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Epi > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

What measures do we use to track a population’s health?

A

Risk factors: Prevalence
Morbidity: disease incidence, disease prevalence, medical care usage
Mortality: total and cause-specific

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2
Q

What are the sources of morbidity data?

A 
Health data systems
disease registries 
surveillance systems 
medication/device sales
surveys 
research studies
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3
Q

Proportion

A

Division of two numbers where the numerator is a subset of denominator

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4
Q

Rate

A

A proportion where time is always in deominator

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5
Q

How do you measure burden of disease?

A

Proportions - Number affected / total population

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6
Q

How do you measure risk of disease?

A

Rates - events / population-time

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7
Q

Incidence

A

number of new disease events

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8
Q

Incidence rate

A

rate at which new diseases are occurring

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9
Q

Cumulative incidence

A

cumulative risk for developing new disease among persons over some period of time

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10
Q

Incidence rate per 1000

A

Number of new cases of a disease occurring in the population during a specified interval of time / number of persons at risk of developing the disease during that interval of time X 1000

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11
Q

Person-years

A

(# of subjects) x (years of follow-up per subject)

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12
Q

Prevalence per 1000

A

Number of cases of disease present in the population at a specified time / Number of persons in the population at that specified time X 1000

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13
Q

What are the types of prevalence?

A

Point prevalence

Period prevalence

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14
Q

Cumulative incidence (proportion)

A

Number of new cases of a disease occurring in a population during a specified period of time / Number of person at risk for the disease during that period of time

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15
Q

What are estimates of risk?

A

Incidence rate and Cumulative incidence

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16
Q

When is cumulative incidence used commonly?

A

Period of time = lifetime

17
Q

Prevalence = Incidence x Duration

A

Higher incidence results in higher prevalence

Longer duration results in higher prevalence

18
Q

What decreases prevalence?

A

Deaths

Cures

19
Q

Incidence and prevalence for pancreatic cancer

A

Incidence low
Duration short
Prevalence low

20
Q

Incidence and prevalence for common cold

A

Incidence high
Duration short
Prevalence low

21
Q

Incidence and prevalence for chronic lung disease

A

Incidence low
Duration long
Prevalence high

22
Q

Incidence and prevalence for hypertension

A

Incidence high
Duration long
Prevalence high

23
Q

Factors that increase observed prevalence

A

Increase in new cases
Longer duration of the disease
Prolongation of life of patient withoutcure
Improved diagnostic facilities (better reporting)
In-migration of cases
Out-migration of healthy people

24
Q

Factors that decrease observed prevalence

A 
Decrease in new cases
Shorter duration of disease
High case-fatality from disease
Improved proportion cases cured
In-migration of healthy people
Out-migration of cases
25
Q

What are the problems with numerators and denominators

A

Strict criteria to define both
Numerator must come from denominator
All in the denominator must be able to go into the numerator

26
Q

What are the variability in defining disease?

A 
Level of illness (sick, disabled, etc)
Specific illness (diagnosis)
27
Q

What are the variability in methods of ascertainment?

A

Using regularly available data (disease reporting, review of medical records)
Using specially planned data collection (interviews, direct examinations)

28
Q

What are the issues related to identifying cases?

A

Variability in defining disease

Variability in methods of ascertainment

29
Q

How could we measure the prevalence of childhood asthma?

A

questionnaire, physiological measures, medical records

30
Q

“Do you currently have asthma?”

A

Example of point prevalence

31
Q

“Have you had asthma during the n years?”

A

Example of period prevalence

32
Q

“Have you ever had asthma?”

A

Example of cumulative or life-time incidence

33
Q

Limitations of Surveys: Characterizing disease by asking questions

A
  • widely used to describe population health
  • depend on access to care
  • depend on recall
  • subject to bias (limited recall, lack of knowledge, interviewer/informant)
34
Q

Errors in classifying numerators

A
  • bias and variation in self-reporting
  • variation in disease classification
  • errors in administrative data bases/medical records (coding for billing purposes, temporal changes, incomplete information, legibility)
35
Q

Problems with denominator

A
  • characterizing the population

- defining the population at risk

36
Q

Major uses of cumulative incidence

A

Research on causes, prevention, and treatment of disease

37
Q

Major uses of incidence rate

A

Research on causes, prevention, and treatment of disease

38
Q

Major uses of prevalence

A

Resource planning

Epi (2 decks)

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