Public Health/ Genetics/ Causation Flashcards
What is absolute risk?
Incidence of disease in a given population
Can be further divided into absolute risk for exposure vs non-exposure to determine if exposure plays a role in disease prevalence.
What is relative risk?
Tells you whether people who have a given exposure or risk factor have a difference in risk to developing disease
RR= incidence in exposed/ incidence in not exposed
How is relative risk interpreted?
If RR = 1, risk in exposed = risk in not exposed so no association
If RR > 1 risk in expose > risk in not exposed (positive association, (causal?))
If RR < 1 risk in exposed < risk in not exposed (negative association (protective?))
What does a case-control study evaluate?
Involves a case (disease) and a control (no disease) and works backwards to try and determine exposures.
Works using an odd ratio
What is an odds ratio?
(Odds that the number of positive cases were exposed) / (odds that the controls were exposed)
How do relative risk and odds ratio differ?
RR is gold standard but obtained through cohort study
RR will give better measure with a highly prevalent disease
RR=ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group
What is attributable risk?
Incidence of cases among those exposed that are due to exposure/risk factor
Also termed absolute risk reduction, as it is the difference in absolute risk for exposed vs non-exposed
Why is attributable risk important when evaluating public health?
Will allow you to asses how relative and absolute risk impact the population as a whole by looking at the risk of developing the disease if you have/haven’t got the risk factor, and how many people in the public actually have that given risk factor.
What are the differences between the following audits; research, clinical, and service evaluation?
Research: Tries to derive generalisable new knowledge including studies that aim to generate hypotheses and test them. Addresses clearly defined aims, questions and objectives.
Clinical: Aims to produce information to inform delivery of best care. Answers question “does this service reach a predetermined standard?”. Involves intervention in use only.
Service: Defines/judges current care. Answers question “what standard does this service achieve” without reference to the actual standard. Involves intervention in use only.
What things can be audited?
Structure (the resources and staff available, i.e. skill mix of staff, patient access to see GPs), Process (amount and type of activity), outcome (result of intervention i.e. pain relief, patient satisfaction)
What do placebo effects rely on?
Extrinsic factors like trust, emotional engagement with clinicians, social/physical value of interaction/intervention, setting, anticipation and expectation of clinical improvement, placebo type (large pill, red pill, injection)
What neurobiological mechanisms are involved in placebo effects?
Neurotransmitters (endorphins, cannabinoids, and dopamine)
Activation of specific, quantifiable, and relevant areas of the brain (prefrontal cortex, anterior insula, rostral anterior cingulate cortex, and amygdala in placebo analgesia)
What can placebos be used to treat?
Symptoms, rarely treats disease
What is a proband?
Person who brings the family to the attention of medical genetics team.
Shown by an arrow pointing to them
What is a consultand?
Person who has come to genetics for advice, shown by the letter C.
What is a consanguineous relationship and how is it shown on a pedigree?
When two people who are in a relationship have a blood relation.
Shown by a double line connecting them
How does a dominant disease appear on a pedigree?
Vertical inheritance is seen in multiple generations.
How does a recessive disease appear on a pedigree?
Horizontal, one generation appear to be impacted