2nd year Flashcards
(102 cards)
1
Q
A
2
Q
What is the definition of epidemiology?
A
Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems
3
Q
What is the definition of prevalence?
A
The number of cases of a disease in a given population at a designated time
4
Q
What is the definition of incidence?
A
The number of new cases of a disease in a given population during a specific time period
5
Q
What type of epidemiology is the following?
- systematic approach
- data to describe the distribution of diseases/health states and determinants in populations and areas in time (who, what, when, where)
- can be used to develop hypothesis on risks and causes
A
descriptive epidemiology
6
Q
What type of epidemiology is the following?
- concerned with the search for causes and effects, or the why and how. This is used to quantify the association between exposures and outcomes to test hypotheses about casual relationships
A
analytic epidemiology
7
Q
What type of epidemiology is the following?
- observational approach which attempts to relate differences in prevalence or incidence to differences in environmental, biological or social factors that may be relevant to understanding aetiology or prevention
A
observational epidemiology
8
Q
What 3 things is epidemiology used to compare between diseases/disorders?
A
- time (trends across time)
- place (geographic - high risk groups)
- people (gender, class, ethnic group)
9
Q
What are 3 reasons why to survey oral health?
A
- to understand the distribution and determinants of oral diseases
- to enable trends in the prevalence of oral diseases to be monitored
- to assist in the planning of services
10
Q
Which type of survey is the following?
- comparable data across parts of the UK, monitor trends through time
- used for national planning
- provides information on all major oral conditions
- only once every 10 years
- data is only available for large geographical regions therefore there is a lack of local data for planning
A
national surveys
11
Q
Which survey is the following?
- annually since 1985
- public health dentists wanted local oral health data
- local data needed to be comparable to data from other regions
- surveys carried out under the umbrella of the British Association for the Study of Community Dentistry (BASCD)
- official statistics
A
public health england
national dental epidemiology programme (NDEP)
12
Q
What is the following indices used to measure?
- D3MFT
A
decayed, missing, filled adult teeth
13
Q
What is the following indices used to measure?
- d3mft
A
decayed, missing, filled baby teeth
14
Q
What is the following indices used to measure?
- BPE
A
basic periodontal examination
15
Q
What is the following indices used to measure?
- IOTN
A
index of orthodontic need
16
Q
What is the following indices used to measure?
- DDE
A
developmental defects in enamel
17
Q
What are the indices used to measure fluorosis?
A
- thylstrup fejekov index
- deans index
18
Q
What is the following indices used to measure?
- PAR (peer assessment rating)
A
orthodontic treatment outcome
19
Q
What are the 6 properties of an ideal index?
A
- simple
- objective
- valid
- reliable
- quantifiable
- sensitive
- acceptable - volunteer and user
20
Q
What is the purpose of calibration for survey examiners?
A
to minimise variation between examiners and over time
21
Q
How is examiner calibration measured?
A
measured by performing 2 or more independent measures and comparing the findings using an appropriate statistical procedure such as Kappa
22
Q
What are dental aspects of standardisation?
A
- equipment
- light
- position
- dry/not dry
- patient factors
- environment
- diagnostic aids
23
Q
What are the 3 caries measures used in the NDEP surveys?
A
- proportion with caries (using DMFT/dmft)
- care index
- proportion with sepsis
24
Q
What would surface code 0 indicate?
A
sound
25
What would surface code 2 indicate?
decayed
26
What would surface code 4 indicate?
filled and decayed
27
What would surface code 1 indicate?
arrested dentinal decay
28
What would surface code 5 indicate?
filled with no decay
29
What would surface code T indicate?
trauma
30
What would surface code 3 indicate?
gross caries into the pulp
31
What does D4 indicate?
lesions into pulp
32
What does D3 indicate?
clinically detectable lesions in dentine (open and closed)
33
What does D2 indicate?
clinically detectable cavities limited to enamel
34
What does D1 indicate?
lesions detectable only with additional diagnostic aids
35
What are 6 oral epidemiology measures?
- pulp ulceration fistula abscess
- tooth wear
- enamel defects
- periodontal disease
- oral cancer
- quality of life measures
36
What are 3 advantages of using DMFT?
- measures caries experience
- easy to use, simple
- world wide usage
37
What are 5 disadvantages of DMFT?
- diagnostic criteria can be different between countries and through time
dmft = 10, patient could have 10 extracted teeth or 10 minimally filled teeth
- assumes all extractions due to caries
- assumes all fillings due to caries
- the decayed component includes arrested caries, dentinal caries, caries with pulpal involvement, filled with caries
38
Who measures oral health in the UK?
- government national surveys
- Public Health England (national dental epidemiology programme local surveys)
39
What is included in the national survey of adult dental health interviews?
- social and behavioural characteristics
- reasons for attending the dentist
- experiences
- opinions about visiting the dentist
- dental hygiene behaviour
- impact of dental disease
- treatment preferences
- attitudes, expectations and experiences
40
What is included in the national surveys of adult dental health dental examinations?
- condition of the teeth
- loss of teeth
- fissure sealants
- tooth wear
- restorative treatment
- root caries
- periodontal status/loss of attachment
- dentures
41
What has the national surveys of adult dental health found over time?
- levels of dental decay have been falling for decades
- numbers of restored teeth have decreased in younger adults and increased in older adults
- increased numbers of crowns
- decrease in edentulousness
42
NDEP survey of 5 year olds (2019)
What is the mean dmft of 5 year olds in England?
0.8
43
NDEP survey of 5 year olds (2019)
What is the percentage of caries in 5 year olds in England?
23.4%
44
NDEP survey of 5 year olds (2019)
What is the care index percentage in England?
10.3%
45
What is the definition of validity?
the degree to which a study accurately reflects or assesses the specific concept that the researcher is attempting to measure
- produces an outcome that reflects the aim
- substantiation based on what will happen in the future
- includes an element of judgement
- may be an element of reality bias
46
What is the definition of reliability?
the extent to which a measure, procedure or instrument yields the same result on repeated trials
- consistent replicable outcomes
- substantiation due to past experience
- uses objective variables
- minimises judgement
- aims to avoid bias
47
Which type of research is the following?
- classifies, counts and constructs statistical models in an attempt to explain what is observed
- the researcher uses tools, such as questionnaires or equipment to collect numerical data
quantitative research
48
What are 5 types of quantitative studies?
- non randomised controlled trial
- randomised controlled trial
- case control study
- cohort study
- cross sectional study
49
Which type of observation study is the following?
- participants HAVE the disease - goes back in time to find possible cause
case control study
50
Which type of observational study is the following?
- participants have been exposed.
- goes FORWARD in time to see the differences
cohort study
51
Which type of observational study is the following?
- one off exploration linking disease and possible association
cross sectional study
52
Which type of study design is the following?
- the intervention is under the control of the researcher
interventional (active)
53
Which type of study design is the following?
- the researcher observes patients at a point in time (cross-sectional studies) or over time (longitudinal studies)
- these can be done by looking forward and gathering new data (prospective) or if the data already exists - backwards (retrospective)
observational (passive)
54
What is the definition of bias?
any factor or process that acts to deviate the results or conclusions of the study away from the truth, causing either an exaggeration or an underestimation of the effects of an intervention
55
Which type of observational study is the following?
- often used to describe a condition, usually a rare disorder or a novel aspect of a less rare condition, a new treatment or innovation, or adverse effects of an intervention
- the description of cases may alert the world to important new problems and then allow hypotheses to be developed, leading to focused studies of stronger design
case reports
56
Which type of study is the following?
- one group (inception cohort) are people who have a positive screening test or who have all been diagnosed with an early stage of a disease
- they are followed and evaluated on a repeated basis to assess the development of the disease
descriptive study
57
What is an advantage of a descriptive study?
- provide a richness of information which cannot be conveyed in a trial
58
What are 2 disadvantages of a descriptive study?
- isolated observations, are collected in an uncontrolled, unsystematic manner
- information gained cannot be generalised to a larger population of patients
59
Which type of study is the following?
- people with a particular condition are matched with a group of people who do not have the disorder
- researchers looks back in time to determine the proportion of people in each group who were exposed to the suspected causal factor
case control study
60
What are 2 advantages of a case control study?
- this is a relatively quick and inexpensive study and is often the best design for rare disorders or when there is a long time lag between the exposure or the outcome
- small number of recruits required
61
What are 2 disadvantages of a case control study?
- relies on memory (recall bias) or on medical records, which may be inaccurate or incomplete
- bias may be a problem in this type of study
62
Which type of study is the following?
- it is known at the outset whether people have been exposed, or not, to a treatment or possible causal agent
- the subjects are divided into groups on this basis
- followed forward in time for years or even decades to see how many in each group develop a particular disease or other outcome
cohort study
63
What are 3 advantages of a cohort study?
- these studies are usually less expensive and easier to administer than RCTs
- they may also be ethically more acceptable, because a potentially beneficial treatment is not withheld
- a possibly harmful treatment is not given
64
What are 2 disadvantages of a cohort study?
- you can never be sure that the cohorts are well matched and that there are not other factors, such as social class or occupational exposure, that may influence the results
- rare disorders, the sample size or length of follow up needed to show an effect may be large
65
Which type of study is the following?
- this design attempts to establish an association between a possible causal factor and a condition, by determining an exposure to the factor and situation at the same time
e.g. a large proportion of parents might be interviewed to determine if their child had visited the dentist in the last few months and had been given a fluoride varnish application
cross-sectional study
66
What are 3 advantages of a cross-sectional study?
- relatively easy
- inexpensive to carry out
- ethically acceptable
67
What are 2 disadvantages of a cross-sectional study?
- can only establish an association, not a cause and effect relationship
- in addition, both 'exposure' and 'situation' may depend on accurate recall of past events
68
Epidemiological studies can be classified as descriptive, interventional or analytical.
Rank them from most to the least sophisticated
interventional, analytical, descriptive
69
Which type of data is the following?
- the aim is a complete, detailed description
- recommended during earlier phases of research projects
qualitative
70
In what order is the hierarchy of evidence?
1. systematic review
2. randomised controlled trials
3. cohort studies
4. case-control studies
5. case series, case reports
6. editorials, expert opinion
71
In DBOH, which stage of prevention is the following?
- Reducing the incidence of disease and health problems within the population, either through universal measures that reduce lifestyle risks and their causes or by targeting high-risk groups.
primary
72
In DBOH, which stage of prevention is the following?
- Detecting the early stages of disease and intervening before full symptoms develop
secondary
73
In DBOH, which stage of prevention is the following?
- Softening the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often complex health problems and injuries.
tertiary
74
What is the definition of ethics?
the application of moral rules and professional codes of conduct to the collection, analysis, reporting and publication of information about research subjects, in particular active acceptance of subjects right to privacy, confidentiality and informed consent
75
Which principle of research ethics is the following?
- research should be designed, reviewed and undertaken to ensure integrity, quality and transparency
principle 1
76
Which principle of research ethics is the following?
- research staff and participants must normally be informed fully about the purpose, methods and intended possible uses of the research, what their participation in the research entails and what risks, if any are involved
principle 2
77
Which principle of research ethics is the following?
- the confidentiality of information supplied by research participants and the anonymity of respondents must be respected
principle 3
78
Which principle of research ethics is the following?
- research participants must take part voluntarily, free from any coercion
principle 4
79
Which principle of research ethics is the following?
- harm to research participants must be avoided as far as possible, this includes publishing studies that have not 'worked' or harm has been done (malevolence)
principle 5
80
Which principle of research ethics is the following?
- the independence of research must be clear, and any conflicts of interest or partiality must be explicit, having an independent review of the research is good practice
principle 6
81
What is the purpose of the health research authority?
to protect and promote the interests of patients and the public in health research, and to streamline the regulation of research
81
Researchers undertaking research within the NHS must satisfy a research ethics committee, what 4 things must they show?
- ensure any anticipated risks, burdens or intrusions will be minimised and are justified by the expected benefits for the participants or for science and society
- protects people who take part in research
- promotes public confidence about the conduct of researchers and the dignity, rights, safety and well-being of research participants
- hopefully resulting in more people taking part in research, this in turn leads to more, better and quicker improvements in health and social care
81
Which group within research is the following?
- meet approximately every 1-2 months
- consist of trained lay and specialist members
- proper governance arrangements are essential to ensure that service users and the public can have confidence in, and benefit from, high quality ethical research
research ethics committee
82
If research poses more than a minimal risk, who would review this?
full review by NHS national research ethics service REC
83
If research does not pose more than a minimal risk, who would review this?
review by 'light touch' department of the national research ethics service REC
84
Research involving which 8 criteria must legally be considered for ethics committee review?
- people who lack (or lose) capacity to give informed consent to take part in the research
- processing of confidential patient information without consent where this would otherwise breach confidentiality using material that does not or did contain living cells
- patients who cared for in private and voluntary sector nursing homes and/or residential homes
- exposure to ionising radiation
- testing medical devices that are not CE-marked, or those which are CE-marked and have been modified
- investigating medicines
- practicing midwives
85
What are the 11 ways of putting ethical principles into action?
- honesty
- objectivity
- integrity
- carefulness
- openness
- have respect for intellectual property
- confidentiality
- responsible publication
- social responsibility
- competence
- legality
86
Which type of research is the following?
- investigates subjective experiences, perceptives, understandings and constructions of people in their everyday social words
- not interested in objective truth
qualitative research
87
What are 4 values of qualitative research to dentistry?
- patient/practitioner anxieties and attitudes towards treatment modalities
- relationships between professional groups and/or managers
- attitudes towards policy, organisation, management and new practices
- dental pedagogy: dental teaching, learning and assessment
88
What is the following describing?
- research being carried out with or by members of the public rather than to, about or for them
this includes, for example, working with research funders to prioritise research, offering advice as members of a project steering group, commenting on and developing research materials, undertaking interviews with research participants
patient and public involvement (PPI)
89
What are 3 qualitative research traditions?
- ethnography
- phenomenology
- grounded theory
90
Which qualitative research tradition is the following?
- cultural interpretation, participant observation/field setting
- beliefs, kinship, ways of living
- what is happening and why?
ethnography
91
Which qualitative research tradition is the following?
- the study of lived experience
- exhaustive, reflective description of what it is like to experience something
- not interested in cause-effect or objective reality
phenomenology
92
Which qualitative research tradition is the following?
- the discovery of theory from data
- understand a process/phenomena through a theory that is grounded in the data
- iterative process; analysis and collection occur concurrently
- constant comparison, similarities and differences between participants to identify relations, what has caused these differences?
grounded theory
93
What is the analytical strategy of grounded theory?
constant comparative analysis
94
What is the analytical strategy of phenomenology?
phenomenological reduction; hermeneutic analysis
95
What is the analytical strategy of ethnography?
representation, inscription, translations and textualisation of culture into writing
96
What way of gathering qualitative data is being described?
- researcher facilitates and group discusses topic, recorded and transcribed
focus group
97
What are 4 obervational roles?
- observer: observes but remains detached
- participant observer: critically observes but is drawn in
- observing participant: conflict between immersion and remaining detached
- participant: is considered a member of the community; can be difficult to maintain a critical stance
98
What considerations should be thought about when deciding on sample size for qualitative research?
- study aim
- how specific characteristics are
- existence of establish theory
- quality of dialogue
- analysis strategy
99
What are the 7 steps of thematic analysis?
(identifies, analyses, and reports patterns across data sets)
- familiarise yourself with data (transcribe)
- generate initial codes
- searching for themes
- review themes
- define and name themes
- producing the report
100
