Public health deck 2

Question 1

Name 3 types of study design:

Answer 1

1. Ecological
2. Cross-sectional
3. Case-control
4. Cohort
5. RCT

Question 2

How is an ecological study carried out?

Answer 2

Routinely collected population level data to show trends and generate hypotheses

Question 3

What type of study looks at the population at a point in time?

Answer 3

Cross-sectional or prevalence study

Question 4

What type of retrospective study compares people with a disease to those without a disease for age, sex, habits, class etc?

Answer 4

Case-control study

Question 5

What type of study follows a population over time to see if they’re exposed to agent in question and if they develop a disease?

Answer 5

Cohort or incidence study: prospective

Question 6

What is a RCT?

Answer 6

Population is randomized to either interventional or control group: blind or double-blind trials.

Question 7

What type of study is also known as an incidence study?

Answer 7

Cohort study - follows population over time to see if they’re exposed to the agent in question and develop the disease

Question 8

What type of study is known as a prevalence study?

Answer 8

Cross-sectional study - looks at population at a point in time

Question 9

Define primary prevention:

Answer 9

Preventing disease/condition occurring in the first place

Question 10

What prevention method are immunisations?

Answer 10

Primary prevention

Question 11

Define secondary prevention:

Answer 11

Detecting a disease as soon as possible to alter its course and improve health outcomes

Question 12

Give an example of secondary prevention?

Answer 12

Screening e.g. cervical smear, breast screening programmes

Question 13

Define tertiary prevention:

Answer 13

Slowing down disease progression whilst avoiding complications and helping people to manage their disease effectively to reduce mortality

Question 14

Give an example of tertiary prevention:

Answer 14

Diabetes management e.g. diet advice, exercise programmes, self-monitoring.

Question 15

Give an example of a population approach to prevention:

Answer 15

Dietary salt reduction (preventative measures delivered on population level)

Question 16

What is high risk approach to prevention?

Answer 16

Identify individuals above a chosen cut-off and treat them (e.g. treat those with high cholesterol to avoid heart disease)

Question 17

Prevention paradox?

Answer 17

Preventative measure that brings much benefit to the population will offer little to each participating individual.

Question 18

Define screening:

Answer 18

Identifying seemingly health individuals at risk of disease

Question 19

4 different types of screening:

Answer 19

1. Population based
2. Opportunistic
3. Screen for communicable disease
4. Pre-employment and occupational

Question 20

Wilson and Jungar criteria for screening (x10):

Answer 20

1. Condition screened for must be IMPORTANT HEALTH PROBLEM
2. Understanding of NATURAL HISTORY of disease
3. Detectable at an EARLY STAGE
4. Treatment should be AVAILABLE
5. FACILITIES for diagnosis and treatment need to be available
6. SUITABLE TEST available
7. Test suitable for POPULATION
8. AGREED POLICY on who to treat
9. COST balanced against benefits
10. Screening is a CONTINUOUS PROCESS

Question 21

Define sensitivity:

Answer 21

Proportion of people WITH the disease correctly identified

Question 22

Define specificity:

Answer 22

Proportion of people WITHOUT disease correctly identified and excluded from screening test

Question 23

Define positive predictive value (PPV):

Answer 23

Proportion of people with a positive test result who actually have the disease

Question 24

Define negative predictive value:

Answer 24

Proportion of people with a negative test result who do not have the disease

Question 25

What are the 4 main determinants of health?

Answer 25

1. Lifestyle
2. Access to healthcare
3. Genes
4. Environment

Question 26

What is equity?

Answer 26

What is fair and just

Question 27

What is equality?

Answer 27

Equal share

Question 28

Define horizontal equity:

Answer 28

Equal treatment for equal need

Question 29

Define vertical equity:

Answer 29

Unequal treatment for unequal needs (e.g. patient with pneumonia would need significantly different treatment to someone with a common cold).

Question 30

What two factors can impact equity?

Answer 30

1. Spatial - geographical
2. Social factors - age, gender, class, ethnicity

Question 31

What is a meta-analysis?

Answer 31

Statistical tool where one pools all the available results and looks at the effect