Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anki 3a exports > Public health > Flashcards

Public health Flashcards

1
Q

Define public health

A

The science and art of preventing disease prolonging life and improving health through organised efforts of society

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define equity

A

Giving people what they need to achieve equal outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define equality

A

Giving everyone the same rights, opportunities and resources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define horizontal equity

A

Equal treatments for people with equal healthcare needs

E.g. same tx used for pneumonia in different patients with the same severity of pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define vertical equity

A

Unequal treatments for unequal health care needs

E.g. different treatments used in less severe vs more severe pneumonias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the inverse care law?

A

Availability of health care tends to vary inversely with its need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are determinants of health?

A

Wide range of factors that influence a person’s health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name some determinants for health

A

PROGRESS
Place of residence
Race
Occupation
Gender
Religion
Education
Socioeconomic
Social capital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 domains of public health?

A

Health improvement
Health protection
Improving services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is meant by ‘health improvement’

A

Interventions aimed at promoting overall health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is meant by ‘health protection’

A

Measures to control infectious disease and environmental hazards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is meant by ‘improving services’

A

Organisation and delivery of safe, high quality services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name some frameworks used to assess the quality of healthcare

A

Maxwell’s dimensions of quality of healthcare
Structure, process, outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe Maxwell’s dimensions of quality of healthcare

A

3As and 3 Es

Acceptability
Accessibility
Appropriateness

Effectiveness
Efficiency
Equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give an example of a structure in the ‘structure, process, outcome’ framework

A

Number of hospitals, number of doctors etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give an example of a process in the ‘structure, process, outcome’ framework

A

Number of patients seen, number of tests done, number of surgeries done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give an example of an outcome in the ‘structure, process, outcome’ framework

A

Number of deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a health needs assessment?

A

A systematic approach for reviewing health issues affecting a population in order to enable agreed priorities and resource allocation to improve health and reduce inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 3 main things taken into account in a health needs assessment?

A

Need: ability to benefit from an intervention
Demand: what people ask for
Supply: what is provided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give an example of something that is supplied and demanded but not needed

A

Abx for a viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Give an example of something that is demanded and needed but not supplied

A

Large waiting lists for procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give an example of something that is needed and supplied but not demanded

A

Routine vaccinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the types of needs in a health needs assessment

A

Felt need
Expressed need
Normative need
Comparative need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a ‘felt’ need? Give an example

A

Individual perceptions of variation form normal health-‘I feel unwell’, ‘My knee hurts’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is an ‘expressed’ need? Give an example

A

Individual seeks help to overcome variation in normal health-goes to dr
E.g. going to the dentist for a toothache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is a ‘normative’ need? Give an example

A

Professional defines intervention for the expressed need
E.g. Vaccinations, decision by surgeon that a patient needs an operation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a ‘comparative’ need? Give an example

A

Needs identified by comparing services received by one group vs another
E.g Rural village may identify need for a school if the neighbouring village has one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the 3 perspective of a health needs assessment?

A

Epidemiological
Comparative
Corporate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does an epidemiological perspective of a health needs assessment look at?

A

1)Size of population-incidence/prevalence
2)Service available-prevention/treatment/care
3)Evidence base-(cost)effectiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What sources might be used when carrying out a epidemiological health needs assessment?

A

Disease registry
Admissions
GP databases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name some advantages of using an epidemiological perspective to a health needs assessment

A

Uses existing data
Provides data on disease incidence/mortality/morbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Name some disadvantages of using an epidemiological perspective for a health needs assessment

A

Quality of data is variable
Data collected may not be data required
Does not consider felt needs/opinions of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Give an example of an epidemiological perspective

A

Looking at new incidence of measles in a certain town through GP records

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is involved in the comparative perspective of a health needs assessment?

A

Compares services/outcomes received by a population with others
Could compare different areas of patients of different ages etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does a comparative perspective of a health needs assessment look at?

A

Health status
Service provision
Outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Name some advantages of using a comparative assessment for a health needs assessment

A

Quick and cheap if data available
Shows if services are better/worse than compared group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Name some disadvantages of using a comparative perspective for a health needs assessment

A

Can be difficult to find comparable population
Data may not be available/high quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Give an example of a comparative perspective

A

Compare rated of CVD between town A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is involved in a corporate perspective for a health needs assessment

A

Asks local populations what their health needs are
Uses focal groups, interview, public meetings
Wide variety of stakeholders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Name some advantages of using a corporate perspective for a health needs assessment

A

Based on felt and expressed needs of population
Recognises detailed knowledge and experience f those working with the population
Takes into account a wide range of views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Name some disadvantages of using a corporate perspective for a health needs assessment

A

Can be difficult to distinguish needs from demand
Groups may have vested interest
May have political agendas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Give an example of using a corporate perspective for a health needs assessment

A

Arrange focus group with patient from a GP surgery to discuss their views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Name some different approaches to resource allocation

A

Egalitarian: provide ALL care that is necessary and required for everyone(NHS)
Maximising: Act is evaluated solely in terms of its consequences(flu vaccine)
Libertarian: Each is responsible for their own health(private ehalthcare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Name an advantage and disadvantage to an egalitarian approach to resource allocation

A

Good: equality
Bad: too expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Name an advantage and disadvantage to a maximising approach to resource allocation

A

Good: resources allocated to those most likely to benefit it
Bad: Those who don’t make the cut get nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Name an advantage and disadvantage to a libertarian approach to resource allocation

A

Good: promotes positive engagement
Bad: Most diseases are not self inflicted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the 3 kinds of prevention

A

Primary
Secondary
Tertiary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is secondary prevention

A

Early identification of the disease to alter the disease course e.g screening, aspirin after a MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is primary prevention?

A

Preventing the disease from occurring in the first place
E.g. vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is tertiary prevention?

A

Limit consequences of established disease
E.g. prevent worsening renal function in CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is a population approach to prevention

A

Delivered to everyone to shift the risk factor distribution curve
E.g. dietary salt reductions through legislation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is a high risk approach to prevention?

A

ID all individuals above a chosen cut off an treat them
E.g. screening people for high BP and treating them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is meant by the prevention paradox?

A

Preventative measure that brings much benefit to the population often offers little impact to each participating individual
E.g. mass immunisation

53
Q

What is the purpose of screening?

A

ID apparently well individuals who have or at risk of developing a particular disease so you can have a real impact on the outcome

54
Q

Name some disadvantages to screening

A

Exposure of well individuals to distressing/harmful diagnostic tests
Detection and treatment of sub-clinical disease that wouldn’t cause a problem
Preventative intervention that may cause harm to the individual or population

55
Q

What screening programmes are done for pregnant women in the UK

A

Infectious diseases(hep B, syphilis, HIV)
Sickle cell and thalassaemia screening
Fetal anomaly screening(Down’s, Edward’s, Patau’s)

56
Q

What screening programmes are in place for newborn babies?

A

NIPE(heart, eyes, hips, testes)
Hearing screening programme
Blood spot(sickle cell, CF, congenital hypothyroidism)

57
Q

What screening programmes are done for young people and adults in the UK?

A

AAA screening
Bowel cancer
Breast cancer
Cervical screening
Diabetic eye screening

58
Q

What criteria is used to determine if screening should be done for a disease?

A

Wilson and Jungner criteria

59
Q

Describe the Wilson Jungner criteria

A

In Exam Season NAP
Important disease
Effective tx available
Simple and safe
Natural hx of disease known
Acceptable to patients
Policy on who to treat

60
Q

Define sensitivity

A

Proportion of those with disease who are correctly identified
(If you have the disease, what are the chances the test will pick it up?)

61
Q

Define specificity

A

Proportion of people without disease who are currently excluded by screening test
(If you don’t have the disease, what are the chances the test will tell you you don’t)

62
Q

Define positive predictive value

A

Proportion of people with a positive test result who actually have the disease
(SNIP-Sensitivity is positive)

63
Q

Define negative predictive value

A

Proportion of people with a negative test result who do not have the disease
SPIN)Sensitivity is negative)

64
Q

What are predictive values influenced by?

A

Underlying prevalence

65
Q

How do you calculate sensitivity?

A

people with the disease+positive screening/everyone who has the disease

66
Q

How do you calculate specificity?

A

People with negative result who don’t have disease/everyone who doesn’t have the disease

67
Q

How do you calculate the positive predictive value?

A

people with positive result who have the disease/everyone with a positive result

68
Q

How do you calculate the negative predictive value

A

Those with negative result who don’t have disease/everyone who receives a negative result

69
Q

Name 2 biases associated with screening

A

Length time bias
Lead time bias

70
Q

What is length time bias?

A

Screening is more likely to detect slow-growing disease that has a long phase without symptoms-> appear to be survival benefit to screening even when early detection doesn’t improve outcomes

71
Q

What is lead time bias?

A

Patients diagnosed appear to live longer because they know the have the disease for longer-> awareness of disease makes it falsely seem like early diagnosed patients live longer

72
Q

Describe the hierarchy oof evidence

A

Editorials and expert opinions
Case series and case reports
Case-control studies and cross sectional studies
Cohort studies
RCT
Systematic review and met-analysis

73
Q

Describe the features of a case-control study

A

Retrospective, observational study looking at the cause of disease
Compares similar participant with disease to controls without
‘Case’ and ‘control’: look for exposure in both cases and control group and see what the effects are

74
Q

Name some advantages of a case-control study

A

Good for rare outcomes
Quicker than cohort or intervention studies(outcome already happened)
Can investigate multiple exposures

75
Q

Name some disadvantages of a case-control study

A

Difficulties finding controls to match with case
Prone to selection and information bias

76
Q

Describe the features of a cross-sectional study

A

Retrospective observational collects data from a population at a specific point in time ‘snapshot’
Prevalence of risk factors and disease itself

77
Q

Name some advantages of a cross-sectional study

A

Relatively quick and cheap
Provide data on prevalence at single point in time
Good for surveillance and PH planning

78
Q

Name some disadvantages of a cross-sectional study

A

Risk of reverse causality
Can’t measure incidence
Recall and response bias risk(may miss quick recovery)

79
Q

Describe the features of a cohort study

A

Prospective longitudinal study looking at separate cohorts with different treatments/exposures and waiting to see if disease occurs

80
Q

Name some advantages of a cohort study

A

Can follow up group with a rare exposure
Good for common and multiple outcomes-> establish disease risk and confounders
Less risk of selection and recall bias

81
Q

Name some disadvantages of a cohort study

A

Takes a long time
People drop out
Need large sample size, expensive and time consuming

82
Q

Describe the features of a randomised control trial

A

Prospective study, all participants randomly assigned exposure or control intervention

83
Q

Name some advantages of a RCT

A

Low risk of bias and confounding factors
Can infer causality

84
Q

Name some disadvantages of RCT

A

Time consuming, expensive
Drop outs
Inclusion criteria may exclude some populations

85
Q

Describe the features of an ecological study

A

Looks at prevalence of disease over time(population data rather than individual)
Can show prevalence and association but not causation

86
Q

What are ‘odds’ used for looking at?

A

Looking at binary outcomes: disease occurs or does not

87
Q

How do you work out odds?

A

Probability of an event occurring/probability of an event not occuring

88
Q

What is an odds ratio used for?

A

Compare the odds of an outcome occurring between two groups: usually the group with the exposure/treatment and a control group

89
Q

How do you work out odds ratio?

A

Odds of an event(Condition A)/Odds of an event(condition B-control group)

90
Q

What is an absolute risk?

A

Number of events(good or bad) in a treated(exposed) or control(non-exposed) group, divided by the total number of people in that group
Compared risk of health event between 2 groups

91
Q

How do you calculate the absolute risk reduction?

A

Absolute risk of events in control group-absolute risk of events in the treatment group

92
Q

How do you calculate relative risk?

A

Absolute risk(treatment)/absolute risk(control)

93
Q

How do you calculate relative risk reduction?

A

1-relative risk

94
Q

How do you calculate the number needed to treat?

A

1/absolute risk reduction

95
Q

What is meant by numbers needed to treat?

A

Number of pts needed to treat for one to benefit

96
Q

How do you calculate the number to harm?

A

1/(absolute risk in treatment group-absolute risk in control group

97
Q

What does relative risk not take into account?

A

Baseline risk

98
Q

Describe the to interpret relative risk and odds ratios

A

=1: no statistical difference between control and intervention
>1: control better
<1: intervention bettwe

99
Q

How should you interpret confidence intervals?

A

95% statistically significant

100
Q

Name some advantages of using an odds ratio

A

Very simple
Don’t need incidence
Binary outcome
Usually used in retrospective studies

101
Q

Name a disadvantage of using an odds ratio

A

Can overestimate risk in rare disease

102
Q

Name some features that might make yu use relative risk rather than odds ratio

A

Needs incidence of disease
Usually prospective, cross sectional, cohort and RCT
Able to examine and model a variable over time

103
Q

Name some different types of bias

A

Measurement bias
Observer bias
Recall bias
Reporting bias
Selection bias
etc

104
Q

What are the 4 types of information bias

A

Measurement bias
Observer bias
Recall bias
Reporting bias

105
Q

What is measurement bias?

A

Different equipment measuring differently

106
Q

What is observer bias

A

Observers expectations influence reporting

107
Q

What is recall bias

A

Past events not recalled correctly

108
Q

What is reporting bias?

A

People don’t tell the truth because od shame or judgement

109
Q

What is selection bias?

A

Bias in recruiting for a study
Some may be lost to follow up

110
Q

What is publication bias?

A

Trials with negative results less likely to be published

111
Q

What criteria is used for assessing causality?

A

Bradford-Hill criteria

112
Q

Describe the Bradford Hil criteroa

A

Strength
Temporality
Coherence
Consistency
Plausability
Analogy
Dose response
Reversibility
Specificity

113
Q

What is meant by strength in the Bradford hill criteria

A

The stronger the association between exposure and outcome, the less likely the relationship is due to a different factor
High relative risk

114
Q

What is meant by temporality in the bradford hill criteria

A

Most important
Exposure occurs before the outcome
Smoke before getting lung cancer

115
Q

What is meant by dose-response?

A

More risk of outcome with more exposure
Heavier smokers have higher risk of lung cancer

116
Q

What is reversibility with regards to the Bradford hill criteria

A

Removing the exposre decreases/eliminates risk
Stopping smoking reduces risk of lung cancer

117
Q

What is consistency with regards to the Bradford hill criteria

A

Association is seen in different areas, different study designs, in different subjects-repeatability

118
Q

What is plausability with regards to the Bradford hill criteria

A

Existence of reasonable biological mechanism for the cause and effect lends weight to the association

119
Q

What is meant by coherence with regards to the Bradford hill criteria

A

Logical consistency with other information

120
Q

What is meant by analogy with regards to the Bradford hill criteria

A

Similarity with other established cause effect relationships

121
Q

What is meant by specificity with regards to the Bradford hill criteria

A

Relationship is specific to outcome of interest

122
Q

What is a confounder?

A

Apparent association between an exposure and an outcome is actually the result of another factor

123
Q

Name some causes of association

A

Bias
Confounding factors
Chance
Reverse causality
True association-confirmed by Bradford hill criteria

124
Q

Define epidemiology

A

Study of frequency, determinants and distribution of diseases and health related states in populations in order to prevent and control disease

125
Q

Define incidence

A

Number of new cases over a certain time period

126
Q

Define prevalence

A

Number of people with a disease at a certain point in time

127
Q

Define person time

A

Measure of time at risk for all patients n the study
(1000 patients studied for 2.5 years: 2500 person years)

128
Q

What is the difference between incidence and prevalence?

A

Incidence: changes with time, new cases
Prevalence: number at a set time of existing cases

129
Q
A

Anki 3a exports (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions