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PPP Block > Public Health > Flashcards

Public Health Flashcards

1
Q

Relative Risk (RR)

A

An estimate of the magnitude of an association between exposure and outcome.
Likelihood of developing outcome for the exposed relative to the unexposed.

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2
Q

Absolute Risk Reduction (ARR)

A

DIFFERENCE in incidence of outcome between exposed and unexposed.

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3
Q

Number Needed to Treat (NNT)

A

Number of patients needed to be treated in order to prevent ONE adverse outcome (incidence)

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4
Q

Efficacy

A

Combination of RR and ARR. How much of the risk in placebo (exposed) group is reduced by the new treatment (unexposed)?

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5
Q

How does RR measure the strength of an association?

A

The RR tells us how much more/less likely two variables are related. (Strength of etiologic association)

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6
Q

How does ARR measure the strength of an association?

A

ARR will evaluate the actual impact of applying one variable to the other. (ie. treatment group had 2% less bad outcomes than placebo)

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7
Q

Population Attributable Risk (PAR)

A

Indicates proportion of the risk in the GENERAL POPULATION that would be removed if exposure was eliminated.
This is “efficacy.”

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8
Q

Which is most important to public health?: RR, ARR, or PAR?

A

PAR- Population attributable risk

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9
Q

Association

A

Statistical dependence between 2 variables. Does not show causality.

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10
Q

Type 1 Error (alpha)

A

False Positive. We note they are different when they aren’t.

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11
Q

Type 2 Error (beta)

A

False negative. We note they aren’t different when they are.

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12
Q

Hypothesis Testing Steps (3)

A
  1. Define null hypothesis
  2. Calculate probability of observed data if null were true (ie. “tinker plot”)
  3. Look at p-value
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13
Q

Standard Error (SE) vs Standard Deviation (SD)

A

SE is this standard distribution of a sampling distribution. Standard deviation is the standard deviation of a set of data from 1 sample.

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14
Q

Confidence Interval

A

Estimated range of values likely to include an unknown population parameter.
Values calculated from sample data.

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15
Q

Statistical Power

A

The probability of correctly concluding that there is a difference. (1-beta)

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16
Q

What are the 3 forms of community?

A
  1. Proximity
  2. Identity
  3. Purpose
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17
Q

Communities of Proximity

A

Things that are close together have similar interests and concerns. (This is easy to do, but you make a lot assumptions-bad)

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18
Q

Communities of Identity

A

Comprise communities of who you are/identify with; can be very intimate. (Very hard to define)

19
Q

Communities of Purpose

A

A group working toward a goal. Clear organizational structure., but limited resources.

20
Q

Cultural Competence

A

A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations

21
Q

Clinical Diagnosis

A

Identifying diseased/non-diseased people among patients WITH SYMPTOMS

22
Q

Screening

A

The examination of a group of usually asymptomatic individuals to detect those with a high change of having or developing the disease. (ie. physical exam, questionnaire, fluid assays-ie. blood, urine)

23
Q

Validity

A

Probability that a test correctly identifies those with and without disease. (lacks bias)

24
Q

Reliability

A

Test reproducibility: When the test is repeated, you can expect the same result. (lacks random error)

25
Q

Two measures of Validity

A
  1. Sensitivity (Probability of obtaining true positive)

2. Specificity (Probability of obtaining true negative)

26
Q

The “Gold Standard”

A

External source of “truth” regarding disease status of each individual in a population. (This test is very hard to perform)

27
Q

Positive Predictive Value

A

Proportion of people with disease among those who test positive. Probability that patient truly has disease.

28
Q

Negative Predictive Value

A

Proportion of people without disease among those who test negative. Probability that patient truly doesn’t have disease.

29
Q

Likelihood Ratio (LR)

A

How many times more likely is a positive test result is to be found in diseased individuals, compared to non-diseased individuals.

30
Q

Lead Time Bias

A

The appearance that early diagnosis of disease will prolong survival with that disease.

31
Q

Likelihood Ratio Equation

A

(sensitivity) / (1-specificity)

32
Q

Positive Predictive Value Equation

A

PPV= (# correctly screened positive) / (total # screened positive)

33
Q

Negative Predictive Value Equation

A

NPV= (# correctly screened negative) / (total # screened negative)

34
Q

Sensitivity Equation

A

(# Correct Positives) / (Actual # positive)

35
Q

Specificity Equation

A

(# Correct Negatives) / (Actual # Negative)

36
Q

Definitions of Public Health (3)

A
  1. 1988 Fulfilling society’s interest in assuring conditions in which people can be healthy.
  2. Successive re-defining of the unacceptable (1958)
  3. Turnock: “It depends..”
37
Q

Lenses to view public health (4)

A
  1. Government View
  2. Market justice view
  3. Social justice view
  4. Political View
38
Q

Explain the “Epidemiologic Triad?”

A

The idea that diseases have multiple causes. (Environment Agent Host [Vector])

39
Q

Why weren’t Koch’s postulates enough to explain disease?

A

It was not as simple as “bacteria being present to cause disease”

40
Q

Define Evidence-Based Medicine

A

Conscientious, explicit, and judicious use of current best evidence in medical decision-making

41
Q

Hierarchy of Evidence (Most Valid at the top)

A 
(most valid)
1. Systematic Review
2. Randomized Control Trial (RCT)
3. Cohort Study
4. Case-Control Study
5. Physiologic Study
6.Unsystematic Clinical Observation 
(most bias)
42
Q

EBM Process (5 A’s)

A
  1. Assess (knowledge gaps)
  2. Ask (an answerable question;PICO patient intervention comparison outcomes)
  3. Acquire (find evidence)
  4. Appraise (determine evidence quality)
  5. Apply (evidence to patient)
43
Q

Analytic vs Descriptive Epidemiology

A

Determinants of health and disease vs Distribution of health and disease

44
Q

4 Reasons to Break Confidentiality

A
  1. High Probability
  2. Serious Injury
  3. Intervention
  4. Last Resort

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