Practical Application of Epidemiology

Question 1

Secular trends

Answer 1

changes over a long period of time, generally years or decades

Question 2

Cyclic fluctuations

Answer 2

An increase or decrease in the frequency of a disease or health condition in a population over a short period of time.

Question 3

How does the chart on the leading causes of death in the U.S in 1900 differ from that of 2009?

Answer 3

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.

Question 4

What were the factors affecting reliability of observed changes in leading causes of death in the U.S?

Answer 4

1. Lack of comparability over time due to altered diagnostic criteria ( having new case definition such as having new cut offs for BP).
2. Aging in the general population (baby boomers created for a larger number of older people in the community).
3. Changes in the fatal course of the condition.
4. Changes in diagnostic coding system (every 10 yrs, there’s a newer revision of ICD, so there may be different criteria every yr).
5. Efficient surveillance system ( better screening or diagnostic techniques…affects of under reporting)

Question 5

Four trends in disorders

Answer 5

1. Disappearing
2. Residual
3. Persisting
4. New epidemic

Question 6

What are disappearing disorders?

Answer 6

Conditions that were once common but are no longer present in epidemic form.

Question 7

Give examples of disappearing disorders

Answer 7

1. Small pox
2. Polio
3. Schistosomiasis japonica

Question 8

What led to the eradication/elimination of disappearing diseases?

Answer 8

1. Improvement of sanitary conditions
2. Immunization/ Vaccination
3. Use of antibiotics and other medication
4. Control for vectors/reservoirs/animal hosts

Question 9

What are residual disorders?

Answer 9

When the key contributing factors are unknown or the methods of control are not being implemented properly.

Question 10

Give examples of residual disorders

Answer 10

STDs, health problems related to alcohol and tobacco use.

Question 11

Give an example of a persisting disorder?

Answer 11

cancer or mental disorders. Essentially diseases that have no effective method of prevention or known cure.

Question 12

Diseases that increase in frequency are called what? and give and example

Answer 12

New epidemic disorders; diabetes and new influenza strains.

Question 13

What are the 3 things predicted about the future?

Answer 13

1. Demographic projection (about 20% of the U.S population in 2030 will be age 65 and older)
2. The need for health and aging related services will grow.
3. Demographic and epidemiological transitions.

Question 14

knowing the health of the community provides what?

Answer 14

1. a key to the types of problems requiring attention
2. Determine the need for specific health services (for specific population groups.
3. Health related outcome variables

Question 15

Epidemiology and policy evaluation involves what?

Answer 15

1. Using epidemiologist methodologies to enact and evaluate public health policies

Examples: tobacco control policies and food served in schools.

Question 16

Epidemiology and Health Services falls into what two categories?

Answer 16

Operations research and program evaluation

Question 17

Operations research involves what two things?

Answer 17

1. Assessment - helps identify what health services are needed and regional assessments are performed in by hospitals to assess the community.
2. 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.

Question 18

Program Evaluation

Answer 18

Uses epidemiological tools to determine how well a health program meets certain stated goals.

Question 19

Why do epidemiologists prefer to use the term “risk factor” over “cause”?

Answer 19

Because many of the studies have conflicting results. and there is an uncertainty attached to it.

Question 20

What are the 3 criteria for Risk Factors

Answer 20

1. Frequency of the disease varies by category or value of the factor.
2. Risk factor precedes onset of the disease
3. Observed association must not be due to error

Question 21

What are the 9 Bradford Hill Criteria

Answer 21

-Strength of association, time sequence, consistency upon repetition, specificity, coherence of explanation, biologic gradient, plausibility, experiment, and analogy.

Question 22

How does epidemiological research result impact clinical decisions?

Answer 22

Size of the risk/effect size, consistency, biological plausibility, relevance to each patient, predicting prognosis of disease, public health implications.

Question 23

What is the importance of knowing the natural history of a disease?

Answer 23

It helps us identify where in a disease’s natural history effective intervention might be implemented.

Question 24

Parthenogenesis means what?

Answer 24

An health individual

Question 25

Preclinical phase/disease onset is when …

Answer 25

the disease process has started, but not showing symptoms yet

Question 26

Primary prevention occurs during what phase?

Answer 26

Prepathogenesis phase. This is the phase where one can have health promotions and specific protection against diseases.

Question 27

what is active primary prevention?

Answer 27

necessitates behavior change on the part of the subject such as vaccinations, condom use, and smoking cessation.

Question 28

What is passive primary prevention?

Answer 28

does not require any behavior change such as fluoridation of public water.

Question 29

What type of prevention occurs during preclinical phase?

Answer 29

Secondary prevention

Question 30

Functions of secondary prevention

Answer 30

Designed to reduce the progress of disease( early diagnosis and prompt treatment). Examples are screening programs such as cancer, diabetes, HIV, and BP.

Question 31

functions of tertiary prevention

Answer 31

Restores optimal functioning (rehabilitation) and limits disability from disease. Examples are physical therapy for stroke, patients, fitness programs for patients with heart disease.

Question 32

What phase is tertiary prevention?

Answer 32

clinical phase - treatment after diagnosis.