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BPS > Segars: Epidemiology > Flashcards

Segars: Epidemiology Flashcards

1
Q

What is epidemiology?

A
  • a public health-discipline basic science which studies the…
  • distribution
  • determinants
  • … of disease in populations to control disease and illness, and promote health
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2
Q

What are the 3 W’s of patterns of disease ocurrences?

A
  • Who
  • Where
  • When
  • this is descriptive epidemiology
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3
Q

What can descriptive epidemiology be used for?

A

-to know if a location is experiencing disease occurrence more frequently than usual or more than other locations

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4
Q

What are the 3 key factors in comparing measures of disease frequency between groups

A
  • # of people affected/impacted (frequency/count)
  • Size of the source population (from which disease cases or outcomes arose) or those at risk
  • Length of time the “population” is followed
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5
Q

Passive surveillance system?

A

-relies on healthcare system to follow regulations on required reportable diseases/conditions

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6
Q

Active surveillance system

A

-public health officials go into communities to search for new disease/condition cases

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7
Q

Syndromic surveillance system

A

-a system that looks for pre-defined signs/symptoms of pts related to trackable-but-rare diseases/conditions

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8
Q

What is an epidemic

A

-occurrence of disease clearly in excess of normal expectancy

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9
Q

What is an outbreak

A
  • an epidemic limited to a localized increase in the occurrence of disease
  • sometimes interchanged with “cluster”
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10
Q

Endemic

A

-the contant presence of a disease within a given area or population in excess of normal levels in other areas

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11
Q

Emergency of international concern

A

-an epidemic that alerts the world to the need for high vigilance (pre pandemic)

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12
Q

Pandemic

A
  • an epidemic spread world-wide (global health)

- multi national/ multi continent

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13
Q

What are some epidemiological assumptions?

A
  • disease occurrence is not random
  • systematic investigation of different populations can identify associations and causal/preventive factors and impact of changes can impart on health of population
  • making comparisons is the cornerstone of systematic disease assessments/investigations
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14
Q

What are the determinants of disease?

A
  • factors of susceptibility/exposure/risk
  • etiology/causes of disease
  • Modes of transmission
  • social/environmental/biologic elements that determine the occurrence/presence of disease
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15
Q

What are the 3 types of frequencies utilized to measure disease frequencies?

A
  • proportions: division of 2 related numbers (the numerator is a subset of the denominator)
  • Ratios: division of 2 unrelated numbers (numerator is not a subset of the denominator)
  • Rates: division of 2 numbers with time included in the denominator
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16
Q

What is incidence

A

-NEW occurrences of an outcome/disease

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17
Q

What is prevalence

A
  • EXISTING occurrences of an outcome/disease

- includes old and new cases, collectively

18
Q

What are both incidence and prevalence?

A
  • a proportion!
  • a simple percentage
  • part over whole
19
Q

What is the formula for incidence?

A
  • # of new cases of illness/# of people at risk of illness

- ALWAYS subtract out (from the starting population), those who not at risk (already have the disease or are immune)

20
Q

What is the formula for prevalence?

A
  • total # of cases of illness/# of people in population

- remember that there is point prevalence and period prevalence

21
Q

What is infectivity

A
  • the ability to invade a patient (host)

- #infected/# susceptible (at risk)

22
Q

Pathogenicity?

A
  • the ability to cause clinical disease

- # with clinical disease/ #infected

23
Q

What is virulence

A
  • the ability to cause death
  • # of deaths/# with infectious disease
  • synonymous with case-fatality rate
24
Q

What is crude morbidity rate?

A

-# of persons with disease/ # of persons in population

25
Q

Crude mortality rate?

A

-# of deaths (all causes)/# of persons in population

26
Q

Cause-specific morbidity rate?

A

-# of persons with cause-specific disease/# of persons in population

27
Q

Cause-specific mortality rate?

A

-# of cause-specific deaths/# of persons in population

28
Q

case-fatality rate

A

-# of cause-specific deaths/# of cases of disease

29
Q

What is risk?

A
  • the probability of an outcome in a specific group

- remember that 2x2 square thing…. exposure vertical and outcome horizontal

30
Q

What is absolute risk reduction

A
  • AR defines the risk difference of the outcome attributable to exposure difference between groups
  • ex: difference in MI’s between the rampril and placebo group
31
Q

Relative risk reduction (RRR)

A

-ARR/Runexposed

32
Q

What is Number needed to treat or the number needed to harm (NNT/NNH)

A
  • on average, the # of pts needed to be treated to receive the stated benefit/harm
  • 1/absolute risk reduction (ARR)… indecimal format
  • ex: 1/0.038= 27 pts would need to be treated with ramipiril to reduce 1 AMI/CVA/Death from CV causes
  • remember to always round up to the next “whole” person (value)
33
Q

What is Risk ratio?

A
  • ratio of the risks from 2 different groups

- risk of outcome in exposed/risk of outcome in non-exposed

34
Q

What is odds

A
  • a ratio
  • FREQUENCY of an outcome occurring vs. NOT occurring in a specific group
  • NOT a simple percentage, it’s a ratio
35
Q

What is Odds ratio (OR)?

A
  • ratio of the odds from 2 different groups
  • Odds of exposure (in diseased)/odds of exposure (in non-diseased)
  • **you can also cross multiply in the 2x2 table; same answer (AxD/BxC)
36
Q

What does it mean when the ratio is >1.0?

A

-the event/outcome is more likely to occur in the comparison group (numerator group)

37
Q

What does it mean when the ratio is <1.0?

A

-the event/outcome is less likely to occur in the comparison group (numerator group)

38
Q

If RR is 1.53, what does that mean?

A

-the comparator group is 53% increased risk

39
Q

If ratio is >2.0 , what do we say?

A
  • if OR= 6.18

- we say it’s 6.18 greater odds

40
Q

What do we say if HR= 0.73?

A

-then the comparatory group has a 27% decreased probability of the hazard outcome

41
Q

What do we look for when interpreting Ratio’s?

A
  • group comparison orientation
  • direction of words
  • magnitude
42
Q

What was the thing in the red box about the confidence interval (CI)?

A

-when looking at the CI for “ratios”, if both values are on the SAME SIDE of 1.0, it is always statistically significant

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