Measures of Association Flashcards

1
Q

What are measures of association?

A

Provide a mathematical assessment of the relationship between a given exposure and the outcome of interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What two things do measures of association do?

A
  1. determine if there is an association
  2. measure the strength of association

**these are used in analytical studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would you expect a positive and negative association to be when comparing EXPOSURE groups?

A

Positive = more dz is found in a group of subjects that has the exposure than in a group of subjects that doesn’t have exposure

Negative = LESS dz is found in a group of subjects that has the exposure than in a group of subjects that doesn’t have exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would you expect a positive and negative association to be when comparing OUTCOME groups?

A

Positive = MORE of the exposure is found in a group of diseased subjects than in a group on non diseased subjects

Negative = LESS of the exposure is found in a group of diseased subjects than in a group of non diseased subjects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

We assume that the exposure is NOT associated with the disease if…..

A

When comparing exposure groups: the same amount of dz is found in a group of subjects that has the exposure and a group that hasn’t

When comparing outcome groups: the same amount of the exposure is found in a group of diseased subjects as the group of non diseased subjects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Measures of associations are used to make what two comparisons?

A
  1. compare exposure groups: compare the number of animals with the outcome in each exposure group
  2. Compare outcome groups: compare the number of animals with exposure in each outcome group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Since the number of subjects in our study groups are almost never the same, we use measures of disease occurrence; ________, _______, and odds to calculate measures of association

A

prevalence

incidence (risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When comparing exposure in outcome groups (diseased vs non diseased), in retrospective studies, what measure of association will be used?

A

Odds ratio

for cross sectional studies and case control studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When comparing outcomes in exposure groups (exposed vs non exposed), what measure of association is used for prospective studies, and what measure of association is used for retrospective studies?

A

Prospective: Relative risk (incidence ratio), and Attributable risk – used for prospective cohort studies and clinical trials

Retrospective: Prevalence ratio - used for retrospective cohort studies and cross sectional studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: In case control and cross sectional studies, the exposure and disease have already occurred when the study begins

A

TRUE

this means you can not measure incidence (new cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Case control studies cannot estimate _______ in the population, but they can determine the _________ between exposure and disease

A

cannot estimate PREVALENCE

can determine ASSOCIATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cross sectional studies estimate the prevalence, but can also evaluate _________

A

Exposures

if exposure data are collected as part of the study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____ is used to measure exposure in the diseased and non-diseased groups

A

Odds

Odds is the ration of the number exposed to the number not exposed

Ex: if there were 10 diseased animals and 3 of them were exposed –> the odds of exposure in the diseased group would be 3/7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the odds ratio?

A

The ratio of the odds of exposure in the diseased group to the odds of exposure in the non diseased group

Offs of exposure in the dx group/odds of exposure in non dz group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is the odds ration interpreted?

A

Example:
The odds of being exposed was ____ times higher in the diseased animals that in non diseased animals

If OR = 1: odds of exposure among cases was equal to that of controls (no association)

If OR is greater than one: POSITIVE association (odds of exposure among cases was greater than controls)

If OR is less than one: NEGATIVE association (odds of exposure among cases was less than controls)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The odds ration will tell you if there is an association, and the _____ of the association

A

Magnitude/strength

*know how to calculate the odds ratio

17
Q

______ is the measure used to compare the amount of disease that occurs in the exposed and unexposed groups in prospective studies

A

Incidence = risk

18
Q

What is cumulative incidence?

A

aka attack rate

number of new cases at the end of a study divided by the population at risk at the beginning of the study. (think outbreak)

Ex: 10 healthy exposed animals and 3 of them developed dx during the study –> the risk of dz in the exposed group during the study would be 3/10

19
Q

What is the incidence rate?

A

Number of new cases at the end of a study divided by the animal-time at risk.

Ex: if there were 10 healthy animals exposed for 20 months each and 3 of them developed dz:
the incidence rater in the exposed group would be 3/200 animal-months

20
Q

______ risk is used to compare the risk (or incidence) of disease that occurs in the exposed and unexposed groups

A

Relative risk

incidence of disease in the exposed group / incidence of disease in the unexposed group

21
Q

How is the relative risk (RR) interpreted?

A

If RR = one: the risk of disease in the exposed group is equal to the risk of the unexposed group

If the RR is greater than one: POSITIVE association - the risk of dz in the exposed group is greater than the unexposed

If the RR is less than one: NEGATIVE association - the risk of dz in the exposed group is less than the risk in the unexposed group

*know how to calculate this

22
Q

What is the attributable risk (AR)?

A

Amount or proportion of overall disease incidence in a population or group that can be attributed to a specific exposure.

Results are interpreted: “ ____% of the overall disease incidence can be attributed to this particular exposure”

23
Q

T/F: Attributable risk is used to quantify an association in epidemiological studies

A

FALSE

  • typically not
  • it is mostly used to set priorities in disease control programs
  • know how to calculate AR
24
Q

What measure of association is used in retrospective studies?

A

Prevalence ratio

used in retrospective cohorts and cross sectional studies

25
Q

________ is the measure used to compare the amount of disease that occurred in the exposed and unexposed groups in retrospective studies

A

Prevalence

*prevalence is used because the disease has already occurred when the study has begun

= the probability of being diseased: The number of diseased divided by the total number exposed

26
Q

How do you calculate and interpret the PR (Prevalence ratio)

A

PR = prevalence of dz in exposed / prevalence of dz in unexposed

Ex: The prevalence of dz was __ times as high in exposed animals as in unexposed animals”

PR = 1 : no association; prevalence in both groups is equal

PR greater than one = Positive association (possibly causal) - prevalence of the dz in exposed group was equal to the prev. in unexposed

PR less than one = Negative association (possibly protective) - the prev in dz in the exposed group was less than the prev in the unexposed group