Lecture 4, part 3

Question 1

At what point in the natural hx of dz would you use pt interviews/questionnaires for data?

Answer 1

Sx but not formal dx

Question 2

At what point in the natural hx of dz would you use clinical records for data?

Answer 2

Seeking care or dx

Question 3

At what point in the natural hx of dz would you use clinical records, registries, or notifiable dz records for data?

Answer 3

Diagnosed, and captured in those sources

Question 4

At what point in the natural hx of dz would you look at vital statistics for data?

Answer 4

Outcome

Question 5

What is the main purpose of notifications?

Answer 5

They aid in the timely control of specific health problems or hazardous conditions

Question 6

Elements of descriptive epidemiology

Answer 6

Discerning patterns of dz incidence by person, place and time
-Who is getting the dz?
-Where is it occurring?
-How is it changing over time?

Question 7

Aspects of descriptive epidemiology

Answer 7

Understanding the health status of a pop, burden of dz
Planning, implementation, and evaluating PH programs
Formulate hypotheses about the causes of dz

Question 8

Aspects of analytic epidemiology

Answer 8

The search for the causes and effects, or the why and how
Seek to quantify associations between exposures and outcomes and to test hypothesis about causal relationships

Question 9

Elements of using descriptive epidemiology to generate hypotheses about the causes of dz

Answer 9

Explore similarities and/or differences btwn those with the dz and those without the dz
Design studies to further study/test these hypotheses

Question 10

Definition of an outbreak

Answer 10

The localized occurrence of cases of dz in excess of what would normally be expected in a defined community, geographic area, or season
-An unusually high occurrence of dz
-May be geographically concentrated or widespread
-May last for a few days, weeks, or several years

Question 11

How can outbreaks vary?

Answer 11

In terms of scale because it’s based on the scenario

Question 12

Cluster definition

Answer 12

Aggregation of cases in a given area over a particular period without regard to whether the number of cases is more than expected

Question 13

Epidemic definition

Answer 13

Widespread occurrence of more cases of dz than expected in a given area or among a specific group of ppl

Question 14

Pandemic definition

Answer 14

Epidemic that occurs across several countries and affects a sizeable portion of the pop in each

Question 15

Outbreak identification sources

Answer 15

Review routinely collected surveillance data
-Mandatory reporting of certain “notifiable” dzs
Observation of single events or clusters by clinicians, infection control practitioners, or laboratorians
Reports by one or more pts or members of the public

Question 16

Outbreak investigation steps

Answer 16

Detect outbreak and find cases
Generate and test hypothesis about causes
Develop management/control plans

Question 17

Considerations of an outbreak

Answer 17

When should a suspected outbreak be investigated?
OB ixs are almost always public events

Question 18

What to take into consideration with when a suspected OB should be investigated

Answer 18

Public, political, and legal concerns
When is something called an “outbreak”? An “epidemic”?

Question 19

What to take into consideration given that OBs are almost always public events

Answer 19

Clear and effective communication (misinformation/fear)
Concordance with PH law
Diplomacy- not all parties are always cooperative

Question 20

Steps of epidemiologic analysis for OBs

Answer 20

Define the epidemic
Perform descriptive epidemiology
Develop and test hypotheses (epi analysis)

Question 21

Aspects of defining the epidemic for OBs

Answer 21

Create a case definition
Count the cases (numerator)
Determine the pop at risk for developing the dz (denominator)
Calculate attack rates (when possible)

Question 22

Aspects of performing descriptive epidemiology for OBs

Answer 22

Examine the distribution of cases in terms of person, place, and time
Look for interactions of relevant variables
Trends of who is impacted, common exposures, etc

Question 23

Aspects of developing and testing hypotheses in OBs

Answer 23

Based on existing knowledge of the dz (if any)
Analyze existing data using an appropriate study design
Collect additional data
Use results to recommend control measures

Question 24

Definition of case definition

Answer 24

A standardized set of criteria for determining whether a person has a dz for case counting purposes

Question 25

What can criteria of a case definition be based on?

Answer 25

S/sx, physical findings
Lab tests
Medical hx, exposure hx

Question 26

What should be considered when designing an OB ix or study?

Answer 26

Practical and theoretical considerations
“Gold standard” measure from previous reasearch?

Question 27

What is the purpose of ID’ing, investigating, and controlling OBs?