Theme 2 key areas Flashcards

1
Q

Define epidemiology

A

Epidemiology is the study of determinants of disease across populations, and of ways to reduce the impact of these diseases on the health of the community.

Based on the idea that disease is not random and has causal and preventative factors that can be investigated in systematic ways.

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2
Q

Define outbreak

A

The occurrence of disease cases in excess of normal expectancy.

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3
Q

Define endemic

A

When an infection exists within a geographic population perpetually.

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4
Q

Define pandemic

A

A global endemic.

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5
Q

Describe epidemiological functions and their role in public health

A

Functions:
> Studying the determinants of disease
> Finding ways to reduce the impact of diseases on the health of the community
> Investigation of the causal and preventative factors of disease

Role in public health:
Public health draws on epidemiology - a scientific resource - to help guide clinical medicine and help to understand human biology.
Epidemiology contributes to the rationale for many public health policies and services and is an important tool for evaluation of effectiveness.

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6
Q

Understand the epidemiological triad of disease

A

The epidemiological triad is a model of health and consists of 3 key causal factors for disease:

  1. Agent - this could be physical (eg. radiation), chemical (eg. gasses), nutrient (eg. from your diet), psychological (eg. stress) or biological (eg. bacteria, viruses and insects).
  2. Environment - this could be biological (eg. animals and plants), physical (eg. geology, weather, climate and water quality) or social (eg. culture, education, politics and social economic status).
  3. Host - these are the individual factors that can predetermine your susceptibility to disease (eg. immunity, inherent resistance, age, gender, ethnicity, lifestyle, exercise, nutrition and health knowledge).
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7
Q

Describe the levels of prevention

A

There are 3 key levels of prevention:

  1. Primary prevention - aims to avoid the development of a disease and remove risk factors (eg. Vaccination programs).
  2. Secondary prevention - aims for early detection and treatment to prevent the progression of an already present disease (eg. screening programs).
  3. tertiary prevention - aims to reduce the complications of an already established disease (eg. rehabilitation programs).
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8
Q

Where might you find accurate epidemiological data?

A

Australian Institute of Health and Welfare

Department of Health

WHO

Australian Bureau of Statistics

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9
Q

What is a descriptive study?

A

Explores: who, what, when, where (ie. person, place and time). These studies just describe what is happening.
ie. who has the disease? what is the disease? when/is the disease common or rare? where does the condition arise?

the typical study design is that of an observational community health survey.

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10
Q

What is an analytical study?

A

An analytical study explores: why and how. These studies examine associations and test hypothesis.
ie. how did the individual get the disease? and why did they get it?

The typical study design could be a cohort study or a case control study.

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11
Q

What is the difference in global and national life expectancies?

A

In Australia, a male’s life expectancy is currently 80 whilst a female’s is 84. In Australia, women have a life expectancy around 4 years longer than men whilst Indigenous people have life expectancies 5-10 years lower.

At a global level, there are some underdeveloped nations who have life expectancies 10 years less than their developed counterparts.

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12
Q

Why do we measure health status?

A

Measuring health status allows us to:
Identify health issues
Monitor progress
Evaluate health promotion strategies

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13
Q

What is a DALY?

A

A DALY is a disability adjusted life year. It takes in the years of life lost and the years of life with disability. They allow us to have some way of measuring health that is not just death.

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14
Q

What is a YLL?

A

A YLL is a year of life lost.

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15
Q

What is a YPLL?

A

A YPLL is a year of productive life lost.

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16
Q

What is a YLD?

A

A YLD is a year lived with disability.

17
Q

What is a QALY?

A

A QALY is a quality adjusted life year. We use this to determine the quality of life specifically when evaluating the effectiveness of medical intervention.

18
Q

What is the social demographic index?

A

A summary measure of a geography’s socio-demographic development. It is based on average income per person, educational attainment, and total fertility rate (TFR).

19
Q

Define mortality

A

Being dead

20
Q

Define morbidity

A

Being diseased

21
Q

What is a dichotomous outcome?

A

When you get 1 of only 2 possible outcomes.

22
Q

What is a predictor variable?

A

Something that is going to influence the outcome.

23
Q

What is an odds ratio?

A

An odds ratio is a measure of association between an exposure and an outcome.

24
Q

What is an alpha level?

A

An alpha level is chosen by the researcher before any statistical testing is done. It is a statement about the level of risk that the researcher is prepared to accept that their results may bean error.

25
Q

What is a confidence interval?

A

A confidence interval is the possible range around the estimate. ie. how stable the estimate would be if you repeated the same experiment.

26
Q

What is an alpha level?

A

An alpha level is chosen by the researcher before any statistical testing is done. It is a statement about the level of risk that the researcher is prepared to accept that their results may bean error.

eg. If a researcher sets their alpha level at 5, they are prepared to accept the risk that 5% of their results are due to chance and 95% are not due to chance.

27
Q

What is the relationship between alpha levels, levels of confidence, odds ratios and confidence intervals?

A

The lower the alpha level, the higher the level of confidence and the narrower the confidence interval.

The higher the alpha level, the lower the level of confidence and the wider the confidence interval.

The odds ratio is a statistic so it doesn’t change.

28
Q

Understand the different types of studies

A

Case report:
A descriptive study where in which you report that someone has something.
ie. You provide a detailed description of an individual patient and possibly details of the suspected exposure.

Case series:
A descriptive study. A collection of similar case reports. this method is often used to identify an outbreak.

Cohort study:
An analytical study where in which you examine a cohort who starts the study disease free and follow up to see if they have been exposed to a risk factor and if if resulted in the development of a disease.

Case control:
An analytical study where in which you examine a group of people who have the outcome and a group who don’t and gather information on whether they were exposed to a risk factor or not. In this study, the sick people are the case control.

29
Q

Understand the difference between observational and interventional studies

A

During observational studies, there is no intervention from the research and the world continues on as normal.

During interventional studies, there is intervention from the researcher.

30
Q

What is confounding and how is it controlled?

A

Confounding is an issue we see in observational studies where in which elements can influence the results of a study. making it difficult to determine whether the exposure actually caused the outcome. This is why we just determine association.

We need to statistically adjust for confounding by adjusting the odds ratio. We cannot however, adjust for unmeasured confounders.

31
Q

What is selection bias?

A

Bias that occurs through the selection of individuals which results in randomisation not being achieved.

32
Q

What is recall bias?

A

A systematic error caused by differences in the accuracy or completeness of the recollections retrieved by study participants regarding events or experiences from the past.

ie. Some participants recall more vividly whilst others do not.