Measuring and Describing Disease 1

Question 1

Define endemic

Answer 1

Diseases which reside within a population

Question 2

Define epidemic

Answer 2

Diseases that befall a population

Question 3

Define epidemiology

Answer 3

The study of the distribution and determinants of health related states/events in specific populations and the applications of such studies to the control of health problems

Short: Study of how often diseases occur in different groups of people and why

Question 4

List the 3 main types of prevention

Answer 4

Primary prevention

Secondary prevention

Tertiary prevention

Question 5

Define primary prevention

Answer 5

Prevention of disease by controlling exposure to risk factors

Question 6

Give an example of primary prevention for hypertension

Answer 6

Reducing salt intake to reduce risk of hypertension

Question 7

Define secondary prevention

Answer 7

Applying measures, detecting early declines in health and introducing appropriate treatments and interventions

Question 8

Give an example of secondary prevention for hypertension

Answer 8

Adminestering anti-hypertensives to prevent further progression of hypertension

Question 9

Define tertiary prevention

Answer 9

Applying measures to reduce long-term impairments and disabilities as a result of declining health to minimise suffering and to help them adjust to their condition

Question 10

Give an example tertiary prevention

Answer 10

Rehabilitation of stroke patients to help them return to as close as possible to their previous abilities

Question 11

The prevention used before onset of a disease is known as?

Answer 11

Primary prevention

Question 12

Prevention used to slow progression of a disease is known as?

Answer 12

Secondary prevention

Question 13

Prevention used to help return patients as close to normal function is known as?

Answer 13

Tertiary prevention

Question 14

Define exposure

Answer 14

Variable we are trying to see that has an association with a change in health status

e.g. we might look at Drug X (the exposure) and test its association on mortality at five-years (the outcome).

Question 15

State the alternate name for exposure

Answer 15

Independant variable

Question 16

State the alternate name for outcome

Answer 16

Dependant variable

Question 17

Define demographic transition model

Answer 17

Model which looks at historical shift from high birth rates and infant death rates in low initally developed countries to low birth and infant death rates as it becomes more advanced.

Question 18

What are the 4 stages of epidemiological transition?

Answer 18

Pre-stage

Early stage

Late stage

Post stage

Question 19

Viral rates in pre-stage of demographic transition is mostly influenced by?

Answer 19

Pestilence and famine

Question 20

Viral rates in early-stage of demographic transition is mostly influenced by?

Answer 20

Receding pandemics

Question 21

Viral rates in late-stage of demographic transition is mostly influenced by?

Answer 21

Degenerative and man-made diseases

Question 22

Viral rates in post-stage of demographic transition is mostly influenced by?

Answer 22

Delayed degenerative diseases and emerging infections

Question 23

When was the UK in pre-stages demographically?

Answer 23

During pre-industrial revolution which occured up to the 1800s

Question 24

What 2 factors in the pre-industrial revolution resulted in pestillence and famine being the dominating causes of viral rates?

Answer 24

Urbanisation (increased transmition of diseases)

Constraints on food supply (Resulted in famine)

Question 25

What were the implications of high viral rates in the pre-stages?

Answer 25

High mortality and birth rates to compensate

Low life expectancy

Question 26

When was the UK in early-stages demographically?

Answer 26

1800s-1950s

Question 27

What 3 factors in the early-satges influenced the decline in viral rates?

Answer 27

Increase in agriculture and hence improvement of nutrion

Water, sanitation and hygeine promoted

Vaccine emerges

Question 28

What were the implications of decreasing viral rates in the early-stages?

Answer 28

High birth rate

Reducing mortality

Question 29

When was the UK in late-stages demographically?

Answer 29

1950s-2010s

Question 30

Give 4 examples of factors which influenced crude death rates

Answer 30

Lifestyle factors and NCDs (chronic diseases) predominate: cancer and CVD

Environmental and global determinants increase obesity and other risk factors

Increase in technology (reducing physical labor)

Addiction and violence

Question 31

When was the UK in post-stages demographically?

Answer 31

2010s onwards

Question 32

Give 3 examples of factors which influenced crude death rates during post-stages.

Answer 32

Health technology (defers morbidity albeit at increasing financial costs)

Emergence of zoonotic diseases

Inequalities between and within countries become more noticeable

Question 33

What is a population pyramid?

Answer 33

A graphical illustration of the distribution of a population by age groups and sex

Question 34

How can pyramid populations be used?

Answer 34

Different diseases can emerge in different age groups, sexes so knowing the general population can help in the planning of healthcare systems within such populations and predicting what needs are likely to arise.

Question 35

List the 3 main types of population pyramids

Answer 35

Expansive

Constrictive

Stationary

Question 36

Exapanisve pyramids depict which type of population?

Answer 36

Populations that have a larger percentage of younger people (youthful population)

Usually have high rates of fertility and low life expectancies

Question 37

Constrictive pyramids depict which type of population?

Answer 37

Population with high numbers of middle aged and elderly people, but fewer young people (ageing population)

Have low mortality rates with the fertility rates remaining constant

Question 38

Stationary pyramids depict which type of population?

Answer 38

Represent a stable population that will not change significantly (aged population)

Have low mortality and low birth rates

Question 39

List 4 different parts of the healthcare system that can be prioritised differently based on population.

Answer 39

Primary care (e.g. GP, first point of clinical cointact)

Urgent and emergency care (e.g. A&E)

Elective hospital care (e.g. surgery, specialist care planned in advance)

Hospice and end of life care

Question 40

Define case study

Answer 40

h

Question 41

Define a case report

Answer 41

A document comprising multiple case studies drawn together

Question 42

Define a case control study

Answer 42

A study that compares two groups of people: those with the disease or condition (cases) and a very similar group of people who do not have the disease or condition (controls)

Study which looks at two similar groups with the exception being whether they have the outcome (case) or dont (control) to determine whether there is a significant difference in the rates of exposure to a defined risk factor between the groups.

Question 43

Define historical cohort study (aka retrospective cohort study)

Answer 43

A research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are compared for a particular outcome (such as lung cancer).

N.B. The outcome has already occured

Question 44

Define a prospective cohort study

Answer 44

A research study in which groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are observed for a particular outcome (such as lung cancer) over time.

Question 45

Are case-control studies prospective or retrospective?

Answer 45

Retrospective

Question 46

What Is the implications of case-control studies being retrospective?

Answer 46

Results are subjected to recall bias. E.g. a woman with miscarriage may recall or emphasise more exposure to a risk factor versus a woman who has had a healthy child and may not have paid as much attention to risk factors

Question 47

What is the main outcome measure in case-control studies?

Answer 47

Odds ratio

Question 48

What measures of frequency cannot be calculated from case-control studies?

Answer 48

Prevalence and Risk

Question 49

What are the 3 main strengths of a case-control study?

Answer 49

Cheap and quick to conduct

Enables easier assessment of rare and/or long lived diseases

Can assess multiple exposures

Question 50

What are the 3 main weaknesses of a case-control study?

Answer 50

Retrospective so is subjected to bias such as recall bias

Can only assess one outcome

Cannot establish risk or prevalence

Question 51

What is the difference between a retrospective cohort study and a case-control study?

Answer 51

Although both are retrospective, case-controls will try to determine what possible exposures may have affected an outcome. (Basically choose participants based on if they had the outcome or not)

Retrospective cohort studies on the other hand tries to determine whether a specific exposures had an association with an outcome. (Choose participants based whether they were exposed or not and looks at difference in outcome)

Question 52

What are 3 strengths of using retrospective cohort studies?

Answer 52

Able to calculate risk

Able to look at rare exposure

Able to look at multiple outcomes

Question 53

What are 3 weaknesses of retrospective cohort studies?

Answer 53

Not good for rare disease or diseases with long latency periods (hard to find multiple people with highly controlled exposures)

Longer/harder to conduct and more expensive