epi.242

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scsu2012
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104158
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epi.242
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2011-12-14 14:05:12
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exam epidemiology
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PCH 242 exam #1
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  1. knew importance of enviroment & behavior
    identified key risk factors that epidmiologist use today
    left out quantifcation-baisis for determining eitology
    Hippocrates
  2. father of medicine
    grandfather of epidemiology
    hippocrates
  3. why it comes and when it hits some die, others live?
    theroies about epidemiology
  4. Why those who survive, some get sick and others dont?
    theories about epidemiology
  5. Why of those who get sick some recover faster than others who diesease remains a while before survival?
    theories about epidemiology
  6. still an idea about disease around in present day
    Gods are responsible for disease
  7. diseases are caused by smelly air
    comes from decaying soil
    miasma theory
  8. introduced quanitification
    biological phenomena such as birth and deaths varied in predictiable ways (can be used to qantify disease)
    john graunt
  9. father of biostatisitics
    John Graunt
  10. first person to put into practice the principles of epidemiology
    John Snow
  11. father of epidemiology
    John snow
  12. Principle theories of Epidemiology?
    • Distrubution of Disease occurances
    • determination of disease etiology
    • control of disease occurance
  13. leader in developing health and vital statisics records
    first to demonstrate vital statistics and surveillance
    (watchfullness over the distribution and trends of incidence through the systematic collection consolidation and evalutaion of morbidity reports and other relevant data)
    William Farr
  14. father of surveillance
    william farr
  15. first to take a stand aganst cross contamination in hospitals
    infection control
    ignaz semmeiweis
  16. father of hospital epidemiology
    ignaz semmiweis
  17. deffinition of epidemiology
    (word for word)
    epidemiology is the study of the distribution and determinants of health realated states or events in specific populations and the application of this study to the control of health problems
  18. deffinition of an epidemiologist
    (word for word)
    an investigator who studies the occurance of disease or other health related conditions or event in a defined population or the control of disease in populations
  19. subspecialties of epidemiology
    • clinical
    • infectious disease
    • chronic
    • psychiatric
    • enviromental
    • pharmaco
    • social
  20. definition of an epidemic
    an increase in the number of cases over past experience for a given population time and place
  21. what is the name for a graph showing distribution of disease outbreaks?
    epidemic curve
  22. list the recipe for an epidemic?
    • 1. increase amout of a pathogen agent or toxin material
    • 2. exposed and susceptible persons
    • 3. commom circumstances which lead to occurence of an epidemic
    • a. susceptible are introduced to epidemic
    • b. a new pathogen is introduced
    • c. change in behavior, sexual or cultural practices
    • d. host altered by drug induced immunosuppresent or nutrition
  23. list the steps of an outbreak investigation?
    • define epidemic
    • examine the distribution of cases
    • look for the combination interactions of relevant variables
    • develop hypothesis
    • test the hypothesis
    • recommend control measures
  24. description of define the epidemic
    • find case
    • find denominator
    • calcualte attack ratio
    • distribution of cases
    • look for combination of variables
    • devlop hypothesis
    • test hypothesis
    • control measure
  25. epidemiological triad
    • host natural shelter for the organism or agent
    • agent toxins that is usually associated with the occurance of the disease
    • envrioment medium in which the disease occurs
    • disease will not occur unless three are present
    • herd immunity to kill off certian diseases
  26. uses of epidemiology
    • establishing causation
    • study of natual history of disease
    • describing the health status of population
  27. person time
    disease free time
  28. definition of health
    health is the state of complete physical, mental, social and spiritual well being and not merely the absence of disease or infirmity
  29. measurement of validity
    a variable is vaild measure of a property if it is relevant and appropriate as a representation of that property
  30. rate three types
    crude specific adjusted
  31. two types of standardization
    direct indirect
  32. two measures
    incidence prevalence
  33. prevalence of specific disease
    prevalence is the proportion of the population at risk affected by the disease at a speicifc point in time
    point prevalence
  34. specific point or period in time
    # of exsiting cases during a time period (ie the numerator)
    average population size durring a time period (exsiting cases + incident case) ie denominator
    period prevalence
  35. factors that influence prevalence
    • fatality
    • incidence
    • treatment
    • diagnosis
    • migration
    • reporting
    • duration
  36. when a new treatment is developed that prevents death but does not produce recovery from a disease the following will occur?
    incidence of disease will decrease
  37. disease rate of TB 2010
    prevalence
  38. crude mortality rate in new haven
    cumulative incidence
  39. proportion mortality due to TB
    cumulative incidence
  40. age sex specific mortality rate
    cumulative incidence
  41. cause specific mortalilty
    cumulative incidence
  42. advantages and disadvatages of curde mortality
    • are readily caculated
    • the numbers are of a whole and do not show a population composition
  43. ad disadvantages of speicific
    • ad-homogenous sub groups
    • dis-to many sub groups to calculate
  44. adjusted advant and disadvantage
    • ad-re moving bias
    • dont no dis advantage
  45. two measures of association
    • Relative risk
    • odds ratio
  46. why analyze data
    • determine the magniture of association
    • rule out the role of chance in the results by doing confidence intercal and hypothesis testing
    • rule out condounfing by restriction or statistical adjustment
  47. properties of RR
    • Ranges from 0 to infinity (ie cannot be
    • negative)


    If RR = 1 then there is no association


    • If RR > 1 then there is a positive
    • association


    If RR < 1 then there is negative association
  48. properties of OR
    • regardless of how the data are
    • sampled the or will remain the same

    • it has similar properties to the
    • RR in terms of range magnitude and statistical significance

    • under the conditions of rare
    • disease the odds ratio will be a decent approximation to the true relative risk
  49. difference between observational and experimental design study
    lack of exposure manipulation by the researcher in an observational study
  50. observational study
    study were nature is allowed to takes its course changes in one chaacteristic are studied in relation to changes in another with out intervention of investigator
  51. goals of epidemiology
    maintain an accurate picture of diesase incidnce and prevalence in a population

    • find and evaluate risk factors and correlates of a disease
    • prevent futre disease reduce incidnce/prevalence
  52. two types of observational studies
    descriptive analytical
  53. analytical studies
    • ecological-correlational-populations
    • corss sectional-prevalence-individuals
    • case control -case reference-individuals
    • cohort-followup-individuals
  54. experimental studies
    another name for it
    intervention studies
  55. randomized controlled trials
    • clinical trials
    • patients
  56. feild trials
    • community intervention studies
    • healthy people
  57. ad vantages og a observatinal study
    • Subjects more representative of target
    • population

    • More practical or feasible (although not
    • necessarily less expensive)
  58. disadvantages of observational study
    • Researcher had the least amount of control over
    • the study

    • Many distorting biases are possible and mist be
    • guarded against
  59. basic steps in design study
    • general hypothesis
    • operationalize hypothesis
    • choose study design
    • choose sample
    • collect and enter data
    • analyze data
  60. general hypothesis
    • conceptual
    • practical
  61. operationalize hypothesis
    • §
    • Define disease

    • §
    • Define exposure/correlates of interest

    • §
    • Choose a target population
  62. choose study design
    • §
    • Based on what is known about a disease

    • §
    • Time and money constraints

    • §
    • Feasibility of getting an appropriate sample
  63. choose sample
    • §
    • Should be representative of target pop

    • §
    • Should be large enough to rule out chance
  64. analyze data
    • §
    • Calculate observed association between exposure
    • and disease

    • §
    • Rule out the possibility of chance

    • §
    • Rule out alternative explanation (confounding)
  65. advantages of cross sectional study
    • ·
    • Quick

    • ·
    • Cheep

    • ·
    • Do not need large sample to do study

    • ·
    • Unit of study is individual
  66. disadvantages of cross sectional study
    • ·
    • Samples from cross sectional study designs amy
    • not be representative of disease in target population

    • ·
    • The diseases that may be reflected in the sample
    • group may not be reflected in target population

    • ·
    • Temporal relationship –idea of chicken an
    • egg—measuring exposure and disease at same time—run into problem making
    • cases—one came before other—show/demonstrate—that exposure—risk factor is responsible
    • for disease—both at same time—no opportunity to show that exposure lead to
    • disease
  67. advantages of case control
    • §
    • Cheep

    • §
    • Quick

    • §
    • Small population (sample)

    • §
    • Establish measures of association using odds
    • ratio
  68. disadvantages of case control
    • §
    • Temororal relationship (which came first)

    • §
    • Not always easy to get control
  69. §
    Compares prevalence of a disease between exposed
    and unexposed groups (aka Prevalence study)

    Data collected on individuals in a population or
    in a sample of the population about their current disease status and their
    pervious exposure status
    cross sectional
  70. ·
    Compare and contrast each design—directional
    inquire is present and case control is retrospective

    ·
    What kind of measures of association for case
    control—odds ratio –due to its retrospective (it already happened) in a case
    control study you cannot get incidence, your going back in time and you already
    have those who have the disease—therefore you cannot calculate relative risk
    case control study
  71. o
    Direction of inquiry is going forward

    o
    Begins from target population—assemble
    (cohort—group of people-specific group—have things in common) cohort(people absolutely without disease)
    eliminates confounding

    o
    Assemble cohort—exposed—non exposed

    o
    (study)Exposed—disease / no disease (assemble
    based on the factor that they have been exposed to risk factor)

    o
    (control)Non exposed—disease / no disease
    cohort study
  72. advangages of cohort
    • §
    • Best observational designs

    • §
    • Easy temporal

    • §
    • Incidence cases because going into future

    • §
    • Calculate relative risk
  73. disadvantages of a cohort
    • §
    • Expensive

    • §
    • Time consuming

    • §
    • Expensive due to time

    • §
    • Mortality—drop off by subjects of study

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