Practical Application of Epidemiology Flashcards
Secular trends
changes over a long period of time, generally years or decades
Cyclic fluctuations
An increase or decrease in the frequency of a disease or health condition in a population over a short period of time.
How does the chart on the leading causes of death in the U.S in 1900 differ from that of 2009?
In 1900, the deaths were caused by infectious diseases such as influenza and pneumonia; In 2009, the deaths were caused by chronic diseases such as heart and respiratory problems.
What were the factors affecting reliability of observed changes in leading causes of death in the U.S?
- Lack of comparability over time due to altered diagnostic criteria ( having new case definition such as having new cut offs for BP).
- Aging in the general population (baby boomers created for a larger number of older people in the community).
- Changes in the fatal course of the condition.
- Changes in diagnostic coding system (every 10 yrs, there’s a newer revision of ICD, so there may be different criteria every yr).
- Efficient surveillance system ( better screening or diagnostic techniques…affects of under reporting)
Four trends in disorders
- Disappearing
- Residual
- Persisting
- New epidemic
What are disappearing disorders?
Conditions that were once common but are no longer present in epidemic form.
Give examples of disappearing disorders
- Small pox
- Polio
- Schistosomiasis japonica
What led to the eradication/elimination of disappearing diseases?
- Improvement of sanitary conditions
- Immunization/ Vaccination
- Use of antibiotics and other medication
- Control for vectors/reservoirs/animal hosts
What are residual disorders?
When the key contributing factors are unknown or the methods of control are not being implemented properly.
Give examples of residual disorders
STDs, health problems related to alcohol and tobacco use.
Give an example of a persisting disorder?
cancer or mental disorders. Essentially diseases that have no effective method of prevention or known cure.
Diseases that increase in frequency are called what? and give and example
New epidemic disorders; diabetes and new influenza strains.
What are the 3 things predicted about the future?
- Demographic projection (about 20% of the U.S population in 2030 will be age 65 and older)
- The need for health and aging related services will grow.
- Demographic and epidemiological transitions.
knowing the health of the community provides what?
- a key to the types of problems requiring attention
- Determine the need for specific health services (for specific population groups.
- Health related outcome variables
Epidemiology and policy evaluation involves what?
- Using epidemiologist methodologies to enact and evaluate public health policies
Examples: tobacco control policies and food served in schools.
Epidemiology and Health Services falls into what two categories?
Operations research and program evaluation
Operations research involves what two things?
- Assessment - helps identify what health services are needed and regional assessments are performed in by hospitals to assess the community.
- Evaluation of healthcare utilization - helps prevent unnecessary duplication and provides info on underutilized of some services and identification of why people are not utilizing them.
Program Evaluation
Uses epidemiological tools to determine how well a health program meets certain stated goals.
Why do epidemiologists prefer to use the term “risk factor” over “cause”?
Because many of the studies have conflicting results. and there is an uncertainty attached to it.
What are the 3 criteria for Risk Factors
- Frequency of the disease varies by category or value of the factor.
- Risk factor precedes onset of the disease
- Observed association must not be due to error
What are the 9 Bradford Hill Criteria
-Strength of association, time sequence, consistency upon repetition, specificity, coherence of explanation, biologic gradient, plausibility, experiment, and analogy.
How does epidemiological research result impact clinical decisions?
Size of the risk/effect size, consistency, biological plausibility, relevance to each patient, predicting prognosis of disease, public health implications.
What is the importance of knowing the natural history of a disease?
It helps us identify where in a disease’s natural history effective intervention might be implemented.
Parthenogenesis means what?
An health individual
Preclinical phase/disease onset is when …
the disease process has started, but not showing symptoms yet
Primary prevention occurs during what phase?
Prepathogenesis phase. This is the phase where one can have health promotions and specific protection against diseases.
what is active primary prevention?
necessitates behavior change on the part of the subject such as vaccinations, condom use, and smoking cessation.
What is passive primary prevention?
does not require any behavior change such as fluoridation of public water.
What type of prevention occurs during preclinical phase?
Secondary prevention
Functions of secondary prevention
Designed to reduce the progress of disease( early diagnosis and prompt treatment). Examples are screening programs such as cancer, diabetes, HIV, and BP.
functions of tertiary prevention
Restores optimal functioning (rehabilitation) and limits disability from disease. Examples are physical therapy for stroke, patients, fitness programs for patients with heart disease.
What phase is tertiary prevention?
clinical phase - treatment after diagnosis.
