Module 2 Flashcards
Lecture 12
Can you take preventative action before the cause is identified?
yes
List the stages of the public health framework & each stage’s study type
Defining the problem-cross sectional
Identifying risk and protective factors- cohort / case control studies
Develop/ test prevention strategies - RCT/ diagnostic accuracy test
Assure widespread adoption - cross sectional
–> Monitor and evaluate
What is the goal of population health
give the maximum benefit to the most people while reducing inequities in the distribution of health and well being
Instead of seeking the cause of the disease in the individual, epidemiology seeks
the relationship between the exposure and the disease in populations (outcome)
What is the Bradford Hill criteria
An ‘aid to thought’ used to confirm that an exposure is the cause of a disease.
Do all the BHcriteria have to be met?
no
What is Temporality?
The exposure must precede the disease
Which criteria is a requirement
temporality
What is strength of association
If associations are stronger due to a larger RR or RD, this can infer a casual relationship –> however, small RR / RD shouldn’t be dismissed
What is consistency of Association
The association is found in similar studies done by different investigators at different times using different samples
What is the thing to watch out for in Consistency of Association
lack of consistency may be caused by poor study design so causal effect may still be there
What is Dose Response
Dose response is when you observe that increasing the level of exposure produces a proportional effect in the risk of disease
What is the thing to watch out for in Dose response
Some relationships although causal don’t have a proportional relationship but rather have max effect if it reaches a threshold.
What is Biological plausibility
If there can be a biological explanation linking the exposure to the disease then it could support it being causal
What is Specificity
The idea that one cause has lead to one effect- however this isn’t so necessary because it is common to have multiple exposures cause a disease or multiple diseases being caused by an exposure
What is reversibility
The principal that if the exposure is indeed causing the disease, then changing the exposure will change the outcome
List all the headings of the BH criteria
Temporality, Strength of Association, Consistency of Association, Dose response, Biological plausibility, Specificity and Reversibility.
Define Cause
An event, condition, characteristic or COMBINATION of these factors that play an essential role in producing the disease
What is a ‘necessary cause’
individual factor that must be present in the causal pie for the disease to be present
What is a ‘sufficient cause’
a causal pie made of component causes and these are all factors that will all contribute to the inevitable production of the disease.
What is a ‘ component cause’
this is a cause that contributes towards the disease causation but is not sufficient to cause the disease by itself
Where can intervention take place
at any of the points of the causal pie.
Do you need to know the whole disease pathway to intervene ?
no
How are the determinants of social health found
First they look at the whole population to see who is at risk, then they use the Dahlgren and Whitehead model to identify the effects of different determinants on different populations health, then finding the inequities and inequalities and how/why to reduce them.