Epidemiology Chp. 4
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What is the crude birth rate?
 Used to project population changes; it is
 affected by the number and age composition of women of childbearing age

How do you calculate the crude birth rate?

What is the general fertility rate?
 Used for comparisons of fertility among
 age, racial, and socioeconomic groups.

How do you calculate the general fertility rate?

How do you calculate the infant mortality rate?

What is the neonatal infant mortality rate?
 •Reflects events happening after
 birth, such as congenital malformations, prematurity (birth prior to 28 weeks
 gestation), Low birth weight (<2500 grams)
 •Number of deaths occurring in
 infants less than or equal to 28 days old per total number of live births

How do you calculate the neonatal infant mortality rate?

What post neonatal infant mortality rate?
 •Reflects environmental events,
 control of infectious disease and improvement in nutrition. Relatively stable over time
 •Number of deaths in infants age
 greater than 28 days but less than 365 days old per total number of live births

How do you calculate the fetal death or mortality rate?

What is the fetal death or mortality rate?
 •Used to estimate the risk of death
 of the fetus associated with the stages of gestation
 •The number of fetal deaths after 20
 weeks gestation per 1,000 live births plus fetal deaths

What is maternal fatality rate?
Reflects health care access and socioeconomic factors; it includes maternal deaths resulting from causes associated with pregnancy and puerperium (during and after childbirth).

How do you calculate the maternal fatality rate?

What is the perinatal mortality rate?
 •Reflects events that occur during
 pregnancy and after birth; it combines mortality during the prenatal and
 postnatal periods
 •The number of deaths to infants
 between 28 weeks gestation to 7 days after birth per 1,000 live births plus
 fetal deaths

How do you calculate the perinatal mortality rate?

What the abortion ratio?
•Compares the number of abortions to the number of live births occurring during the same time period

How do you calculate the abortion ratio?

Median age at death is _____
Life Expectancy

What is frequency?
•Raw counts
Number of males
Number of patients missed appointments
Number of cancer deaths
Number of cases

What is relative frequency?
 Frequency/counts relative to something.
 Ex.

What is rate?
a ratio that consists of a numerator and a denominator and in which time forms part of the denominator.
•Contains the following elements:
–disease frequency
–unit size of population
–time period during which an event occurs

Give an example of a rate.

What is the caution when using crude rates?
 •Use crude rates with caution when
 comparing disease frequencies between populations.
 •Observed differences in crude rates may
 be the result of systematic factors (e.g., sex or age distributions) within the
 population rather than true variation in rates.

What are specific rates?
 Specific rates refer to a particular subgroup of the population defined in terms of
 race, age, sex, or single cause of death or illness

What is a ratio?
 •The value obtained by dividing one
 quantity by another
 •The most general form has no specified
 relationship between numerator and denominator.
 •Proportions, rates, and percentages are
 also ratios.

What is a proportion?
 •A measure that states a count relative to
 the size of the group.
 •A ratio in which the numerator is part of
 the denominator.
•May be expressed as a percentage.

List mortality measures.
•Crude death rate
 •Agesexrace
 specific death rate
 •Cause
 specific death rate
 •Proportionate
 mortality rate
 •Standardized
 Mortality Ration (SMR)

How do you calculate age specific rate?

How do you calculate the agesexrace specific rate?

How do you calculate the proportionate mortality rate?

What is the proportional mortality ratio?

How do you calculate the Standardized Mortality Ratio (SMR)?

How do you interpret SMR?
 •If the observed and expected numbers are
 the same, the SMR would be 1.0, indicating that observed
 mortality is not unusual.
 •An SMR of 2.0 means that the death rate in the
 study population is two times greater than expected.

What are measures of morbidity?
•Reported Disease Rate
•Hospitalization Rates
•Incidence Rates
•Prevalence Rates
•Attack Rates
•Epidemic Curve

What is the reported disease rate?
 The number of cases of a notifiable
 disease reported during a specified period of time per 100,000 (crude
 rate). Age, race, sex specific reported
 case rates may be obtained in the same manner as crude death rates.

How do you calculate the hospitalization rate?

What is incidence?
 The number of new cases of a disease that
 occur in a group during a certain time period.
 •Describes the rate of development of a
 disease in a group over a certain time period.

What are the three elements of incidence rate?
–Numerator = the number of new cases.
–Denominator = the population at risk.
 –Time = the period during which the cases
 occur.

How do you calculate the incidence rate?

What is incidence density?
 An incidence measure used when members of a population or study group are under observation for different lengths of
 time.

How do you calculate incidence density for time and years?

What is prevalence?
 The number of existing cases of a disease
 or health condition in a population at some designated time.
•Provides an indication of the extent of a health problem.

How do you calculate point prevalence?

How do you calculate period prevalence?

What is prevalence used for?
 •Describing the burden of a health problem
 in a population.
•Estimating the frequency of an exposure.
 •Determining allocation of health
 resources such as facilities and personnel.

what is the interrelationship between prevalence and incidence rate?
 •If duration of disease is short and
 incidence is high, prevalence becomes similar to incidence.
 •Short durationcases recover rapidly or
 are fatal.
•Example: common cold
 •If duration of disease is long and
 incidence is low, prevalence increases greatly relative to incidence.
•Example: many chronic diseases

What are epidemic curves?
Plotting of the frequency of incident cases over time