality; does the exposure precede the disease
temporal sequence
criteria for assessing causality; is there a known biological basis for the relationship
biologic credibility
criteria for assessing causality; do multiple studies report similar findings regarding the E-D relationship
consistency of findings
a factor if present increases the probability of disease occurrence
risk factor
measuring disease occurrence is fundamental in epidemiology
quantification of epidemiology
uses name
nominal scale
follows an order based on severity
ordinal scale
follows a mathematical order but has no true zero
interval scale
follows a mathematical order and has a defined true zero
ratio scale
depending on the time element we can also quantify cases as prevalent or incident by either measuring
prevalence proportion or incidence rate
of cases / # of person in population : (at a specified time)
prevalence
of new cases of disease / population at risk :(over a period of time)
incidence rate
prevalence is not a
rate, the term “prevalence rate” should not exist
incidence is a rate and not meaningful without a
unit of time
__ are concerned with the number of new cases among persons at risk for a specific follow-up period
incidence rate
issues measuring ___; how do we know someone is a case?
how do we count population at risk?
what is a specific time period
incidence and prevalence
always be as __ when articulating units of measurment
specific as possible
