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Epidemiology > Module 1 > Flashcards

Module 1 Flashcards

1
Q

Definition of epidemiology

A

The study of the occurrence and distribution of health-related events, states, and processes in specified populations, including the study of the determinants influencing such processes and the application of this knowledge to control of relevant health problems

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2
Q

Public health practice definition

A

The strategic, organized, and interdisciplinary application of knowledge, skills, and competencies necessary to perform essential public health services and other activities to improve the population’s health.

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3
Q

What are several issues that are typical of many epidemiologic research studies?

A

When there is a linkage or association between a factor and a health outcome, does this observation mean that the factor is a cause of disease?
If there is an association, how does the occurrence of a disease vary according to the demographic characteristics and geographic locations of the affected persons?
Based on the observation of such an association, what practical steps should individuals and public health dependents take? What should the individual consumer do?
Do the findings from an epidemiologic study merit panic or a measured response?
How applicable are the findings to settings other than the one in which the research was conducted?
What are the policy implications of the findings?

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4
Q

Definition of determinants

A

Factors or events that are capable of bringing about a change in health.

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5
Q

What focus is a widely accepted feature of epidemiology?

A

Population, not individuals

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6
Q

Distribution (of disease) definition

A

Relates to differences in disease patterns in subgroups of the population

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7
Q

Burden of disease definition

A

Used to describe how a disease may affect a population with respect to morbidity from illnesses that result in mortality and injuries

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8
Q

What does the term levels denote?

A

The hierarchy of tasks that epidemiologic studies seek to accomplish

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9
Q

What is involved in describing the health status of populations?

A

To enumerate the cases of disease, to obtain relative frequencies of the disease within subgroups, and to discover important trends in the occurrence of disease

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10
Q

Definition of explaining etiology of disease

A

To discover causal factors and determine modes of transmission

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11
Q

Definition of predicting the occurrence of disease

A

To estimate the actual number of cases that will develop and to identify the distribution within the population

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12
Q

What are the two different goals of epidemiology?

A

One related to the distribution of health outcomes and the second related to controlling diseases.

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13
Q

Quantification definition

A

The translation of qualitative impressions into numbers

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14
Q

Definition of epidemic

A

The occurrence, in a defined community or region, of cases of an illness (or an outbreak) with a frequency clearly in excess of normal expectancy. The number of cases indicating presence of an epidemic varies according to the infectious agent, size, and type of population exposed, previous experience or lack of exposure to the disease, and time and place of occurrence; epidemicity is thus relative to usual frequency of the disease.

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15
Q

Usual frequency definition

A

The disease’s typical occurrence at the same time, within the same population, and in the same geographic area.

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16
Q

Pandemic definition

A

An epidemic on a worldwide scale

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17
Q

Endemic definition

A

A term used to characterize a dz that is habitually present in a particular geographic region.

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18
Q

Surveillance definition

A

The systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpretation of these data, and the dissemination of consolidated and processed information to those contributing to the surveillance program and other interested persons.

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19
Q

Definition of count

A

Refers to the number of cases of a disease or other health phenomenon being studied.

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20
Q

Definition of ratio

A

The value obtained by dividing one quantity by another. Rates and proportions are ratios.

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21
Q

Definition of proportion

A

A type of ratio in which the numerator is part of the denominator.

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22
Q

Rate definition

A

A type of ratio where the denominator involves a measure of time. The numerator consists of the frequency of a disease over a specified period, and the denominator is a unit size of the population.

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23
Q

Prevalence definition

A

Refers to the number of existing cases of a disease or health condition in a population at some designated time.

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24
Q

Point prevalence definition

A

Prevalence at an exact point in time

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25
Q

Period prevalence definition

A

The total number of cases of a disease that exist during a specified period.

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26
Q

How is period prevalence determined?

A

Combine the number of cases at the beginning of the time interval (point prevalence) with the new cases that occur during that interval.

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27
Q

Why are prevalence studies useful?

A

They describe the health burden of a population and in allocation of health resources.
Can be used by epidemiologists to estimate the frequency of an exposure in a population.

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28
Q

What are prevalence studies not usually good for?

A

Studies of etiology

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29
Q

Definition of incidence

A

The number of instances of illnesses commencing, or of persons falling ill, during a given period in a specified population. More generally, the number of new health-related events in a defined population within a specified amount of time. It may be measured as a frequency count, a rate, or a proportion.

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30
Q

Incidence rate definition

A

The rate of development of a disease in a group over a certain time period.

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31
Q

What are the three important elements of an incidence rate?

A

A numerator: the number of new cases
A denominator: the population at risk
Time: the period during which the cases accrue

32
Q

Population at risk definition

A

Those members of a population who are at risk for contracting a specific disease or adverse health outcome.

33
Q

Attack rate definition

A

An alternative form of the incidence rate that is used when the nature of the dz or condition is such that a population is observed for a short time period, often as a result of a specific exposure.

34
Q

Crude death rate formula

A

Crude death rate = (number of deaths in a given year/reference population (during midpoint of the year)) x 100,000

35
Q

Incidence rate formula

A

Incidence rate = (number of new cases over a time period/total population at risk during the same time period) x multiplier

36
Q

Point prevalence formula

A

Point prevalence = (number of people ill/total number in the group) at a time point.

37
Q

Period prevalence formula

A

Period prevalence = (Number of persons ill/average population) during a time period

38
Q

Attack rate formula

A

Attack rate = Ill/(ill + well) x 100 during a time period

39
Q

Definition of risk

A

A statement of the probability or chance that an individual will develop a disease over a specified period. Ranges from 0 to 1.

40
Q

Cumulative incidence definition

A

Incidence expressed as a proportion of a cohort or group at risk

41
Q

Conditions of cumulative incidence

A

In order for it to be meaningful, the time period must be specified.
Used when all individuals in the population are thought to be at risk of the health-related event being investigated.
Disease status must be determined for everyone in the denominator.
No individuals are allowed to enter the denominator after the start of the observation period.

42
Q

What is a potential complication of cumulative incidence?

A

Dynamic populations: some people not in the original population can move to the population and become ill. Others may move out and then develop the disease.

43
Q

Incidence density

A

The average person-time incidence rate

44
Q

When is person-time used?

A

When the amounts of time of observation of each of the subjects in the study varies instead of remaining constant for each subject.

45
Q

What is a solution to the problem of dynamic populations in cumulative incidence?

A

Use rates as an indicator of risk

46
Q

Incidence density formula

A

Incidence density = number of new cases during the time period/total person-time of observation

47
Q

How does prevalence usually get reduced?

A

Death or cure

48
Q

What can increase the prevalence?

A

New cases, or incidence
Prolongation of life with treatment, which does not completely cure the disease.

49
Q

What problems can arise in calculating numerators in incidence and prevalence?

A

Defining who has the dz
Ascertaining which persons should be in the numerator (how do we find cases?)

50
Q

What problems can arise with denominators in incidence and prevalence?

A

Selective undercounting of certain groups
Determining who is part of the denominator (think about the uterine cancer example, women who have had hysterectomies? Trans men who still have a uterus?)

51
Q

What are the two types of surveillance?

A

Passive and active

52
Q

Passive surveillance definition

A

Surveillance in which either available data on reportable diseases are used or reporting is mandated or requested with the responsibility for the reporting often falling on the HCP or district health officer.

53
Q

Issues in passive surveillance

A

Underreporting and lack of completeness of reporting
Local outbreaks may be missed

54
Q

Pros of passive surveillance

A

Inexpensive
Relatively easy to develop initially

55
Q

Definition of active surveillance

A

A system in which project staff make periodic field visits to health care facilities to identify new cases of a dz or deaths from the dz that occurred.

56
Q

Pros of active surveillance

A

Reporting is generally more accurate.
Local outbreaks are generally identified.

57
Q

Cons of active surveillance

A

More expensive to maintain
Often more difficult to develop initially

58
Q

What are the two main branches of epidemiology?

A

Descriptive and analytic

59
Q

Descriptive epidemiology definition

A

The study of the distribution of health states in populations by characteristics of person, place, and time.

60
Q

What is the main purpose of descriptive epiemiology?

A

Looks for patterns between groups of people, over time or across geographical areas.

61
Q

What is the main concern of analytic epidemiology?

A

The study of determinants

62
Q

Definition of analytic epidemiology

A

The multi-disciplinary study of the determinants of health states in populations, on all levels from the molecular to the entire ecosystem, and including both the biological sphere and the broader social environment.

63
Q

What are the four main purposes of epidemiology?

A
  1. Public health assessment
  2. Evaluating a health program, policy, or clinical service.
  3. Finding causes of a disease.
  4. Completing the clinical picture of a dz
64
Q

Definition of evaluation

A

A systematic method for collecting, analyzing, and using information to answer questions about health projects, policies, programs, or clinical services.

65
Q

What is a case?

A

Any person who has the dz or injury of interest

66
Q

What are the four ways of quantifying the extent of morbidity and mortality?

A
  1. Counts
  2. Proportions
  3. Rates
  4. Ratios
67
Q

Definition of lifetime prevalence

A

A type of period prevalence, including the proportion of all people who have had a dz at some time in their lives.

68
Q

Definition of duration

A

The average length of time that people are ill with a dz
Begins at illness and ends at recovery or death

69
Q

Definition of person-time

A

The sum of the amount of time that each person in the population at risk was observed to be healthy before they either developed the disease, dropped out of the study, or the study ended.

70
Q

How are counts useful?

A

Useful for planning adequacy of health care allocation at a particular level

71
Q

Limitations of counts

A

Gives very limited information
You cannot compare two populations using counts.

72
Q

What can decrease the prevalence?

A

Decreased incidence
Improved cure rate
Increased death rate

73
Q

What increases incidence?

A

Increased risk

74
Q

What decreases incidence?

A

Decreased risk

75
Q

How is incidence useful?

A

Helps in research of etiology/causality of dz
Estimates the risk of developing a dz
Used to estimate the effects of exposure to a hypothesized factor of interest

76
Q

How are prevalence and incidence related to each other?

A

Prevalence = incidence x duration

Epidemiology (17 decks)

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