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LMAP > Measuring and describing disease > Flashcards

Measuring and describing disease Flashcards

1
Q

What is an epidemic disease?

A

A disease that befalls (visits) a population

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2
Q

What is an endemic disease?

A

A disease that resides within a population

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3
Q

What is the definition of epidemiology?

A

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems

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4
Q

What is the simplified definition of epidemiology?

A

How often disease occur and why

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5
Q

What are the three types of prevention of disease?

A

Primary
Secondary
Tertiary

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6
Q

What is primary prevention of disease?

A

Before onset of disease
The prevention of disease through the control of exposure to risk factors

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7
Q

What is secondary prevention of disease?

A

Slowing of progression
The application of available measure to detect early departures from health and to introduce appropriate treatment and interventions

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8
Q

What is tertiary prevention of disease?

A

Enables return to functioning after insult
The application of measures to reduce or eliminate long term impairments and disabilities, minimising suffering caused by existing departures from good health and to promote the patient’s adjustments to their condition

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9
Q

What is exposure in epidemiology?

A

The variable that we are trying to associate with a change in health status. (For example a drug)

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10
Q

Who was the Broad Street Pump founded by?

A

John Snow

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10
Q

What is epidemiology inherently connected to?

A

Demography (the science of populations)

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10
Q

What are the 4 stages of epidemiologic transition?

A
  • Pestilence and famine
  • Receding Pandemics
  • Degenerative and Man made diseases
  • Delayed Degenerative disease and Emerging infections
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10
Q

In what era did pestilence and famine occur?

A

Pre-industrial revolution (up to 1800s)

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11
Q

What were the 4 key occurences that characterised the pestilence and famine era

A
  • Urbanisation
  • Constraints on Food supply
  • High birth rate and high mortality
  • Low life expectancy at birth
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12
Q

In which era did the age of the receding pandemics occur?

A

1950-2010s

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12
Q

In which era did the age of the receding pandemics occur?

A

1800s-1950

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12
Q

What were the 5 key occurences that characterised the receding pandemics age?

A
  • Agricultural development improves nutrition
  • Life expectancy increases
  • Water, sanitation, hygiene
  • Vaccination emerges
  • High birth rate and reducing mortality
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13
Q

What were the 5 key occurences that characterised the receding pandemics age?

A
  • Lifestyle factors and non communicable diseases predominate (NCDs)
  • Environmental and global determinants drive obesity and other risk factors
  • Technology reduces need for physical labour
  • Addiction violence and other issues emerge
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14
Q

In which era did the age of degenerative and man-made diseases occur?

A

1950s-2010s

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15
Q

What were the 4 key occurences that characterised the degenerative and man made diseases age?

A
  • Lifestyle factors and Non communicable diseases (eg.cancer and CVD)
  • Environmental and global determinants that drive obesity and other risk factors
  • Tech reduces need for physical labour
  • Addiction, violence and other issues emerge
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16
Q

In which era did the age of delayed degenerative diseases and emerging infections occur?

A

2010s onwards

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17
Q

What were the 3 key occurences that characterised the age of delayed degenerative diseases and emerging infections?

A
  • Health tech defers morbidity, albeit and increasing financial cost
  • Emerging zoonotic disease presents new threats
  • Inequalities within and between countries come to the forefront
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18
Q

What does the shape of this population pyramid indicate?

A

Rapidly growing population

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19
Q

What does the shape of this population pyramid indicate?

A

Slow growing population

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20
Q

What does the shape of population pyramid indicate?

A

Negative growth (aging population)

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21
Q

What is a case series?

A

A document comprising of multiple cases reports drawn together with an editorial note providing over-riding commentary

22
Q

What are the three dimensions epidemiology is split into?

A
  • Time
  • Person
  • Place
23
Q

What is qualitative research?

A
  • Explores underlying ideas and themes to inform research questions and future hypotheses
  • Expresses its findings and outputs in words
  • Relies on smaller numbers of participants
  • Used earlier in research process
24
Q

What is prevalence?

A

Prevalence is the proportion of a population who have a specific characteristic in a specific timepoint

25
Q

What is incidence?

A

The rate of new cases of a disease occurring in a specific population over a particular period of time

26
Q

What is absolute risk?

A

Absolute risk of a disease is your risk of developing the disease over a time period.

27
Q

What is relative risk?

A

Relative risk is the ratio of the risks for an event for the exposure group to the risks for the non-exposure group.

28
Q

What is DALY?

A

DISABILITY ADJUSTED LIFE YEARS
- a measure of disease burden that combines years of life lost from ill-health, disability or premature death.

29
Q

What are the 3 conditions of disease?

A

Communicable disease
Non- communicable disease
Injuries

30
Q

What is the difference between mortality and morbidity?

A

Morbidity typically refers to having a specific illness or health condition, while mortality refers to the number of deaths that a specific illness or health condition caused.

31
Q

What are the 3 main take aways from the burden of disease?

A
  • Mortality and morbidity are very different things. Morbidity is just as important to consider as mortality
  • Disease is distributed differently between genders and age groups
  • There is no health without mental health. More focus of innovating therapies for treatment of mental health disorders needed.
32
Q

What are the 4 measures of frequency?

A
  • Odds
  • Prevalence
  • Cumulative incidence
  • Incidence rate
32
Q

What is the definition of odds?

A

The ratio of the probability of an event to its complement

33
Q

What is the definition of prevalence?

A

The proportion of individuals in a population who have the disease or attribute of interest at a specific timepoint

34
Q

What are the weaknesses of using prevalence as ameasure of frequency?

A
  • Prevalence provides no info on new cases of a disease
  • Not useful with studying diseases with a short duration as measured at a specific timepoint
  • Not useful with causal inference
35
Q

Define Cumulative incidence?

A

The proportion of the population with a new even during a given time period i.e. how many new cases of a disease has occurred during a certain time period
- people who had it at the start are not taken into account, also excluded from the denominator.

35
Q

What are the strengths of using prevalence and odds as a measure of frequency?

A
  • Can be used to assess health of population
  • Plan health services
  • Allocate healthcare resources
  • Monitor trends of diseases over time
35
Q

What are the other names cumulative incidence is called?

A
  • Incidence report
  • Risk
36
Q

It is not possible to do these studies if the individuals are not…?

A

Followed up
- must be the same for all participants, no new ones can enter the study.

37
Q

What is person-time?

A

Measure of time participants spend in the study and at risk to develop the disease. Each individual contributes to it.

38
Q

What units is person time measured in?

A

Time units
i.e. person day, person hours eg.

39
Q

What is the incidence rate?

A

Number of new cases during the follow up period per unit of person time

40
Q

What is the range of values that incidence rate can be expressed in?

A

0-INFINITY

41
Q

What is the only way in which rates can be expressed?

A

new cases per unit of person-time

42
Q

What are the strengths of using incidence rates?

A
  • It accounts for the time of follow up
  • It accounts for the time when the new event occurred
  • It is also suitable for studies where participants enter or leave this study at different times
  • It can deal with loss of follow-up and competing risks
  • It can be used when cumulative incidence is problematic or cannot be properly defined
  • Powerful tool to describe the occurrence of disease in the population
43
Q

What is the purpose of standardisation?

A

To allow for comparisons and to adjust for a particular factor

44
Q

What are the 2 types of standardisation?

A

Direct - allows comparison between like for like between populations
Indirect - gives a ratio out of 100

45
Q

How do we use direct standardisation to adjust for age?

A
  • Look at age specific incidents and apply those to a standard population. This gives us a standardised incidence for both A and B of whatever is being studied
46
Q

What are the steps to using direct standardisation?

A

Step A = input counts and population distributions
Step B = **calculate age-specific incidence (crude rate) ** (disease/event/population x 100k)
Step C = apply age specific incidence to standard population
Step D = calculate expected count: (rate x standard population)/100k
Step E = calculate standardised incidence: take expected count and divide by total population to give age standardised incidents per 100k population per year

47
Q

What are the possible differences between incidence rate between towns and populations?

A
  • Lower populations and lower numbers so difference is by chance
  • People are healthier in one population than another
  • Something is missing in terms of prevention
  • Inequalities between population
48
Q

Why do we use indirect standardisation?

A

When we don’t know the age specific data

49
Q

What are the steps to using indirect standardisation?

A

Step A: Calculate expected count (Number of actions (eg. procedures) x national standard for a certain factor (eg. deaths) ) / 100k
Step B: Calculate SMR Observed count/Expected count

50
Q

What is SMR?

A

STANDARDISED MORTALITY RATE <75
- MARKER OF HEALTHY LIFE EXPECTANCY

51
Q

What is SIR

A

Standardised incidence ratio

52
Q

What is SHMI and what is it used for?

A

Summary Hospital Mortality Indicator
- For hospital performance identifying hospitals that report higher than expected mortality

53
Q

When is indirect standardisation useful?

A

When we only have high level data about outcome but cannot make direct comparison. Often first step on a journey of enquiry

54
Q

What are the requirements for direct standardisation?

A

Requires you know variable specific measures like age specific incidence in the insititution or geography of interest , Standardising incidence rate, outputs in units of count/time

55
Q

What are the requirements for indirect standardisation?

A

Requires that you know a benchmark measure eg national incidence rate

LMAP (2 decks)

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