Overview of clinical Epidemiology Flashcards
Application of epidemiologic principles and methods to practice of clinical medicine
Clinical Epidemiology
Deals with population
Epidemiology
Deals with individual
Clinical medicine
Works with a defined population of patients rather than a community-based population
Clinical epidemiology
Modern term for application of clinical epidemiolody to the care of patients
Evidence based medicine
A set of symptoms. physical signs, and laboratory abnormalites
Disease
Symptoms such as pain, nausea, dyspnea, itching, tinnitus
Discomfort
Impaired ability to go about usual activities at home, work or recreation
Disability
Emotional reaction to disease and its care such as sadness and anger
Dissatisfaction
A bad outcome if untimely
Death
An arbitary cut off point on the frquency of distribution in normal
2 SD above or below the mean
In use of percentile, ___ % is considered the dividing line between normal and abnromal
95%
5% population is abnormal
Increased risk of furture disease
Abnormality
/it is better to define values of a particular test if they are associated with the presence of disease state
Abnormal as clinical disease
Determined by evidence from ramdomized controlled trials which indicate the level at which treatment does more good than harm
-rarely available in clinical practice
Abnormal as treateable
What is wrong with me
Diagnosis
To help in confirming possible diagnoses suggested by for example, the demographic features and symptoms od the patient
Purpose
- Begins at diagnosis
- express probability that a particular event will occur
- Foretelling
Prognosis
Evolution of the disease that has come under medical care
Clinical Course
Prognosis of disesase without medical intervention
Natural History
These factors influence disease progression
Prognostic Risk Factors
Characteristics associated with outcome in patients with the disease in question
Prognostic factors
Important to determine when to intervene
Knowledge about stages, mechanisms, cause of disease, and prognostic risk factors
Types of clinical prevention
Immunization, screening, behavioral counseling
Level of prevention: Keeps disease from occuring at all by removing its causes
Primary prevention
Detects early disease when it is asymptomatic and when treatment can stop it from progressing
Secondary prevention
Describes the clinical activities that prevent deteriotation or reduce complications after a disease has declared itself
Tertiary prevention
Denotes wether or not a patient benefits from the medical care provided
Outcome
Does the agent or intervention “work” under ideal “laboratory” conditions?
Efficacy
Measure in a situation in which all conditions are controlled to maximize the effect of agent
Efficacy
If we administer the agent in “real life” is it effective?
Effectiveness
If an agent is shown to be effective, what is its cost benefit ratio?
- cost includes not only money but also discomfort, pain, absenteeism, disability, social stigma
Efficiency
Best study design to prove effectiveness of treatment
Randomized Controlled trials
