Module 1-3 Flashcards
(203 cards)
1
Q
a state of complete physical, mental and
social well-being and not merely the
absence of disease or infirmity.
A
Health
2
Q
the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts for the:
a. Sanitation of the environment
b. Control of community infection
c. Education of the individual in personal health
d. Organization of medical and nursing services for the early diagnosis and treatment of disease
e. Development of social machinery which will
ensure to every individual in the community a
standard of living adequate for the maintenance or improvement of health
A
Public Health
3
Q
Focus of a public health intervention is to
prevent rather than treat a disease through
surveillance of cases and the promotion of
healthy behaviors
T/F
A
T
4
Q
From the early beginnings of human civilization, it was recognized
that __ may spread
vector-borne diseases?
A
polluted water & lack of proper waste disposal
5
Q
Rules governing medical practice
A
1700 BC The Code of Hammurabi
6
Q
Personal, food and camp hygiene, segregating lepers, overriding
duty of saving of life (Pikuah Nefesh) as religious imperatives.
A
1500 BC Mosaic Law
7
Q
Personal hygiene, fitness, nutrition, sanitation, municipal doctors,
occupational health; Hippocrates –clinical and
epidemic observation and environmental health
A
400 BC Greece
8
Q
aqueducts, baths, sanitation, municipal planning, and sanitation services, public baths, municipal doctors, military
and occupational health.
A
500 BC to AD 500 Rome
9
Q
destruction of Roman society and the rise of Christianity; sickness as punishment for sin, mortification of the flesh, prayer, fasting and
faith as therapy; poor nutrition and hygiene
pandemics; antiscience; care of the sick as religious duty.
A
500 – 1000 Europe
10
Q
origins in Asia, spread by armies of Genghis Khan, world pandemic kills 60 million in fourteenth century, 1/3 to 1/2 of the
population of Europe.
A
1348 – 1350 Black Death
11
Q
bubonic plague, smallpox, leprosy, diphtheria, typhoid, measles, influenza, tuberculosis, anthrax, trachoma, scabies and others
until eighteenth century
A
1300 Pandemic
12
Q
microscope, observes sperm and bacteria.
A
1673 Antony van Leeuwenhoek
13
Q
first vaccination against smallpox.
A
1796 Edward Jenner
14
Q
growth of science.
A
1830 Sanitary and social reform
15
Q
waterborne cholera in London: the Broad Street Pump, Father of epidemiology; founded the science of epidemiology
A
1854 John Snow
16
Q
modern nursing and hospital reform – Crimean War
A
1854 Florence Nightingale
17
Q
He proves no spontaneous generation of life.
A
1858 Louis Pasteur
18
Q
publishes On the Origin of Species.
A
1859 Charles Darwin
19
Q
He publishes findings on microbial causes of disease.
A
1862 Louis Pasteur
20
Q
He discovered anthrax bacillus.
A
1876 Robert Koch
21
Q
He discovered gonococcus organism.
A
1879 Neisser
22
Q
He discovered the tuberculosis organism, tubercle bacillus.
A
1882 Robert Koch
23
Q
He discovered bacillus of cholera.
A
1883 Robert Koch
24
Q
Vaccinates against anthrax
A
1883 Louis Pasteur
25
Gas gangrene organism discovered by
1892 Welch and Nuttal
26
Pertussis vaccine developed
1926
27
Alexander Fleming discovers penicillin
1928
28
wide spread economic collapse, unemployment,
poverty, and social distress in industrialized
countries.
1929 – 1936 The Great Depression
29
World Health Organization was founded on year?
1946
30
WHO declares eradication of smallpox
achieved
1979
31
First recognition of cases of acquired immune deficiency syndrome (AIDS).
1981
32
W.F. Anderson performs first successful gene therapy.
1990
33
brief document that recognizes primary health care as a means to achieving the objective of health for all people of all nations.
Alma Ata Declaration
34
In terms of health and safety programs, it's a joint declaration of nations under the umbrella of the World
Health Organization (WHO) that was adopted and
announced to the world in 1978 during the International Conference on Primary Health Care in Almaty, Kazakhstan.
Alma Ata Declaration
35
Core Functions of Public Health:
Assessment: of the health of the community
Policy Development: in the public interest
Assurance: of the public's health
36
Systematically collect, analyze, and make available information on healthy communities
Assessment
37
Promote the use of a scientific knowledge
base in policy and decision making
Policy Development
38
Ensure provision of services to those in need
Assurance
39
failure of the body defense mechanism to cope with forces tending to disturb body equilibrium
Disease
40
science of theory of the causes or origins of diseases
Etiology
41
study of the distribution of disease and the factors that influence the occurrence of disease in groups of people
Epidemiology
42
is an organized plan of services.
Health care system
43
responsible for the maintenance of the Barangay Health Center and provision of servicesand facilities
related to general hygiene
Barangay
44
for primary health care programs, establishment of clinics and health centers, and provision of services and facilities related to general hygiene
City or Municipality Government
45
is mandated to assist the municipal and barangay government through hospitals and pollution control systems
Provincial Government
46
composed of barangay, municipal, and medicare healthcare institutions, which have facilities and capabilities for first emergency care
Primary Level
47
consists of district healthcare institutions with capabilities and facilities for medical care of cases requiring hospitalization. Municipal hospital with 50-100 bed capacity
Secondary Level
48
composed of specialized centers, regional healthcare institutions, and provincial. Regional medical center with complete facilities and above100-bed capacity
Tertiary Level
49
Primary focus on population
PUBLIC HEALTH/MEDICINE
PUBLIC HEALTH
50
Primary focus on individual
PUBLIC HEALTH/MEDICINE
MEDICINE
51
Emphasis on Prevention and Health Promotion of the whole community
PUBLIC HEALTH/MEDICINE
PUBLIC HEALTH
52
Emphasis on Diagnosis and Treatment of the whole patient
PUBLIC HEALTH/MEDICINE
MEDICINE
53
Paradigm: Intervention aimed at environment, human
behavior and lifestyle, medical care.
PUBLIC HEALTH/MEDICINE
PUBLIC HEALTH
54
Paradigm: Medical care
PUBLIC HEALTH/MEDICINE
MEDICINE
55
Organizational Lines of Specialization:
-Analytical (epidemiology)
-Setting and populations (occupational health)
-Substantive health program (nutrition)
-Skills in assessment, policy, development and assurance.
PUBLIC HEALTH/MEDICINE
PUBLIC HEALTH
56
Organizational Lines of Specialization:
-Organs
-Patient group
-Etiology, pathophysiology
-Technical skills
PUBLIC HEALTH/MEDICINE
MEDICINE
57
Science that forms the basis for public health action and unites the public health professions. It now refers to the study of the distribution and determinants or conditions in defined population
Epidemiology
58
Applied to the study of outbreaks of acute infectious diseases and was defined as science of epidemics. It is based on two fundamental assumptions:
○ Diseases do not occur by chance
○ Diseases are not distributed randomly in the
population; thus their distribution indicates
something about how and why that disease process
occurred
Epidemiology
59
often described as the basic science of public health"
Epidemiology
60
refers not only to the number of health events
Frequency
61
refers to the occurrence of health-related events by time, place, and person.
Pattern
62
the causes and other factors that influence the occurrence of disease and other health-related events.
Determinants
63
is the study (scientific, systematic, data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (patient is community, individuals viewed collectively), and the application of (since epidemiology is a discipline within public health) this study to the control of health problems.
Epidemiology
64
is the ongoing, systematic collection, analysis, interpretation, and dissemination of health data to help guide public health decision making and action.
Public health surveillance
65
One of the first actions that results from a surveillance
case report or report of a cluster is investigation by the
public health department.
Field investigation
66
Clusters or outbreaks of disease frequently are
investigated initially with
Descriptive epidemiology
Analytic epidemiology
Descriptive epidemiology
67
the use of a valid comparison group.
Descriptive epidemiology
Analytic epidemiology
Analytic epidemiology
68
the process of determining, as systematically and objectively as possible, the relevance, effectiveness, efficiency, and impact of activities with respect to established goals
Evaluation
69
refers to the ability of a program to produce the intended or expected results in the field; effectiveness differs from efficacy, which is the ability to produce results under ideal conditions.
Efficiency
Effectiveness
Effectiveness
70
refers to the ability of the program to produce the intended results with a minimum expenditure of time and resources.
Efficiency
Effectiveness
Efficiency
71
To promote current and future collaboration, the epidemiologists need to maintain relationships with staff of other agencies and institutions.
Linkages
72
Epidemiologists working in public health regularly provide input, testimony, and recommendations regarding disease control strategies, reportable disease regulations, and
health-care policy.
Policy Development
73
aims to describe the distributions of diseases and determinants.
Descriptive epidemiology
Analytic epidemiology
Descriptive epidemiology
74
It provides a way of organizing and analyzing these data to describe the variations in disease frequency among populations by geographical areas and over time (i.e., person, place, and time).
Descriptive epidemiology
Analytic epidemiology
Descriptive epidemiology
75
3 epidemiologic variables:
Time
Place
Person
76
The occurrence of disease changes over time. Some of these changes occur regularly, while others are unpredictable.
* Displaying the patterns of disease occurrence by time is critical for monitoring disease occurrence in the community and for assessing whether the public health interventions made a difference.
Time
Place
Person
Time
77
Graphing the annual cases or rate of a disease over a period of years shows long- term or secular trends in the occurrence of the disease
Day of week and time of day
Secular (long-term) trends
Epidemic period
Seasonality
Secular (long-term) trends
78
For some conditions, displaying data by day of the week or time of day may be informative. Analysis at these shorter time
periods is particularly appropriate for conditions related to occupational or environmental exposures that tend to occur at regularly scheduled intervals.
Day of week and time of day
Secular (long-term) trends
Epidemic period
Seasonality
Day of week and time of day
79
To show the time course of a disease outbreak or epidemic, epidemiologists use a graph called an epidemic curve.
Day of week and time of day
Secular (long-term) trends
Epidemic period
Seasonality
Epidemic period
80
disease occurrence can be graphed by week or month over the course of a year or more to show its seasonal pattern, if any
Day of week and time of day
Secular (long-term) trends
Epidemic period
Seasonality
Seasonality
81
Describing the occurrence of disease by place provides insight into the geographic extent of the problem and its geographic
variation. Characterization by place refers not only to place of residence but to any geographic location relevant to disease
occurrence.
Time
Place
Person
Place
82
"Person" attributes include age, sex, ethnicity/race, and socioeconomic status.
Time
Place
Person
Person
83
Person Attribute:
Age
Sex
Ethnic and Racial Groups
Socioeconomic Status
84
most important "person" attribute. When analyzing data by age, epidemiologists try to use age groups that are narrow enough to detect any age- related patterns that may be present in the data.
Age
Sex
Ethnic and Racial Groups
Socioeconomic Status
Age
85
Males have higher rates of illness and death than do
females for many diseases.
* For some diseases, this sex-related difference is
because of genetic, hormonal, anatomic, or other
inherent differences between the sexes.
* These inherent differences affect susceptibility or
physiologic responses
Age
Sex
Ethnic and Racial Groups
Socioeconomic Status
Sex
86
Sometimes epidemiologists are interested in analyzing
person data by biologic, cultural or social groupings such
as race, nationality, religion, or social groups such as
tribes and other geographically or socially isolated
groups.
* Differences in racial, ethnic, or other group variables
may reflect differences in susceptibility or exposure, or
differences in other factors that influence the risk of
disease, such as socioeconomic status and access to
health care.
Age
Sex
Ethnic and Racial Groups
Socioeconomic Status
Ethnic and Racial Groups
87
Socioeconomic status is difficult to quantify. It is made up of many variables such as occupation, family income, educational achievement, or census track, living conditions, and social standing.
Age
Sex
Ethnic and Racial Groups
Socioeconomic Status
Socioeconomic Status
88
The key feature of analytic epidemiology is a
_______?
comparison group
89
concerned with the search for causes and effects, or the why and the how. Epidemiologic studies fall into two categories:
____ and _____.
experimental
observational
90
is similar in concept to the experimental study
* In a _____ the epidemiologist records whether each study participant is exposed or not, and then tracks the participants to see if they develop the disease of interest.
COHORT STUDY
91
An alternative type of cohort study is a ______. In this type of study both the exposure and the outcomes have already occurred.
retrospective cohort study
92
A sample of persons from a population is enrolled and their exposures and health outcomes are measured simultaneously.
* tends to assess the presence (prevalence) of the health outcome at that point of time without regard to duration.
CROSS-SECTIONAL STUDY
93
in order for a disease process to occur, there must be a
unique combination of events, a harmful agent that comes in contact with a susceptible host in the proper environment.
Epidemiologic Triangle
94
s consistent with the infectious disease process, but it can also
be applied to chronic noninfectious diseases
Triangle Model
95
refers to a disease that occurs infrequently and irregularly.
Endemic
Sporadic
Epidemic
Hyperendemic
Sporadic
96
refers to the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.
Endemic
Sporadic
Epidemic
Hyperendemic
Endemic
97
refers to persistent, high levels of disease occurrence.
Endemic
Sporadic
Epidemic
Hyperendemic
Hyperendemic
98
refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area.
Endemic
Sporadic
Epidemic
Hyperendemic
Epidemic
99
carries the same definition of epidemic, but is often used for a more limited geographic area.
Cluster
Outbreak
Pandemic
Outbreak
100
refers to an aggregation of cases grouped in place and time that are suspected to be greater than the number expected, even though the expected number may not be known
Cluster
Outbreak
Pandemic
Cluster
101
refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people
Cluster
Outbreak
Pandemic
Pandemic
102
outbreak is one in which a group of persons are all exposed to an infectious agent or a toxin from the same source
Common-source
Propagated
Mixed
common-source
103
If the group is exposed over a relatively brief period
point-source outbreak
intermittent common-source outbreak
continuous common-source outbreak - case
point-source outbreak
104
patients may have been exposed over a period of days, weeks, or longer
point-source outbreak
intermittent common-source outbreak
continuous common-source outbreak - case
continuous common-source outbreak - case
105
has a pattern reflecting the intermittent nature of the
exposure
point-source outbreak
intermittent common-source outbreak
continuous common-source outbreak - case
intermittent common-source outbreak
106
results from transmission from one person to another. Transmission is by direct person-to-person contact
Common-source
Propagated
Mixed
Propagated Outbreak
107
have features of both common-source epidemics and propagated epidemics. Pattern of a common-source outbreak followed by secondary person-to-person spread
Common-source
Propagated
Mixed
Mixed Epidemics
108
_____compare one part of the distribution to another part of the distribution, or to the entire distribution.
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Frequency Measures
109
refer to the number of cases of a disease or other health event under study
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Counts
110
is the relative magnitude of two quantities
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Ratio
111
examine all persons with the health event of interest (A, nominator) and all persons in the total population (A + B,
denominator).
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Proportions
112
is a measure of the frequency with which an event occurs in a defined population over a specified period of time.
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Rate
113
refers to the rate of occurrence of new cases of a disease or disorder in a given period in a specific population.
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Incidence
114
refers to frequency of existing cases in a defined population at a given point in time
Frequency Measures
Proportions
Prevalence
Incidence
Counts
Ratio
Rate
Prevalence
115
has been defined as any departure, subjective or objective, from a state of physiological or psychological well-being. In practice, it encompasses disease, injury, and disability.
Morbidity
116
is a measure of the frequency of occurrence of death in a
defined population during a specified interval.
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
mortality rate
117
is the mortality rate from all causes of death for a population
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
crude mortality rate
118
is the mortality rate from a specified cause for a population.
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
cause-specific mortality rate
119
is a mortality rate limited to a particular age group
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
age-specific mortality rate
120
is perhaps the most commonly used measure for comparing
health status among nations
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
infant mortality rate
121
widely used measure of health status because it reflects the health of the mother and infant during pregnancy and the year thereafter
mortality rate
crude mortality rate
infant mortality rate
age-specific mortality rate
cause-specific mortality rate
infant mortality rate
122
covers birth up to but not including 28 days
neonatal period
postneonatal period
neonatal period
123
defined as the period from 28 days of age up to but not
including 1 year of age
neonatal period
postneonatal period
postneonatal period
124
is really a ratio used to measure mortality associated with
pregnancy
mortality rates
race-specific mortality rate
sex-specific mortality rate
maternal mortality rate
death-to-case ratio
maternal mortality rate
125
is a mortality rate among either males or females
mortality rates
race-specific mortality rate
sex-specific mortality rate
maternal mortality rate
death-to-case ratio
sex-specific mortality rate
126
is a mortality rate related to a specified racial group
mortality rates
race-specific mortality rate
sex-specific mortality rate
maternal mortality rate
death-to-case ratio
race-specific mortality rate
127
can be further stratified by combinations of cause, age, sex, and/or race.
mortality rates
race-specific mortality rate
sex-specific mortality rate
maternal mortality rate
death-to-case ratio
mortality rates
128
is the number of deaths attributed to a particular disease during a specified time period divided by the number of new cases of that disease identified during the same time period.
mortality rates
race-specific mortality rate
sex-specific mortality rate
maternal mortality rate
death-to-case ratio
death-to-case ratio
129
is the proportion of persons with a particular condition (cases)
who die from that condition
case-fatality rate
maternal mortality rate
death-to-case ratio
Proportionate mortality
case-fatality rate
130
describes the proportion of deaths in a specified population over a period of time attributable to different causes.
case-fatality rate
maternal mortality rate
death-to-case ratio
Proportionate mortality
Proportionate mortality
131
study of uses and drug effects in a defined population
Pharmacoepidemiology
132
"the study of the use and effects/side-effects of drugs in large numbers of people with the purpose of supporting the rational and cost-effective use of drugs in the population thereby improving health outcomes"
Pharmacoepidemiology
133
Examines real world = experience; Mainly relies on observational research
Pharmacoepidemiology
134
Pharmacoepidemiology involves disciplines such as:
epidemiology, clinical pharmacology and biostatistics
135
Father of modern medicine. Coined the term 'endemic' and promoted clean hands for wound management.
40 BC Hippocrates
136
Father of modern epidemiology; work in tracing the source of a cholera outbreak in Soho, England.
1854 John Snow
137
British Surgeon. Discovered antiseptic (carbolic acid) as an antiseptic by applying Louis Pasteur's advances in microbiology.
1865 Joseph Lister
138
Introduced mathematical methods in epidemiology
Early 20th Century Ronald Rose & his team
139
Molecular epidemiology focusing on the relationship between biomarker and disease evolved.
Later 20th Century Ronald Rose & his team
140
US govt passed pure Food and Drug act in response to excessive adulteration and misbranding of food and drugs
1906
141
people died from renal failure due as a result of the elixir sulfanilamide dissolved in diethylene glycol
1937
142
Drug and Cosmetics Act was passed
1938
143
Thalidomide tragedy
1950-1960s
144
UK established a committee on safety of medicines
1968
145
WHO established a bureau to collect and analyze information and similar national drug monitoring organizations
1968
146
Kefauver-Harris Amendments
1962
147
related field of drug utilization was developed along with the study of ADRs
– considered to be the beginning of field of pharmacoepidemiology
1960
148
obtain more data on risk and benefits of drugs in population and to discuss, develop & disseminate information
ISPE (International Society for Pharmacoepidemiology)
149
Activities related to ISPE:
* Pharmacovigilance
* Drug utilization research and outcome
research
* therapeutic risk management
150
is an area unique to pharmacoepidemiology and it is a type of
continual monitoring of unwanted effects and other safety-related aspects of drugs.
Pharmacovigilance
151
Randomized clinical trials
Experimental/Non-experimental
Experimental
152
Field trials
Experimental/Non-experimental
Experimental
153
Community intervention trials
Experimental/Non-experimental
Experimental
154
Prospective cohort
Experimental/Non-experimental
Non-experimental
155
Retrospective cohort
Experimental/Non-experimental
Non-experimental
156
Case control
Experimental/Non-experimental
Non-experimental
157
Case series
Experimental/Non-experimental
Non-experimental
158
Case report
Experimental/Non-experimental
Non-experimental
159
Cross sectional
Experimental/Non-experimental
Non-experimental
160
Ecological
Experimental/Non-experimental
Non-experimental
161
Hybrid Studies
Experimental/Non-experimental
Non-experimental
162
Randomized
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
163
Protocol-mandated visit & treatment schedule
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
164
Treatment by protocol
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
165
Restrictive entry
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
166
Rigidly specified
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
167
Prospective
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
168
One primary objective
Interventional/Clinical Trial
Observational
Interventional/Clinical Trial
169
Non-randomized
Interventional/Clinical Trial
Observational
Observational
170
Routine care, no mandated visit & treatment schedule
Interventional/Clinical Trial
Observational
Observational
171
Broad entry criteria
Interventional/Clinical Trial
Observational
Observational
172
Naturalistic
Interventional/Clinical Trial
Observational
Observational
173
Prospective and / or retrospective
Interventional/Clinical Trial
Observational
Observational
174
Could state several objectives
Interventional/Clinical Trial
Observational
Observational
175
Little / no monitoring
Interventional/Clinical Trial
Observational
Observational
176
Study patients with specific disease
Community intervention trials
Randomized clinical trials
Field trials
Randomized clinical trials
177
study subjects to prevent disease
Community intervention trials
Randomized clinical trials
Field trials
Field trials
178
Study communities to prevent disease
Community intervention trials
Randomized clinical trials
Field trials
Community intervention trials
179
Observe group of patients treated with the same drug
Case control
Retrospective cohort
Prospective cohort
Prospective cohort
180
Extract data from an existing repository to look at outcomes of exposed group
Case control
Retrospective cohort
Prospective cohort
Retrospective cohort
181
determine association between a drug and a rare event
Case control
Retrospective cohort
Prospective cohort
Case control
182
Reveal common experience of a number of patients following drug exposure
Cross-sectional
Ecological
Case report
Case series
Case series
183
reveal the experience of a single patient following drug exposure
Cross-sectional
Ecological
Case report
Case series
Case report
184
Determine the prevalence of drug use in a patient population at a given time
Cross-sectional
Ecological
Case report
Case series
Cross-sectional
185
Determine the association between drug use of a population or group and an event
Cross-sectional
Ecological
Case report
Case series
Ecological
186
study of the effects of drugs
Pharmacology
187
study of the effects of drugs in humans
Clinical Pharmacology
188
therapy should be individualized which requires the determination of a risk/benefit balance
Central principle of clinical pharmacology
189
is the study of the distribution and determinants of diseases
in populations
Epidemiology
190
Reasons to perform Pharmacoepidemiology Studies:
* Regulatory
* Marketing
* Legal
* Clinical
– Hypothesis testing
– Hypothesis generating
191
SOURCES OF PHARMACOEPIDEMIOLOGY DATA:
Spontaneous AE reporting
Global Drug surveillance
Case-control surveillance
Prescription event monitoring
Automated databases
Others
192
all unsolicited reports of suspected AEs
– confirmed by formal epidemiological studies
Spontaneous reporting
193
large complex databases
data mining
signal
data mining
194
previously unrecognized hazard
– known hazard more frequent or more serious
data mining
signal
signal
195
uses case-control methodology to systematically evaluate and detect effects of medications and other exposures on the risk
of serious illnesses
* non prescription drugs and dietary supplements
Case Control Surveillance
196
defined from prescriptions and followed-up for a defined period as to identify all adverse events occurring in the early post-treatment period
Prescription Event Monitoring
197
potential data sources
– Claim databases – Medical record databases – e.g. Medicaid, United Health Group
Automated Databases
198
provide insight into disease and treatment patterns of physicians e.g National Disease and Therapeutic Index
Drug utilization studies
199
useful in performing analysis of secular trends
Disease Incidence data
200
collection of cases w/out controls useful for performing case-control study
RegistryData
201
• artificial and raise logistical problems
• intended to address specific questions about drug efficacy and few for drug safety
Randomized Control Trial as post marketing surveillance
202
* practice of monitoring the safety of a pharmaceutical drug or device after it has been released on the market
* important part of pharmacovigilance
POST MARKETING SURVEILLANCE (PMS)
203
Applications of Pharmacoepidemiology:
* Estimation of risk of drug use
* Use in patient counseling
* Formulation of public health policy decision
* Formulation of therapeutic guidelines and discovery of new indications
* Facilitate thepharmaco-economic evaluation
