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Epidemiology > Module2 - Midterm > Flashcards

Module2 - Midterm Flashcards

1
Q

Public health surveillance

A

ongoing systematic collection, analysis, and interpretation of health-related data essential to the planning, implementation, and evaluation of public health practice

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2
Q

Passive surveillance

A

in which available data on reportable diseases are used or in which is mandated or requested by the government or the local health authority. Often falls responsibility on the physician.

Underreporting and lack of completeness are likely

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3
Q

Active surveillance

A

system in which project staff are specifically recruited to carry out a surveillance program.
Recruited to make periodic field visits to health care facilities such as clinics, primary health centers, and hospitals.

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4
Q

Which type of surveillance is more accurate?

A

active surveillance because they have been specifically employed and trained to carry out this responsibility

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5
Q

public health surveillance is closely integrated with?

A

timely spread of the data to those who need to know for the application of these data to prevention and control

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6
Q

Purpose of Public Health Surveillance

A
  1. Track conditions of public health importance
  2. Assess public health status
  3. Define public health priorities
  4. Evaluate programs
  5. Develop public health research
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7
Q

Tracking condition of public health importance includes:

A

Detection of outbreaks, clusters, and epidemics

Portrayal of the natural hx of disease of injury

monitor change in infectious agents

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8
Q

How we track - Assessing public health status includes:

A

Quantitative estimates of the magnitude of a health problem in a population at risk ; Monitoring of isolation activities

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9
Q

Prevalence per 1000

A

No. of cases of a disease present in the pop. at a specified time / No. of persons in the pop. at that specific time x 1000

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10
Q

How we track - Defining Public health priorities include:

A

Documentation of the distribution and spread of a health event

detection of changes in health practice

facilitate planning

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11
Q

How we track - Evaluating Programs in Public Health Surveillance includes:

A

Plan public health actions and use of resources

Apprpriation/allocation of prevention of resources

Evaluation of control/prevention measures

Assess quality of health care

Assess safety of drugs, devices, diagnostics, or procedures

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12
Q

How we track - Developing PH resources in Public Health Surveillance includes:

A

generating hypothesis about etiology and in a limited way, test hypotheses

facilitation of epidemiological/lab research

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13
Q

PHS collection should be ____

A

systemic and ongoing

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14
Q

Research vs Public Health Surveillance

A

Research must go through IRB (Review board) takes data from certain population and extrapolates to generalize for bigger pop.

PHS is considered practice not research - it is required, does not require consent, however, if you take data from PHS and are going to analyze it, it could be research

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15
Q

epidemiologists role in PHS

A

look at, analyze, and interpret data, keeping in mind that it will be used for something; know that it will be disseminated

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16
Q

Purpose of Surveillance - answers the questions:

A

Who, What, When, Where (questions related to descriptive analysis)

NOT THE WHY!! (no terms of causation)

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17
Q

Conditions (to determine disease) for PH surveillance:

A

Public Health importance
Prevention, control, treatment ability
Capacity for Control and Prevention

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18
Q

PHS Loop Order:

A

Collection –> Analysis –> Interpretation –> Dissemination

Dissemination needs to be (ideally) timely for big public health action

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19
Q

Surveillance may also be carried to assess changes in _____

A

environmental risk factors for disease

***This monitoring may give an early warning about a possible rise in rates of disease associated with that environmental agent.

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20
Q

death rate is _____ in groups with more severe illness such as those who hospitalized

A

proportionately greater

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21
Q

Which sources of at a can be used to obtain information about the person’s illness?

A

For hospitalization: medical and hospital records useful

If hospitalization is not required: primary care providers’ record may be the best source

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22
Q

Rates

A

tell us how fast the disease is occurring in a population

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23
Q

proportions

A

tell us what fraction of the population is affected

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24
Q

Incidence Rate Definition and Equation

A

number of new cases of a disease that occur during a specified period of time in a population at risk for developing the disease

No. of new cases of a disease occurring in the pop during a specified period of time / No. of persons who are at risk of developing the disease during that period of time x 1000

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25
Q

The critical element in defining incidence rate is _____ of disease

A

new cases

*** disease is identified in a person who develops the disease and dod not have the disease previously

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26
Q

the incidence rate is a measure of ___

A

risk

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27
Q

For an incidence rate to be meaningful, any individual who is included in the denominator must have ____

A

the potential to become part of the group that is counted in the numerator

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28
Q

incidence density

A

When different individuals are observed for different lengths of time, in which the denominator consists of the sum of the units of time that each individual was at risk and observed.

29
Q

What is the difference between incidence and prevalence?

A

Prevalence can be viewed as a snapshot or slice through the population at a point in time in which we determine who has the disease and who does not.

Incidence includes only new cases or events and a specified a time period

30
Q

Point Prevalence

A

Prevalence of the disease at a certain point int is - this is the use of term prevalence

31
Q

Period Prevalence

A

People who have had the disease during a time period
- time period can be selected such as month, etc.

32
Q

Why do we bother to estimate prevalence?

A

Prevalence is an important and useful measure of the burden of disease in a community to inform rescue allocation by decision-makers. We also want to make future projections and anticipate the changes that are likely to take place.

33
Q

If we want to look at the cause, of the disease, we must explore the relationship between an exposure and risk of disease, we need data on?

A

incidence

34
Q

Mortality Rate Equation

A

Total no. of deaths from all causes in 1year / No.of persons in the pop. at midyear x 100000

35
Q

specific rate

A

When a restriction is placed on a rate

Ex: putting age as a restriction on mortality rate

36
Q

Case-fatality Equation

A

No. of individuals dying during a specified period of time after specific disease onset / No. of individuals with specified disease x 100

37
Q

What is the difference between case fatality and a mortality rate?

A

In a mortality, rate the denominator represents the entire population at risk of dying from the disease including those who have and those who don’t have disease.

In cases-fatality, denominator is limited to those who already have the disease.

38
Q

case-fatality is a measure of what?

A

severity of the disease

39
Q

Proportionate Mortality

A

No.of death from cardiovascular diseases in the US in 2015 / Total deaths in the US in 2015. x 100

40
Q

YPLL

A

measure of premature mortality, or early death.

41
Q

The younger the age at which death occurs, _____ of potential life are lost

A

more years

42
Q

YPLL can assist in three important public health functions:

A
  1. establishing research and resource priorities
  2. surveillance of temporal trends in premature mortality
  3. evaluating the effectiveness of program interventions
43
Q

A mortality rate is a good reflection of the incidence rate under two conditions:

A
  1. when the case-fatality rate is high
  2. duration of disease is short
44
Q

___ is the single most important predictor of mortality

A

age

45
Q

The people conducting surveillance should: (5)

A

1 identify, define, and measure the health problem of interest
2. collect and compile data about the problem, and possible the factors that influence it
3. analyze and interpret the data
4. provide these data and their interpretation to those responsible
5. monitor and periodically evaluate evaluate the usefulness and quality of surveillance

46
Q

What are the characteristics of surveillance? (4)

A
  1. Timeliness: implement effective control measures
  2. Representation: provide an accurate picture of the temporal trend
  3. Sensitivity: to allow identification of individual persons with disease to facilitate treatment, quarantine,
  4. Specificity: exclude persons not have disease
47
Q

In certain countries, selection of a health problem, is based on?

A

prioritizing disease, review of available morbidity and mortality data, knowledge of diseases, geographic and temporal patterns, impressions of public and political concerns

48
Q

Syndromic surveillance

A

Surveillance using less specific criteria such as constellation of signs and symptoms, chief complaints, presumptive diagnoses

49
Q

What is the goal of syndromic surveillance?

A

provide and earlier indication of an unusual increase in illness than traditional surveillance might, to facilitate early intervention.

50
Q

Sentinel Surveillance

A

Pre-arranged sample of health care providers or others who agree to report cases of a certain disease

51
Q

What is the Major infectious disease surveillance system

A

NNDSS: states can choose what to include in their laws regarding reportable conditions –> they primarily use the CDC/CSTE definitions but not necessarily.

52
Q

State-Based Notifiable Disease

A

state mandate; NNDSS/NEDSS

  • stable, widely used, required
53
Q

Healthcare Associated Infections

A

federal requirements/state mandates; NHSN

  • stable, widely used, required
54
Q

Influenza Surveillance

A

voluntary-except pediatric deaths; Sentinel Surveillance and Syndromic Surveillance

  • stable, but not required, but widely used
55
Q

Big Data Systems, Google Flu, Flu near You

A

not as stable, use varies, not required

56
Q

What are the Limitations on ID Surveillance

A
  1. Any minor changes may not be easy to detect
  2. Delayed Detection/Notification - Issues
  3. Biases: Selection bias (have info on those tested due to clinical disease; Misclassification non-differential (different testing platforms with varying specificities); Misclassification differential (providers may be morel key to test/ report certain groups of people
  4. Limitation of surveillance data: of utilized beyond intended purpose
57
Q

____ over _____ for much of surveillance

A

sensitivity; specificity

58
Q

Data Sources

A

General public, environmental conditions, healthcare providers and facilities, non-traditional

59
Q

Data Collection Methods

A

Notifications, surveys, registries, environmental monitoring

60
Q

Will have much higher rates of death in the subset of _____ patients

A

hospitalized

61
Q

what are the two frequency measures?

A

morbidity and mortality

62
Q

What is the purpose of incidence?

A

to find cause; explore the relationship between exposure and risk of disease

63
Q

What is the purpose of mortality?

A
  1. Severity
  2. Proxy for risk –> Casa-fatality high, Disease duration short
64
Q

What are the issues with morbidity

A

Defining cases, finding cases, under counting certain groups/populations

65
Q

What are the issues with mortality

A

cause of death-underlying cause, changes in definition

66
Q

What is the goal of adjustment mortality rates?

A

compare at least two populations and want to eliminate possible effect of a given factor such as age on rates being compared

***Adjusted rates are not “real” rates

67
Q

Direct adjustment rates?

A

use an outside, standard population, compare at least two populations (most commonly used)

68
Q

indirect adjustment rates?

A

use a population to calculate a standardized number of observed/expected; when number of deaths in each age-specific stratum

Epidemiology (5 decks)

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