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Surveillance Flashcards

0
Q

What is epidemiology used to determine

A

Problem in a population
Risk factors of a disease
Change in disease outcome after intervention

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1
Q

Definition of epidemiology

A

The study of distribution and determinants of health conditions or events in a specific population

Takes in the consideration person place and time

Body of knowledge and method of study

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2
Q

Epidemiological triangle

A

Host
Environment
Agent
NOT TIME

All if these elements can influence the occurrence of disease

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3
Q

What is incidence

A

The number of new cases of a disease in a given time period and multiplied by a constant

NEW CASES - Prevalence is New and Old

Number of newly diagnosed cases of active TB in a calendar year in a given county.

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4
Q

What is a incidence density rate

A

It is another type of incidence rate in which time such as device days are patient days is incorporated into the denominator

Usually used in cohort studies

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5
Q

What is crude mortality rate

A

Crude mortality rate measures the proportion of the population during each year from all causes

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6
Q

What are the most commonly used rates and surveillance programs for healthcare settings

A

Incident
attack incident
density
prevalence

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7
Q

Attack rate

A

new cases/population at Risk x 100

Attack rate is a type of incident rate
Used for epidemics or outbreaks of disease
Frequency of new cases. Probability of becoming a case.
Condition in a specific population during a time period.

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8
Q

What is prevalence

A

The number of cases events or conditions occurring in a population

Old or new cases
Incidence is different because it’s only New cases

Example: census 487. 7 pts have pseudomonas calculate the prevelance rate.
Number of active TB cases in a county

of existing cases/ population during time period x 100

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9
Q

What is an endemic

A

Presence of a disease or condition of the specific population or geographical area

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10
Q

What is an epidemic

A

More cases of a disease that is expected in a given area for people over certain amount time
synonym - outbreak

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11
Q

What is a pandemic

A

An epidemic spread over why geographical area are countries

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12
Q

What is a reservoir

A

Replace one infectious agent can survive but not multiply

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13
Q

What is a fomite

A

Inanimate object in which an organism may exist for some period of time

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14
Q

What is heard immunity

A

Resistance of a group to invasion of the spread of an infection based on immunity of the population

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15
Q

What is artifactual association

A

False association that can be due to a chance or bias in the study method

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16
Q

What is indirect association

A

Mixing of effects of Effects among disease and a third factor that is associated with the exposure and independently affects the outcome

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17
Q

What is casual association

A

Evidence indicates that a factor clearly increases the probability of the occurrence of a disease and reduction of this fact or decreases the frequency of the disease

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18
Q

What is the strength of association in causality

A

The incidence of disease should be higher in those who are exposed to the factor under consideration

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19
Q

What is quantitative research

A

Transitional Scientific methods
Seeks to establish casual relationships
Use the statistics to test the strength and significance of the relationship in the study

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20
Q

What is qualitative research

A

Research that seeks to provide understanding of human experiences perceptions behaviors

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21
Q

What are the two types epidemiological studies - quantitative research

A

Observational studies - investigator doesn’t intervene

experimental studies- controls certain factors in the study

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22
Q

What are the two types of observational studies

A

Descriptive- characterize a population by occurrence of an outcome of time, place, person.

Analytic studies-compare individuals with or without an outcome with the presence of one or more risk factors

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23
Q

What are the three analytic studies

A

Cross-sectional
case-control
cohort

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24
What is a cross-sectional study
I'll come and rest factors are reviewed in a population at one point in time outcomes are measured (incident rates are not determined)
25
What is a case-control study
Population of individuals with and without an outcome of interest studied for exposure to one or more risk factors studies are quicker and less expensive and easier Example retrospective study
26
What is a cohort study
Start with a sample of individuals with and without exposure to potential risk factor for followed for incidents of the outcome in each group strong evidence of casual association Less pt selection Example, 100 kids were monitored for colds during winter. Some had asthma, colds, or neither.
27
Name 5 data gathering techniques in qualitative research
``` Focus groups Participants observation Interviews Field notes Tape recording ```
28
Descriptive statistics
Data analysis that helps show, describe, or summarize, the data in a meaningful way such that patterns might emerge from the data. Can't make any conclusions from the data
29
Descriptive statistics
Numerical information about variables | uses numbers to describe characteristics of the data set
30
Inferential statistics
Differentiate between two groups | Can choose a subset of a population
31
Inferential statistics
Make an assumption about a population based on a sample of the population
32
Name three types of frequency distribution
Normal distribution - bell shape curve, mean, median, and mode are all equal Skewness- asymmetrical distribution. Curve left - negative. Curve right - positive Kurtosis- how flat or peaked a curve is
33
What is rate
Frequency with which an event occurs in a population
34
Measures of association | 2x2 table
Relative risk- probability of developing a disease estimates how likely the disease is to occur. Odds ratio-probability of having the risk factor. Looks at prevalence. Used for retrospective or cross sectional studies.
35
What is Mean
Central tendency Average of values in a data set Add numbers together and divide Value is affected by outliers. ``` 8+2+4+12+10 = 36 36/5 = 7.2 ```
36
What is median
A value this divides the the data into 2 groups. Value of the median is not affected by outliers 3,3,5,9,11. Median is 5 6,7,9,11,12,15. Median is 10
37
What is mode
Value in data set that occurs most frequently Most useful for qualitative data Least stable of mean,median, mode 1 3 6 6 6 6 7 7 11 6 is the mode
38
What is the p value | Probability
Probability of having committed a type I error Helps determine the significance of your results Small p value o.05 week evidence against the bulk hypothesis - accept High p values likely a true null P value of 0.04 week evidence 4%
39
What is null hypothesis
No effect of the research on a group | No difference
40
Confidence interval
Estimated range of values that is likely to include an unknown population Calculated as 95% but could be 90, 99, or 99.5
41
Graphs
Y axis shows frequency Vertical | X Axis shows time interval horizontal
42
4 ways to test for reliability
Sensitivity % of persons with true positive results Specificity- % of persons with true negative results Positive predictive value- % of test + when disease is present Negative predictive value- % of tests that are negative when disease is not present.
43
Components,of initial outbreak investigation
``` Confirm presence Alert key partners Lit review Case definition Methodology for case finding Line list or Epi curve Observe pt care Environmental sampling Control measures ```
44
Pneumonia
Early onset within first 4 days of hospitalization, caused by moraxella catarrhal is, haemophilus influenza, streptococcus pnemoniae Late onset caused by gram neg bacteria or SA, MRSA, viruses, yeasts. Fungi,
45
Clinically defined pneumonia
Two or more CXR with one of the following. Infiltrate Consolidation Cavitation Pneumatoceles infants < 1
46
What type of transmission occurs in s point source epidemic?
A vehicle Could be a single meal or event Rises quickly and falls gradually
47
How is the specificity of a test for infection or disease defined?
true negatives X 100 -------------------- Total # of persons without disease
48
What is Range (variability)
Difference between the smallest number and the largest number, 2,4,5,6,9,10,11,15,18 16 is the answer
49
What is variability
Measures how the values are spread around the main and includes range, deviation, standard deviation, and variance
50
What does it mean when a test has a higher specificity?
A negative result will be more accurate than a positive
51
Frequency Polygon uses:
Shows 2 sets of data on a single graph Uses lines and points Uses histogram
52
What is the Chi square test used for?
To evaluate the effect of a variable on outcomes To calculate an odds ratio or relative risk If each cell of the table is greater than 5
53
What are SPC (statistical process control) charts used for
Monitor the process of care Facilitate the determination of variation Monitor outcomes DOES NOT eliminate natural variation
54
Statistical Process Control
Use an upper and lower control limit - beyond those limits is out of range Useful in showing changes in rates Less stable with small denominators AKA control chart Monitor quality assurance
55
Confounding variable
extraneous variable even that systematically varies with the independent variable and influences the dependent variable
56
What can cause bias in a study
Instrument Observer Data collection method Case and control group selection
57
Hill's criteria for causation
``` Strength Consistency Specificity Temporality Biological gradient Plausibility Coherence Experiment Analogy ```
58
Strength of association
Incidence of disease should be higher in those who are exposed to the factor under consideration than those who are not exposed
59
Consistency
Association should be observed in numerous studies by different researchers
60
Specificity
Association between one factor and on disease, this is more casual The ability of a test case definition or surveillance system to exclude persons who do not have the health condition of interest
61
Biological gradient
Dose response relationship between increased exposure to a factor and increased likelihood of disease.
62
Enzootic
Presence of disease among animals within a geographical area.
63
Epizootic
Excess over the expected extent of disease within an animal population in a geographical area during a specified time period.
64
Zoonosis
Disease transmitted from animals to humans
65
Descriptive study
Simplest observation study Describes person, place, or time Generate rates or identify populations at risk. Can't show causality.
66
Using GRAPHS to present data
Quantitative dats using system coordinates Two sets of lines that intersect at right angles More than one variable can be shown on a graph X axis variable of time (year, month, quarter) Y axis reflects frequency (# of cases)
67
Presenting data in tables
Tables used to present data in rows & columns. Frequency of events Provide information on person, place, and time
68
Arithmetic line graph
Equal distances along the Y axis
69
Semi logarithmic scale
Used H axis measures in logarithms of units.
70
Histogram
Graphic of a frequency distribution in which one bar is used for each time interval there is no space between intervals Area on graph uses two rectangles Epidemic curve
71
Frequency polygons
Place data points over the center point of the data range. | Bars are connected
72
Frequency Polygon
Similar to a line graph Each coordinate point represented by a point displayed on the graph with straight line connecting them. Provides the same data as histogram
73
Data displayed in charts
``` Uses one coordinate Compare parts of a total picture Bar charts Geographical coordinates Pictograms Pie charts ```
74
Device ratio
of device days/# patient days = device utilization ratio
75
What is sensitivity
The ability of a test case definition or surveillance system to identify true cases or persons who have the health condition of interest
76
What is a pseudo outbreak
Rise in test results without clinical disease | Positive microbiology results
77
What is standard deviation
Standard deviation is a measure of dispersion I have the raw scores that reflect variability and values around the mean P Standard deviation indicates how small the variability is among observations If variability is small, values are close to the mean Large values are not close to the mean If results are normally distributed 68% of them will be within standard deviation of the mean
78
Type I error
Rejects the null hypothesis when it's true attributing significance when there is none. Type I error is referred to as the significance level Keeping the level small 0.05 0.01 will decrease the risk of committing a type I error.
79
Type II error
Accepting the null hypothesis when it is false or not attributing significance when it exists. Type II error can be avoided by increasing the sample size
80
When is the Fishers test used?
Statistical test used when data numbers are low SMALL SAMPLE SIZE
81
z test
Most appropriate to test that the means of two samples are not different two-tailed hypothesis Example used to compare the mean of infection rates again and NHSN mean sample size should be at least 30
82
What is that T test
It's used for continuous data on the sample size is less than 30 can be one or two tail
83
What is true if prevalence of disease is very low?
Positive predictive value of a diagnostic test is lowered

CIC Exam (9 decks)

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