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Epidemiology > Overview & Definitions > Flashcards

Overview & Definitions Flashcards

1
Q

The basis of Epidemiology

A

Populations

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2
Q

John Snow

A

Broad Street Pump
Cholera
Father of Epi

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3
Q

Epidemiology

A

Public health discipline that studies the distribution and determinants of disease in populations

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4
Q

Distribution

A

Spread

Who, when, where or person, place, time

Descriptive Epi

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5
Q

Determinants

A

Cause

Why, How

Analytic Epi

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6
Q

6 Core Functions of Epidemiology

A
  1. Public Health Surveillance
  2. Field Investigation
  3. Analytic Studies
  4. Evaluation
  5. Linkages
  6. Policy Development
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7
Q

Passive Surveillance

A

Healthcare System

I.e. Reporting diseases

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8
Q

Active Surveillance

A

Going into communities and searching for disease cases.

E.g. John Snow

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9
Q

Syndromic Surveillance

A

Predefined signs/systems of patient related to trackable diseases.

When multiple of a community are being treated for the same symptoms

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10
Q

Incubation (Induction)

A

Time between exposure and onset of disease

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11
Q

Latency Period

A

Time between onset of disease and disease detection (symptoms or diagnosis)

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12
Q

Case Definition

A

Set criteria used to define a disease for public health surveillance

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13
Q

Epidemic

A

Disease in excess of normal expectancy

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14
Q

Outbreak

A

An epidemic limited to a certain or localized increase of disease.

Also called cluster.

E.g. Disease occurring at a school

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15
Q

Endemic

A

An area where the occurrence of a disease is higher than normal for other places, but normal for that particular place

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16
Q

Emergency of International Concern

A

Endemic that alerts the world.. pre-pandemic

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17
Q

Pandemic

A

World-wide endemic

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18
Q

Epidemic Curve

A

Shows all 3 elements of descriptive epi.

I.e. Who, when and where

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19
Q

Incidence

A

New cases of disease

Aka: risk, attack rate

New cases/ people at risk

PROPORTION

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20
Q

Prevalence

A

Existing cases + New cases

PROPORTION

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21
Q

Cumulative Incidence

A

Incidence sum over multiple periods of time

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22
Q

Incidence Rate

A

New cases/ person-time at risk

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23
Q

Incidence Density

A

Sum of Incidence rates over multiple periods of time

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24
Q

Prevalence

A

Existing cases/population

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25
Q

Point Prevalence

A

Prevalence at given period of time

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26
Q

Period Prevalence

A

Prevalence over a given period of time

27
Q

Morbidity

A

Sickness or disease

28
Q

Crude

A

Out of everybody

OR

Unadjusted

29
Q

Mortality

A

Death

30
Q

Crude Morbidity Rate

A

of persons with disease/# in population

31
Q

Crude Mortality Rate

A

of deaths (all causes)/population

32
Q

Cause-Specific Morbidity Rate

A

with cause specific disease/population

33
Q

Cause Specific Mortality Rate

A

of cause specific deaths/population

34
Q

Case-Fatality Rate

A

of cause specific deaths/# of disease cases

35
Q

Case Specific Survival Rate

A

of cause-specific cases alive/# of cases of disease

36
Q

Proportional Mortality Rate (PMR)

A

of cause specific deaths/total deaths in population

37
Q

Live Birth-Rate

A

of live births/ 1000 population

38
Q

Fertility Rate

A

of live births/ 1000 women of childbearing age

39
Q

Neonatal Mortality Rate

A

of death in <28 days of ages/ 1000 live births

40
Q

Postnatal Mortality Rate

A

of deaths > 28 days but <1 year/ 1000 live births

41
Q

Infant Mortality Rate

A

of deaths in those <1 year / 1000 live births

42
Q

Maternal Mortality Ratio

A

of female deaths related to pregnancy / live births divided by 100,000

OR

# of female deaths related to preg/#of live births = ...
... Times 100,000
43
Q

Infectivity

A

The ability to invade a host

infected/ # at risk

44
Q

Pathogenicity

A

The ability too cause clinical disease

with clinical disease/# infected

45
Q

Virulence (Case-Fatality Rate)

A

The ability to cause death

of deaths/# with infectious disease

46
Q

Absolute Risk Reduction (ARR)

Attributable Risk

A

Risk difference of outcome attributable to exposure difference between groups..

47
Q

Relative Risk Reduction (RRR)

A

ARR/ R(unexposed)

48
Q

Number Needed to Treat or Harm (NNT or NNH)

A

1/ARR in decimal form

ALWAYS round up.

Strive for NNT=1, NNH = infinity

49
Q

Risk Ratio or Relative Risk (RR)

A

Ratio of risk from 2 different groups

Risk of outcome in exposed/risk of outcome in non-exposed

50
Q

Odds

A

Ratio

Frequency of outcome occurring / not occurring

Did/didn’t, yes/no

51
Q

Odds Ratio

A

ratio of odds from 2 different groups

Odds of exposure in diseased/odds of exposure in non-diseased

52
Q

Confounding

A

Lack of exchangeability

The confounder has to be associated with both exposure and outcome.

Has to be an independent relationship. Cannot be directly linked.

53
Q

Crude Association / Unadjusted

A

Ignores all other characteristics and explanatory factors. Only looks at exposure and outcome.

54
Q

Adjusted Ratio

A

Ration calculated with both the exposure and outcome compared to the 3rd variable.

55
Q

Impact of Confounding

A
  1. Magnitude: an association more or less extreme that true association
  2. Direction: can produce an association in the opposite direction
56
Q

Purpose of controlling for confounders

A

To get a more accurate estimate of the measure of association between exposure and outcome

57
Q

Ways to Control Confounding

A
  1. Study Design Stage
    Randomization
    Restriction
    Matching
  2. Analysis of Data Stage
    Stratification (w/ weighting)
    Multivariate statistical analysis (regression analysis)
58
Q

Randomization

A

Hopefully gives equal numbers of subjects with known confounders to each group.

Strength: With sufficient sample size, will likely be successful.
Stratified version more precisely assures equal-ness

Weakness: Sample size may not be large enough
No guarantee for all known and unknown confounders
Only practical for interventional studies

59
Q

Restriction

A

Participants are restricted to only subjects that do not have pre-specified confounder

Strength:
Straight forward, convenient, inexpensive

Weakness:
May affect ability to enroll subjects
If not narrow enough, can allow other confounding effects
Eliminates ability to evaluate varying levels of excluded factor
Negatively affects EXTERNAL VALIDITY (Generalizability)

60
Q

Matching

A

Subjects selected in pairs and equally distributed

Strength:
Intuitive, gives more analytic efficiency

Weakness:
Difficult to accomplish, time consuming, may be expensive
Doesn’t control for ant confounders other than those matched.

61
Q

Stratification

A

Descriptive & Statistical analysis of data. Within various levels within the confounding variable

Strength:
Intuitive to some, straight forward and enhances understanding of data

Weakness:
Impractical for simultaneous control of multiple confounders

62
Q

Multivariate Analysis

A

Statistical analysis of data by factoring out effects of confounding variables - mathematically

Strength:
Can simultaneously control for multiple confounding variables
OR’s can be obtained and interpreted in statistical regressions

Weakness:
Requires individuals to clearly understand data
Can be time consuming for researcher

63
Q

Effect Modification (Interaction)

A

A 3rd variable that modifies the magnitude of effect of a true association by varying it within different levels.

Modifies the effect across the strata. (Levels/layers)

If present, researcher must report the measures of association of each strata individually.

Epidemiology (12 decks)

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