Chapter 3

Question 1

Single case or Small Series: Uses

Answer 1

Alert to new disease or resistant disease; alert to potential spread beyond initial area

Question 2

Single case or Small Series: Advantages/Disadvantages

Answer 2

Useful for dramatic, unusual, and new conditions; requires alert clinicians and rapid ability to disseminate information

Question 3

Statistics (“Vital Statistics”) & Reportable Diseases: Uses

Answer 3

Required by law— sometimes penalties imposed for noncompliance; births and deaths key to defining leading causes of disease; reportable disease may be helpful in identifying changes over time

Question 4

Statistics (“Vital Statistics”) & Reportable Diseases: Advantages/Disadvantages

Answer 4

Vital statistics very complete because of social and financial consequences; reportable disease often relies on institutional reporting rather than individual clinicians; frequent delays in reporting data

Question 5

Surveys— sampling: Uses

Answer 5

Drawing conclusions about overall population and subgroups from representative samples
Registries attempt to include all those with a disease in order to be representative of the population

Question 6

Surveys— sampling: Advantages/Disadvantages

Answer 6

Well-conducted surveys allow inferences to be drawn about larger populations; frequent delays in reporting data
Difficult to include all potential patients in disease registries

Question 7

Self-reporting: Uses

Answer 7

May help identify unrecognized or unusual events

Question 8

Self-reporting: Advantages/Disadvantages

Answer 8

Useful when dramatic unusual events closely follow initial use of drug or vaccine; tends to be incomplete; difficult to evaluate meaning because of selective process of reporting

Question 9

Sentinel monitoring: Uses

Answer 9

Early warnings or warning of previously unrecognized events

Question 10

Sentinel monitoring: Advantages/Disadvantages

Answer 10

Can be used for “real-time” monitoring; requires considerable knowledge of patterns of disease and use of services to develop

Question 11

Syndromic surveillance: Uses

Answer 11

May be able to detect unexpected and subtle changes, such as bioterrorism or new epidemic producing commonly occurring symptoms

Question 12

Syndromic surveillance: Advantages/Disadvantages

Answer 12

May be used for early warning even when no disease is diagnosed; does not provide a diagnosis and may have false positives

Question 13

Social media: Uses

Answer 13

Detect and monitor course of influenza epidemic

Question 14

Social media: Advantages/Disadvantages

Answer 14

Potential for immediate data obtained from a large number of individuals
Accuracy and precision of the data for early and ongoing surveillance needs to be established

Question 15

health-adjusted life expectancy (HALE)

Answer 15

Mobility—the ability to walk without assistance
Cognition—mental function, including memory
Self-care—activities of daily living: dressing, eating, bathing, & toilet use
Pain—regular pain that limits function
Mood—alteration in mood that limits function
Sensory organ function—impairment in vision or hearing that impairs function

Question 16

under-5 mortality

Answer 16

the standard health status measure used by the World Health Organization (WHO) to summarize the health of children.

Question 17

disability-adjusted life year (DALY)

Answer 17

compares a country’s performance to the country with the longest life expectancy

Question 18

Health literacy

Answer 18

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Question 19

dread effect

Answer 19

is present with hazards that easily produce very visual and feared consequences.

Question 20

unfamiliarity effect

Answer 20

Our degree of familiarity with a potential harm or a potential benefit can greatly influence how we perceive data and translate it for our own situation.

Question 21

uncontrollability effect.

Answer 21

We often consider hazards that we perceive as in our control as less threatening than ones that we perceive as out of our control.

Question 22

Discounting

Answer 22

a quantitative process in which we give greater emphasis or weight to events that are expected to occur in the immediate future compared to events that are expected to occur in the distant future

Question 23

decision maker

Answer 23

may be an individual; a health professional; or an organization, such as a nonprofit, a corporation, or a government agency.

Question 24

inform of decision approach

Answer 24

implies that the clinician has all the essential information and can make decisions that are in the patient’s best interest. The role of the clinician is then merely to inform the patient of what needs to be done and to prescribe the treatment, or write the orders.

Question 25

informed consent

Answer 25

rests on the principle that ultimately, patients need to give their permission or consent before major interventions, such as surgery, radia- tion, or chemotherapy, can be undertaken. Informed consent may be written, spoken, or implied. Clinically, informed consent implies that individuals have the right to know what will be done, why it will be done, and what the known benefits and harms are.

Question 26

shared decision-making

Answer 26

In this approach, the clinician’s job is to provide information to the patient with which he or she can make a decision.