Test 1 Epidemiology for Pharmacists Flashcards
Vioxx
- cases of heart attacks and CV events
- NSAID
- Merk hid this data
phenylpropanolamine (PPA)
- in cough / cold products
- in weight loss products
- started causing strokes in young women within the first few doses
Epidemiology
study of what comes upon people
Who is the founder of public health?
- John Snow
- London cholera outbreak
Goals of Epidemiology
- Measurement of health outcome
- Occurrence of adverse clinical events
- Degree of therapeutic response achieved
- Success in preventing or reducing morbidity & mortality
Morbidity
Long term disability or disease
Mortality
Deaths attributed to the disease
Types of measures used
- counts
- proportions
- ratios
- rates
Incidence
Development of NEW cases of disease that occur
Cumulative incidence (CI) (proportion)
(Number of new cases during specified period of time) / (Total population at risk during specified period of time)
Prevalence
- Total number of disease cases in the total population at a given point in time
- Quantifies the burden of disease
- (Number of cases) / (Number in total population)
Types of epidemiology study designs
- Observational: cohort, case-control
- Experimental: RCT
RCT design
- we use this to test efficacy in order to approve drugs
- efficacy does not equal effectiveness
- random assignments to groups
Cohort study
- two groups: exposed and non-exposed
- groups studied over time to see what happens
- Framingham heart study
- results: relative risks
Relative risk (RR)
- Ratio of cumulative incidence rates
- compares the number of people who are at risk of disease after being exposed with number of people who got the disease but were not exposed
RR values
- 1: both exposed and non-exposed have equal likelihood of getting disease
- > 1: exposure increases the likelihood of disease
- <1: exposure is protective and decreases likelihood of disease
Calculating Relative risk
[ a/(a+b) ] / [ c/(c+d) ]
Case-control study
- Selects individuals based on disease status
- go back and determine if they were exposed to a risk
- results: odds ratio
Odds ratios
used to compare likelihood that people who have the disease were exposed to those who were not exposed
Odds ratios values
- 1: indicates equal odds, cases exposed or not exposed
- > 1: indicates increased likelihood that cases were exposed to causal factor
- <1: indicates exposure conferred some protective effect against disease
Calculating Odds ratios
(ad) / (bc)
Calculations
Exposed - Disease A - No disease B Not exposed - Disease C - No disease D
