Module 3 Flashcards
Define Epidemiology
Epidemiology is 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
What does the Bradford Hill criteria show?
a group of minimal conditions necessary to provide adequate evidence of a causal relationship between an incidence and a possible consequence,
What are the seven aspects to the Bradford Hill criteria?
- Temporality
- Strength of association
- Consistency of association
- Biological gradient (dose-response)
- Biological plausibility of association
- Specificity of association
- Reversibility
Explain Temporality
The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
Explain Strength of association
The stronger an association, the more likely to be causal in absence of known biases (selection, information, and confounding)
Explain Consistency of association
Replication of the findings by different investigators, at different times, in different places, with different methods
ie multiple studies have shown similar results
Explain Biological gradient (dose-response)
Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence
EXPLAIN Specificity of association
A cause leads to a single effect
However, a single cause often leads to multiple effect
e.g. smoking
EXPLAIN Reversibility
The demonstration that under controlled conditions changing the exposure causes a change in the outcome
define the term ‘a cause of disease’
an event, condition, characteristic (or combination of these factors) which play an essential role in producing the disease
Define ‘A Necessary cause’
is a factor (or component cause) that must be present if a specific dis-ease is to occur
A Component cause is a
factor that contributes towards dis-ease causation, but is not sufficient to cause dis-ease on it’s own
A Sufficient cause is a
factor/s that will inevitably produce the specific dis-ease
Is Knowledge of the complete pathway of a dis-ease a pre-requisite for introducing preventive measures
no
What is the high risk strategy?
Focuses on individuals perceived to be a high risk
• Examples: Intervention targeting obese adults, intravenous drug users
What is the Population based (mass) strategy?
Focuses on the whole population
• Aims to reduce the health risks/ improve the outcome of all individuals in the population
• Useful for a common disease or widespread caus
What are the advantages for Population (mass) strategy?
- Radical - addresses underlying causes
- Large potential benefit for whole population
- Behaviourally appropriate e.g. smoking in airplanes (smokers get onto flight knowing that they can’t smoke)
What are the disadvantages for Population (mass) strategy?
• Small benefit to individuals • Poor motivation of individuals • Whole population is exposed to downside of strategy (less favourable benefit-to-risk ratio
What are the advantages forHigh risk individual strategy?
• Appropriate to individuals • Individual motivation • Cost effective use of resources • Favourable benefit-to-risk ratio
What are the disadvantages forHigh risk individual strategy?
- Cost of screening, need to identify individuals
- Temporary effect
- Limited potential - might miss people not in the high risk group who still may get the disease
- Behaviourally inappropriate - since it is a relatively smaller target group, its easier to go against it since it is not the social norm.
What is Primary care?
Patients regular source of healthcare e.g. GP, pharmacist, physiotherapist Community based
What is secondary care?
Specialist care (e.g. Neurologists, dermatologist)
What is tertiary care?
hospital based care, Rehabilitation
What are the three types of health actions?
- HEALTH PROMOTION
- DISEASE PREVENTION
- HEALTH PROTECTION