Population Health Flashcards

1
Q

Main reason for increased life expectancy in Canadians

A

Decreased infant mortality rate

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2
Q

Lead time bias

A

Overestimate the survival time from dx b/c screening at occult stage of dz vs dx at later stage

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3
Q

Length time bias

A

Overestimate the survival time due to screening at one point including more stable cases than aggressive cases, who may have shorter survival times

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4
Q

Screening test must have high sensitivity or specificity?

A

High sensitivity

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5
Q

Incidence

A
# new cases in a time interval / persons at risk in time interval
Measures rate of new infections
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6
Q

Prevalence

A
# existing cases at a point in time / persons at risk at that time 
Measures frequency of disease at a point in time
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7
Q

Top 5 causes of mortality in women in Canada

A
Cancer
Heart disease 
Stroke 
Chronic lower respiratory dz 
Accidents
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8
Q

Top 5 causes of mortality in men in Canda

A
Cancer
Heart disease 
Accidents 
Chronic lower respiratory dz 
Stroke
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9
Q

Specific test

A

Use to rule IN a hypothesis

Very few false positives

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10
Q

Sensitive test

A

Use to rule OUT a hypothesis

Very few false negatives

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11
Q

Likelihood Ratio definition

A

Likelihood that a given test result would be expected in a pt with disease compared with likelihood that same result would be expected in pt without disease

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12
Q

Likelihood ratio + equaiton

A

Sensitivity / (1- specificity) = (TP / (TP + FN)) / (FP/(TN+FP)
How much the probability of a disease increases if the test is positive

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13
Q

Likelihood ratio - equation

A

(1-sensitivity)/specificity = (FN/(TP+FN)) / (TN/(TN+FP))

How much the probability of disease decreases if the test is negative

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14
Q

Positive predictive value

A

Proportion of ppl with +ve test who have the disease

PPV = TP / (TP + FP)

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15
Q

Negative predictive value

A

Proportion of ppl with -ve test who don’t have the disease

NPV = TN / (TN + FN)

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16
Q

Sensitivity

A

Proportion of ppl with disease who have a +ve test

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17
Q

Specificity

A

Proportion of ppl without disease who have a -ve test

18
Q

Sensitivity/specificity are characteristics of the test or prevalence of the disease?

A

Test

19
Q

Likelihood ratio depends on the test or prevalence of the disease?

A

Test

20
Q

PPV and NPV depend on the test or prevalence of the disease?

A

Prevalence

21
Q

Pretest probability

A

Probability particular pt has given disease before test/assessment results are known

22
Q

Posttest probability

A

Revision of probability of dz after pt has been interviewed/examined/tested

23
Q

Odds Ratio eq

A

(A/C) / (B/D)

Ratio of the odds in favour of disease among the exposed to odds in favour of no disease among the exposed

24
Q

Relative risk

A

(A/(A+B) / (C/ C+D)

Ratio of risk of a disease among exposed to risk among unexposed

25
Q

Attributable risk

A

Rate of health outcome in exposed individuals that can be attributed to exposure

26
Q

PICO

A

Population
Intervention
Comparison Group or Control Group
Outcome that you are trying to prevent or achieve

27
Q

P-value

A

Denotes the probability that the error of declaring an observed difference to be real rather than by chance
P<0.05

28
Q

Power

A

Probabilty of a true positive result

29
Q

95% confidence interval means

A

If this test were repeated 100 times, 95 times the result would fall within the interval

30
Q

Level 1 evidence

A

Based on RCTs big enough to have low risk of incorporating FP or FN results

31
Q

Level II evidence

A

Based on RCTs too small to provide level I evidence

32
Q

Level III evidence

A

Based on non-randomized, controlled or cohort studies

33
Q

Level IV evidence

A

Based on opinion of respected authorities or expert committees

34
Q

Level V evidence

A

Opinions of individuals who have written/reviewed the guidelines based on experience/knowledge

35
Q

Common diseases spread by contact

A

Impetigo
Chicken pox
Warts

36
Q

Common diseases spread by airborne

A

TB

37
Q

Common diseases spread by droplet

A

Influenza
Mumps
Pneumonia

38
Q

10 step approach to control an outbreak

A
  1. Identify the team (local public health units)
  2. Establish existence of an outbreak
  3. Verify dx (obain medical records)
  4. Define a case (Person, place, time)
  5. Find cases systemically and create a line listing
  6. Perform descriptive epidemiology and develop hypotheses
  7. Evaluate hypotheses and conduct additional studies as needed (case-control or cohort studies)
  8. Implement control measures (can occur at any stage in outbreak)
  9. Communicate findings
  10. Continue surveillance
39
Q

Risk assessment for environmental exposures

A

HIRA
Hazard Identification
Risk characterization
Exposure Assessment

40
Q

Contaminants in water

A
E. coli 
Salmonella
Pseudomonas
Shigella 
Giadia (protozoa) 
Cryptosporidium (protozoa)
41
Q

Contaminants in soil

A

Tetanus

Pseudomonas

42
Q

Common reportable diseases

A
AIDS
Botulism 
Campylobacter enteritits 
Chancroid 
Chickenpox 
CHlamydia 
Cholera
CDiff 
Creutzfelt-Jakob 
Crypospoidiosis, cyclosporiasis
Diphtheria
Encephalitis (even if viral) 
Food poisoning all causes 
Gastroenteritis institutional
Gonorrhea 
H. influenza b invasive 
Ebola 
Hepatitis 
Legionellosis 
Listeriosis 
Lym disease
malaria
Measles 
Meningitis 
Meningococcal 
Mumps
Pertussis
Pneumococcal invasive
Polio
Rabies
Rubella 
Salmonellosis 
SARS
Shigellosis 
Smallpox 
Strep invasive 
Syphilis 
Tetanus 
TB 
Typhoid 
West nile, yellow fever