Module 3 Lecture 21

Question 1

The Public/Population Health Model

Answer 1

Provide the maximum benefit for the largest number of people at the same time reducing inequities in the distribution of health and well being

Question 2

Individual vs Population Health Care

Answer 2

Individual: Clinicians genereally deal with individuals as they aim to treat disease to restore health (Reactive)
Population: concerned with the health of groups of individuals, in the context of their environment (comprehensive, proactive approach)

Question 3

Epidemiology determines the ______ or ______ between a given ______ and _______ in populations so appropriate _______ ______ can be taken

Answer 3

relationship or association; exposure and dis-ease; preventive measures

Question 4

Bradford Hill Criteria (every criteria doesn’t have to be filled)

Answer 4

Temporality, Strength of Association, Consistency of Association, Biological Gradient (dose-response), Biological plausibility of association, specificity of association and reversibility

Question 5

Temporality

Answer 5

First the cause then the disease (essential to establish a causal relationship) e.g. smoking causes lung cancer

Question 6

Strength of Association

Answer 6

The stronger the association, the more likely to be causal in absence of known biases e.g. British Drs study: RR>10

Question 7

Consistency of Association

Answer 7

Replication of findings by different investigators, at different times, in different places, with different methods proving it is less likely due to chance e.g. multiple studies showing similar results

Question 8

Biological Gradient (dose-response)

Answer 8

Incremental change in disease rates in conjunction with corresponding changes in exposure

Question 9

Biological plausibility of association

Answer 9

Does the association make sense biologically? e.g. chemicals in tobacco that are known to promote cancers (carcinogens)

Question 10

Specificity of association

Answer 10

A cause leads to a single effect. However, a single cause often leads to multiple effect e.g. smoking leads to multiple outcomes

Question 11

Reversibility

Answer 11

The demonstration that under controlled conditions changing the exposure causes a change in the outcome

Question 12

Cause of a disease

Answer 12

An event, condition, characteristic or combination of these factors which play an essential role in producing the disease

Question 13

A Sufficient cause…

Answer 13

is a factor/s that will inevitably produce the specific disease

Question 14

A Component cause…

Answer 14

is a factor that contributes towards dis-ease causation, but is not sufficient to cause dis-ease on it’s own

Question 15

A Necessary cause…

Answer 15

is a factor (or component cause) that must be present if a specific dis-ease is to occur

Question 16

Factors on causal pie for TB

Answer 16

Poverty, poor sanitation, overcrowding and reduced immunity

Question 17

How a causal pie is used

Answer 17

Use the association and several other factors to infer causation and intervene to prevent diseases