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PASS II > Session 2 > Flashcards

Session 2 Flashcards

1
Q

What is incidence?

A

The number of new cases.

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2
Q

What is prevalence?

A

The number of existing cases within a given period of time.

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3
Q

What is descriptive epidemiology used for?

A

A way of measuring the burden of a disease - how frequently and how quickly a disease occurs.

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4
Q

What is analytical epidemiology?

A

The causes and effects of a disease - how and why a disease occurs.

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5
Q

How do you calculate incidence risk?

A

Number of new cases of disease or injury during a specified period/ size of disease-free population at the start of the period.

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6
Q

How do you calculate incidence rate?

A

Number of new cases of disease or injury during specified period/ Time each person was observed, totalled for all persons (the duration of disease free people).

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7
Q

How do you calculate prevalence rate?

A

All new and pre-existing cases during a given time period/ Population during the same time period.

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8
Q

What is the difference between incidence risk and prevalence rate for a short-lived disease?

A

They will be the same as they are ill for a very short amount of time, and so there would be an incredibly small number of people who were ill prior and during the study.

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9
Q

What is case-fatality rate?

A

The number of people that died from a disease.

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10
Q

What is mortality rate?

A

The number of people that died in a specified time period.

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11
Q

How can you apply incidence and prevalence to clinical medicine?

A

For signs and symptoms of different diseases, request a test for the one with the higher incidence risk.

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12
Q

What can a cause and effect be in a study, and what is required?

A

The intervention/ risk factor/ exposure os the cause.
The effect is out outcome.
We need to compare 2 different groups.

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13
Q

What are risk ratios and what are odds ratios?

A

Effect measures that quantify the strength of the association between the exposure and the event. Both RR and OR are calculated based on incidence risks.

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14
Q

How do you calculate risk ratio?

A

You divide the proportion of one group (with totals) divided by the proportion of another group (with totals).
Risk of one group/ Risk of another group.

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15
Q

How do you calculate odds ratio?

A

The probability of an event/ probability of a non-event.
Divide the odds of one group by the odds of another group.

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16
Q

What does no association mean?

A

It means that two different groups have the same risk of a disease.

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17
Q

What is a positive association.

A

The odds ratio divided by the risk ratio being greater than 1.

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18
Q

What is a negative association?

A

The odds ratio divided by the risk ratio being less than 1.

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19
Q

What is chance?

A

Does the observed association occur by chance? (Random error).
There is a different odds ratio between different samples.

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20
Q

What is bias?

A

Are there any errors in data collection, analysis, and interpretation leading to results that are systematically different from the truth? (Systematic error).
There are many different types of bias, with no study being free from bias. They cause systematic error.

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21
Q

How can you reduce the random error?

A

Increasing the size of the sample.

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22
Q

What is selection bias?

A

The sample is not representative of the entire population.

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23
Q

What is confounding bias?

A

The effect of exposure on outcome is mixed with another activity, which increases the incidence or risk of the outcome.

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24
Q

What is recall bias?

A

Incompetent or inaccurate recollection of information by participants.

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25
Q

What are the 3 types of epidemiological study designs?

A

Review studies.
Experimental studies - controlled environment.
Observational studies - can be descriptive (cannot confirm the association) or analytical (study the association).

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26
Q

What are the different types of review studies?

A

Systematic review.
Meta-analysis.
Narrative reviews.
Scoping reviews.

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27
Q

What are systematic reviews and meta-analysis?

A

Present, analyse, and synthesise results from different studies concerning similar research topics.

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28
Q

Why use systematic reviews and meta-analysis?

A

Studies can be compared against.
Allows one to understand information of a topic comprehensively.
Practice is based on the best available evidence.

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29
Q

What are the benefits and weaknesses of systematic reviews and meta-analysis?

A

B: Relatively unbiased if conducted correctly.
W: Publication bias

30
Q

What are systematic reviews?

A

Given the research questions, collect existing studies then review and analyse their results.
Collection procedure: use pre-determined search terms to look for studies in databases.
Summaries are qualitative.

31
Q

What is meta-analysis?

A

Collecting the information from a systemic review and drawing conclusions, showing them in a quantitive manner.

32
Q

What are narrative reviews?

A

A literature review, not answering a research question.

33
Q

What is a scoping review?

A

A broad topic or question that is answered through research for a systematic review.
It has a defining question that is answered.

34
Q

What is the difference between a scoping and systematic review?

A

A systematic review is much more specific than a scoping review.

35
Q

What are the two types of experimental studies?

A

Randomised control trials.
Quasi-experiments.

36
Q

What are randomised control trials?

A

They can be blinded or non-blinded - this can be unknown through the participant (single) or participant and controller (double).
A participation is recruited and then the participants are randomised.
Some take a control and some take an intervention.
Allow the natural development to occur.
Observe and compare the outcomes.

37
Q

What are some drawbacks of RTCs?

A

Expensive.
Quite a small scale.
It is randomised - reduce biases and confounding.
Non-compliance - some participants may not comply.
Loss of follow-up - they need to be removed from the study.
Not always ethical to randomise - participants without the intervention may die, like in cancer.
Not efficient if the outcome is a rare condition.

38
Q

What are quasi-experiments?

A

Experimental studies that are not RCTs, so they are not randomised. This may be because:
- It is not ethical to do so.
- Difficult to randomise by location.

39
Q

What are the different types of observational studies?

A

Descriptive - case reports/ series.
Analytical - cohort, case-control, cross-sectional, ecological.

40
Q

What is a case report/ series?

A

A detailed report of a patient or group of patients.
Actual content varies: signs, symptoms, diagnosis, treatment, follow-up, etc.
They are educational.

41
Q

What are some disadvantages of case reports/ series?

A

Generalisation.
Hard to compare.
Not free from selection bias.
Can be hard to follow up on.

42
Q

What is representation?

A

Accurately reflecting the characteristics of the larger group e.g. sex, age, ethnicity, occupation, health status, literacy levels.

43
Q

What is validity?

A

Being logically or factually correct or true.

44
Q

What is internal validity?

A

The strength of the study’s findings. It is determined by how well a study can rule out alternative explanations for its findings. Alternative explanations are usually explained by bias.

45
Q

What is external validity?

A

The extent to which results can be generalised from the study population to another population. Generalisable conclusions are almost always a goal in research. The study sample will influence the external validity.

46
Q

What are errors, and what are the two types?

A

Reasons why the findings of a study may not be correct.
Two examples are chance (random error) and bias (systematic errors).

47
Q

What is chance?

A

Random error which cannot be predicted which occurs due to taking a sample rather than studying the whole population. Chance can be reduced as a sample size increases.

48
Q

What is an unbiased sample?

A

Everyone in the population has the same probability of being chosen for the sample. An unbiased sample should be more representative of the population than a biased sample.

49
Q

What is selection bias?

A

Individuals or groups in a study differ systematically from the population of interest leading to a systematic error in an association or outcome.

50
Q

What is the healthy worker effect?

A

Lower relative mortality and morbidity rates from all causes combined and from selected causes in an occupational cohort compared to the general population. Less healthy individuals are more likely to be unemployed than are healthy individuals.

51
Q

What is information bias?

A

Systematic differences in the collection, recall, recording or handling of information used in a study, including missing information. Major types of information bias are misclassification bias, observer bias, recall bias and reporting bias.

52
Q

What is misclassification bias?

A

When a study participant is categorised into an incorrect category, altering the observed association or research outcome of interest e.g. undiagnosed conditions, forgotten exposures, different researchers’ impressions of the categories.

53
Q

What is observer bias?

A

Difference between a true value and the value actually observed due to variation between whoever took the observations.

54
Q

What is recall bias?

A

When participants do not remember previous events or experiences accurately or omit details.

55
Q

What is reporting bias?

A

The selective disclosure or withholding of information by parties involved in the design, conduct, analysis, or dissemination of a study or research findings.

56
Q

What is the incidence rate ratio?

A

Incidence rate in group A/ Incidence rate in group B.

57
Q

What is risk?

A

Risk is the likelihood of something happening, it is not necessarily good or bad.

58
Q

What are ecological studies?

A

A type of Descriptive study design, which look at a population in a snapshot in time and try to describe associations in the population. They often look for associations in routinely collected data.

59
Q

What needs to occur to conduct an ecological study?

A

Identify groups to study.
Define the characteristics that are being studied - exposure and outcome.
What method of date collection is going to be used, and what data can be collected.
The collection of gathering data.

60
Q

What are the two types of data?

A

Categorical data.
Continuous data.

61
Q

What is a confidence interval, and what does it mean for the precision of the graph?

A

It is the range in which the true answer lies within.
The greater the confidence interval, the lower the precision.

62
Q

What affects the confidence interval, and how can we adjust for that?

A

It is affected by confounding factors.
We can adjust the graph to take the confounding factors into account.
We can make subdivisions within the populations that take the confounding factors into account.

63
Q

What are some issues with ecological studies?

A

Defining characteristics - it can be difficult to make groups of populations.
Measurement variation.
Confounding.

64
Q

What is ecological fallacy?

A

A form of confounding, where an inference is made about an individual or group that cannot be explained.

65
Q

What are cross-sectional studies? What is an example?

A

Descriptive studies that collect data at one time.
The data is often collected through asking questions about past or present experiences.

The census is an example.

66
Q

What are the disadvantages with cross-sectional studies?

A

Sampling bias.
Responder bias.
Confounding.

67
Q

What are case-control studies?

A

An analytical study design where researches identify people who have the outcome of interest and those who do not have the outcome of interest.
Researchers then find out previous exposures for both groups.
The researcher then makes comparisons between the two groups, with the levels of exposures.

68
Q

What are case-control studies good for, and what is the outcome?

A

Studying disease.
It is an odds ratio as they are comparing two different populations which are healthy or ill with a disease.

69
Q

What are the issues with case-control studies?

A

Selection bias.
Information bias.
Confounding.
Chance.

70
Q

What are cohort studies?

A

An analytical study that recruits participants based on exposure status.
They then follow up the patients, check on developments, or they can look back on records and outcomes of events.

71
Q

What are the two types of cohort studies?

A

Prospective - exposed and unexposed cohorts are selected and then followed up using interviews, medical records, tests, and other methods.
Retrospective - exposure and outcomes have already happened and are defined, which can help to look at causations.

72
Q

What are some issues for cohort studies?

A

Loss of patient follow up.
Information bias.
Confounding.
Chance.

PASS II (8 decks)

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