Public Health Flashcards by Abby Russell

What are the 3 types of prevention?

Primary - prevent it occuring
Secondary - detect in early phase
Tertiary - slow down disease progression

How well did you know this?

Not at all

Perfectly

What is prevention paradox?

Preventative measure which brings benefit to population but little to each individual

How well did you know this?

Not at all

Perfectly

What is sensitivity formula?

True positive / (true positive + false negatives)

How well did you know this?

Not at all

Perfectly

What is specificity formula?

True negatives / (true negatives + false positives)

How well did you know this?

Not at all

Perfectly

What is positive predictive value formula?

True positive / (true positive + false positives)

How well did you know this?

Not at all

Perfectly

What is negative predictive value formula?

True negative / (True negative + false negatives)

How well did you know this?

Not at all

Perfectly

What is ecological study?

Observational study of case reports of groups rather than individuals -> no causation

How well did you know this?

Not at all

Perfectly

What is a cross-sectional study?

Study used to generate hypotheses by looking at population at ONE point in time -> cannot assess incidence + recall bias

How well did you know this?

Not at all

Perfectly

What is a case control study?

Retrospective study which matches people with and without the disease to a factor -> cannot assess causation and recall bias

How well did you know this?

Not at all

Perfectly

What is a cohort study?

Prospective study which can establish causation -> takes a long time

How well did you know this?

Not at all

Perfectly

What is an RCT?

Randomising control and intervention groups and measuring outcomes -> time consuming and expensive

How well did you know this?

Not at all

Perfectly

What is incidence?

Number of new cases of a disease in a population

How well did you know this?

Not at all

Perfectly

What is prevalence?

Total number of people in a population at one point in time

How well did you know this?

Not at all

Perfectly

What is relative risk?

Incidence in exposed / unexposed

How well did you know this?

Not at all

Perfectly

What is attributable risk?

Incidence in exposed - incidence in unexposed

How well did you know this?

Not at all

Perfectly

What is relative risk reduction?

(Incidence in unexposed - exposed) / incidence in unexposed

How well did you know this?

Not at all

Perfectly

What is absolute risk reduction?

Incidence in unexposed - incidence in exposed

How well did you know this?

Not at all

Perfectly

What is odds?

Probability / (1 - probability)

How well did you know this?

Not at all

Perfectly

What is odds ratio?

(P exposed ÷ [1 – P exposed]) ÷ (P unexposed ÷ [1 – P unexposed])

How well did you know this?

Not at all

Perfectly

What is number needed to treat?

1 / (incidence in unexposed - incidence in exposed)

What is epigenetics?

Study of how genes interact with environment

What are the 3 concerns of public health?

Inequalities
Wider determinants of health
Prevention

What are the 3 domains of public health?

Improvement
Protection
Improving services

What is equality vs equity?

Equality - concerned with equal shares
Equity - concerned with what is fair and just

What is horizontal vs vertical equity?

Horizontal - equal treatment for equal need Vertical - unequal treatment for unequal need

What are the Fraser guidelines?

- Understand advice - Cannot be persuaded to inform parents - They will continue to have sex without contraception - Physical/Mental health may suffer without contraception - Best interest of patient

What are the 3 things needed for DOLS?

- Patient is under continuous supervision and control - Person is not free to leave - Person lacks capacity to consent to this

What are screening tests in pregnancy?

- Hep B - HIV - Syphilis - Downs, Edwards, Patau - Sickle cell and thalassaemia

What are newborn screening?

- NIPE - Hearing - Heel prick

What are the adult screening programmes?

- Diabetic eye - Cervical - Breast - Bowel - AAA

What is selection bias?

Error in assigning individuals to groups may lead to differences which influence outcomes

What is lead time bias?

When screening identifies outcomes earlier than they would have resulting in an apparent increase in survival time but it has no effect on outcomes

What are the phases of clinical trials?

1 - safety assessment on healthy volunteers 2 - Assess efficacy on those with disease 3 - Large scaled RCT to assess effectiveness 4 - Post marketing surveillance

What is confounding bias?

A factor which is associated with what you are looking at and independently influences outcome but is not considered in the study

What are examples of parametric (can be measured) tests?

- T-test - Pearon's product moment coefficient

What are non parametric (cannot be measured) tests?

- Mann-Whitney U test (compares - Chi-squared test (compare proprtions/percentages) - Spearman rank

What is a Bolam and Bolitho test?

Bolam: A test used to judge the expected standard for doctor If they do not meet the standards then the Bolitho test is used Bolitho: scrutinise actions to see if they are logical

What is important about DNACPR?

It is not legally binding -> a decision can overrule this if CPR is now in best interests

What is an advanced decision?

A legally binding document to refuse treatment they do not want to happen

What are the important criteria around advanced decisions?

- Had capacity - Over 18 - Written down and witnessed - Cannot include basic care like washing. pain relief etc

What is an advanced statement?

A statement of wishes, beliefs and values around their future care which is not legally binding but should be considered when making best interests decisions under Capacity Act

What is a doctrine of double effect?

Accept an action if the intention is good even if it may lead to harm

What are the key principles of the capacity act?

- Capacity is assumed - Individuals should be enabled people to make their own decisions - They can make unwise decisions - Decisions must be made in their best interests - Least restrictive option should be used

What do Box and Whisker plots show?

Box - median and 2 quartiles Whiskers - 1st and last data value

What are type 1 and type 2 errors?

Type 1 - rejecting a null hypothesis when it is true Type 2 - failing to reject a null hypothesis when it is false

What is validity?

How accurately a study measures what it is supposed to

What is reliability?

How consistent the results are

What is attrition bias?

Skew in data due to a systematic issue in study e.g. people dropping out