Module 3 cheat sheet Q's Flashcards
Health promotion
acts on the determinants of wellbeing in the population and enables people to increase control over and improve their health.
Usually pre disease
Health protection
focus in environmental hazard (pre and during disease)
Disease prevention
looks at ways of preventing disease or consequences
Primary screening
acts before disease aims to limit incidence
Secondary screening
acts at early stages, aims to reduce more serious consequences
Tertiary screening
acts after diagnosis, aims to reduce the progress of more seriousness consequences
Population based intervention advantages
Addresses underlying cause
large potential benefit for whole population
behaviorally acceptable
Population based intervention disadvantages
small benefit to individual and population
poor individual & physician motivation
less favorable benefit: risk ratio
will not change health differentials
High risk individual strategy advantages
individuals and physicians are motivated and its appropriate for them
cost effective use of limited resources
favorable benefit benefit :risk ratio
High risk individual strategy disadvantages
Screening difficulties
limited potential for individual and population
Behaviorally inappropriate
Bradford hill 7 criterias
Temporality Strength of association Consistency of association Biological gradient Biological plausibility reversibility Specificity of association
Temporality
exposure must precede outcome
Strength of association
Strength of statistical evidence in the absence of known biases
Consistency of association
replication of findings by multiple studies
Biological gradient
Incremental changes in exposure are correlated with incremental changes in disease rate
Biological plausibility
logical association between exposure and disease
Reversibility
removing the exposure changes the outcome
Specificity of association
a single cause has a single effect (less common)
State the factors involved in rothmans causal pie
sufficient cause
componient cause
necessary cause
sufficient cause
a combination of factors which when together will invariably produce the disease
component cause
contributes towards the disease
necessary cause
a component cause that must present if a specific disease is to occur
What is prioritizing
allows us to allocate funding to services that are more effective in improving health, because there are limited resources and a finite amount of funding
How are prioritization established
using evidence based measurements
community expectations/ values
consider human rights, social justice and obligations tot he treaty of Waitangi
What are the three epidemiological measures used in priorisation
years of potential life lost to death (YLL)
years lived with disability (YLD)
population Attributable risk (PAR)
Attributable risk
another word for risk difference. for high risk interventions we target the risk factor with the greatest AR
Population Attributable risk
amount of extra disease in a population which is attributable to a specific risk factor which we could prevent if we completely removed the risk factor.
For population based interventions we target the risk factor which has the greatest PAR as this will benefit most people
Population Attributable risk equation
PAR= PGO- CGO
Describe Screening
Attributes of a suitable screening test
reliable safe simple affordable Acceptable Accurate (high sensitivity and specificity)
Specificity
likehood of a negative test in those who dont have the disease. It is high if the proportion of true negatives in high
fixed characteristic of a test
How do you calculate Specificity
d/ (B+d)= true negatives without disease
Sensitivity
likelihood of a positive test in those with the disease. It is high if the proportion of true positives is high
A fixed characteristic
Sensitivity equation
a/(a+c)= true positives/ total with disease
Describe Postitive predicted value (PAR)
The proportion who really have disease, of all who test positive
The probability of having the disease if the test is positive
How is PAR calculated
a/(a+b)= true positives who test positive
Describe Negative Predicted Value
proportion of people who are free of disease of all who test negative (the probability of not having the disease if the test is negative)
How is NPV calculated
d/(c+d)= true negatives who test negative
What is lead time bias
SCREENING
increase in survival time caused by a difference in the time between diagnosis and death when screening compared to clinical diagnosis.
Patients dont live longer, just screening lengthens the time that they know they have the disease. This may give a false impression of success of the screening program
What is Length time Bias
SCREENING
Occurs when there is a disease that can progress at a rapid or slow rate, with equal incidence of each version of the of the disease.
OTTAWA character basic strategy
Enable
Advocate
Mediate
Describe OTTAWA
enable
provide opportunities for all individuals to make healthy choices
people cannot achieve their fullest health potential unless they are able to take control of those things
Describe OTTAWA
advocate
Create favourable political/ economic/ social/ cultural/physical environments by promotion health and focusing on achieving equity
Describe OTTAWA
Mediate
Health personnel have a major responsibility to mediate and form compromises.
OTTAWA Strand
develop personal skills
Increases the options available to peop;e to exercise more control their own health and make choices conductive to health( through individual empowerment, providing information and education for health)
OTTAWA Strand
Strengthen community action
Community empowerment: ownership and control of their own endeavors and destinies and their abilities to priorities health interventions and issues relevant to them
OTTAWA Strand
Reorient Health services
Healthcare must be responsive to needs of patient and families(their culture, aspirations, capacities, resources and social norms)
Include a health promotion angle as well as being curative
Requires strong attention to health research
OTTAWA Strand
Build healthy public policy
Placing health in the agenda of policy makers in all sectors- policy must reflect the changing needs of communities and individuals
Coordinated action to create policies that foster equity
