Epidemiology Spring 2017

  1. What are the elements of disease pattern
    Time characteristics: annual, seasonal, and daily or even hourly occurrence during an epidemic

    Place characteristics: geographic variation, urban-rural, location of work or school

    Personal Characteristics:  age, race, sex, SES, Behaviors, etc...
  2. Types of epidemiology
    Descriptive: what, who, when, where

    Analytic:  Why, How
  3. This class emphasizes the methods developed by epidemiologists to:
    • Observe
    • Analyze
    • Identify
    • "natural experiments" in human populations
  4. What is a natural experiment
    Humans will naturally conduct experiments on themselves by:

    • choice
    • lifestyle
    • accident
    • political atmosphere
    • cultural beliefs
  5. Evolution of Epidemiology - Hippocrates
    400 BC - explain disease occurrence from a rational instead of supernatural viewpoint.  He suggested environmental, host factors, and behaviors might influence the development of disease
  6. evolution of epidemiology - John Graunt
    1600's - first to quantify patterns of birth, death, and disease occurrence, noting male-female disparities, infant mortality, urban-rural differences etc..
  7. Evolution of epidemiology - William Farr
    1830's - systematically collected and analyzed britains mortality statistics.  He is considered the "Father of Modern Vital Statistics and Surveillance"
  8. Evolution of epidemiology - John Snow
    1840's - an anesthesiologist who became known as the " Father of Field Epidemiology".  His work illustrates the sequence from descriptive epi to hypotheses generation to hypothesis testing (analytic) to application (the broad street pump)
  9. How to diagnose the health of the community
    • Most commonly measured by SES, education, and occupation.
    • Other ways are:
    • demographics (age gender Family status SES)
    • community (define what services are available also causes of death leading disease in community etc..)
    • Health variables
  10. The process we talked about for epidemiology for community health practice
    • 1 look at history of the health of populations
    • 2 diagnose the health of the community
    • 3 health services and evaluation
    • 4 causality in epidemiology
    • 5 identification and studies
  11. It is not ------------ to take ------------- findings and apply to the ---------------- without this -----------. However once an ---------- or -------- has been -------------- in a larger population or study group it ------- reasonable to apply findings to the -----------.
    • reasonable
    • individual
    • population
    • process
    • association
    • risk
    • identified
    • IS
    • individual
  12. define pathogenesis (natural history of disease)
    origin and development of disease
  13. what are the characteristics of pathogenesis
    • occurs after the precursors have interacted with the host
    • initial appearance of disease (presymptomatic?) characterized by tissue and physiologic changes
    • development of active signs and symptoms
    • recovery or death
  14. define prepathogenesis (natural history of disease)
    • occurs before the precursors of disease have interacted with the host
    • What are precursors?
    • How do they interact with host?
    • symptoms?
    • recovery or death?
  15. strategies for disease prevention
    • Primary prevention
    • secondary prevention
    • tertiary prevention
  16. What is primary prevention
    occurs during prepathogenesis.  Can be active or passive ie education about how have healthy eyes
  17. What is secondary prevention
    occurs during pathogenesis.  Reduce progress of disease.  ie screening for disease, eye test
  18. What is tertiary prevention
    disease has occurred.  limit disability from disease ie glasses, rehab treatment
  19. example of different types of prevention for blood pressure
    • primary: exercise limit salt, education
    • secondary: health screenings, take blood pressure
    • tertiary: medicine
  20. Define Count
    number of cases being studied
  21. Define proportion
    number of cases in a group. cases is the numerator and group is the denominator. The cases are always part of the denominator.  Always expressed as a percent so you multiply by 100.  5 cases of sickness over 21 people in class = 0.238 times by 100 for a percent = 23.8%
  22. Define Ratio
    There is no relationship between numerator and denominator. ie 21 people in class 1 is male and 20 are female so write it 1:20
  23. define rate
    uses a measure of time and allows comparisons of groups or populations over the same time period. Can also be comparisons among different groups in same time period.
  24. Prevalence rate
    • is the proportion of persons in a population who have a particular disease at a specified point in time (point prevalence) or over a specified period of time (period prevalence)
    • all new and preexisting cases during a given time period/population during the same time period multiplied by 10 to the nth power
  25. Incidence rate
    • is a measure of the frequency with which an event occurs in a population over a period of time.  The numerator is new cases during the specified period.  The numertor should not include cases which occurred or were diagnosed earlier.  The denominator is the population at risk.
    • new cases occurring during a given time period/ population at risk during the same time period multiplied by 10 to the nth power
  26. Attack rate
    similar to incidence rate.  used for a well defined population observed for a limited time (you know everyone who was there like at a church party).  This rate is usually expressed as a percent so 10 to the nth power equals 100. number of new cases among population during the period/ population at risk at teh beginning of the period multiplied by 10 to the nth power
  27. Crude rates
    • based on the actual number of events in a population over a given time period
    • Birth rate
    • fertility rate
  28. Birth Rate (crude rate)
    • number of live births during a time period
    • live births/population
  29. Fertility rate (crude rate)
    number of live births in an area during a time period divided by the number of women of child bearing age (generally 15 - 44)
  30. What is Data Sharing
    • Investigator shares findings with others to create large data sets and pooling of information (called meta analysis)
    • Enhances knowledge BUT primary investigator loses control
  31. Vital Records - Mortality statistics
    • All deaths in the US and other developed countries
    • includes demographic information and cause of death
    • cause of death may not be a secondary illness to the initial disease of interest
    • primary cause of death may be unclear
  32. Communicable Disease Rule to report diseases to public health
    • individual states can add diseases of local concern
    • CDC maintains surveillance for diseases of interest that can spread rapidly and affect large populations or diseases of rare occurrence
Card Set
Epidemiology Spring 2017
Cards for study for the midterm in epidemiology spring 2017