McFarland: Intro to Population-Based Health Epidemiology Flashcards
What was the question the study question in the article on acute coronary syndrome?
Are there differences in access to care among male and female patients with premature acute coronary artery syndrome?
What type of epidemiological study did the authors use?
observational - prospective cohort study
What is an analytic study?
it investigates the hypothesized relationship in an available dataset between risk factors and outcome
Why are cohort studies advantageous compared to other designs?
they can examine many outcomes
What is the “exposure” in this study? What is the “outcome?”
gender; access to care
What is prevalence? What is incidence?
the number of existing cases of a disease/the total number in population
the number of new cases of a disease/the total number in population
What is the cumulative incidence?
number of new cases of disease/number in candidate population
What is the incidence rate?
number of new cases of a disease/person-time of observation
What is the exposure odds ratio?
odds of being exposed among cases/odds of being exposed among controls
**ad/bc
What does strength of association refer to?
stronger associations are more likely to be causal
What is temporality?
is there evidence that exposure preceded disease
What is the biological gradient/dose response?
Does disease risk increase with increased exposure level?
What is plausibility?
Does the association make sense?
What is consistency?
Do different studies yield the same results?
What is internal validity?
Are the results free of bias?
What is external validity?
Are the results generalizable?
How can you increase external validity?
random sampling
larger sample sizes
high response rate
Which is more important in an epidemiologic study, internal or external validity?
internal!
Three ways in which you can evaluate bias?
- identify the source
- estimate the magnitude/strength
- assess the direction
What is selection bias?
preferential or uneven selection of subjects
What is loss to follow up?
when participants drop out of the study
What is the healthy worker effect?
phenomenon of workers usually exhibiting overall death rates lower than those of the general population due to the fact that the severely ill and disabled are ordinarily excluded from employment.
Occurs when there is a different level of accuracy in the information provided by compared groups
recall bias
A systemic difference in soliciting, recording or interpreting information that occurs in studies using a person or telephone interviews
interviewer bias
All cases are not detected at the same stage of the disease (ex: in cancer)
lead-time bias
If a subject knows that he/she is being observed, their behavior or response can change
Hawthorne effect
In a pre-test/post-test situation, the subjects tend to remember some of the previous questions and they do better regardless of the intervention
repeat-testing bias
This is a variable that is associated with the exposure and associated with the outcome (independently of the exposure); it is not an intermediate variable in the causal pathway
confounding variable
What did the article conclude about differences in health care access among men and women?
younger adults with ACS, both men and women, had differing access
women with anxiety, men and women with no chest pain, feminine gender and identity roles all were at increased risk for poor access to care
List the top 10 leading causes of death in the US
heart disease malignant neoplasms chronic lower respiratory disease stroke unintentional injury Alzheimer's disease diabetes mellitus influenze and pneumonia nephritis and nephrosis suicide
Leading cause of death in Nevada
heart disease
Higher prevalence of heart disease among these populations
blacks
older adults
low SES
