Epidemiology

Question 1

What is Epidemiology

Answer 1

The study of populations in order to determine the burden – frequency, distribution and trends of disease

Question 2

What are the major roles of epidemiology

Answer 2

Monitor infectious and non-infectious diseases​

Study natural history of diseases​

Investigation of disease risk factors​

Health care needs assessment​

Development of preventive programmes​

Evaluation of interventions​

Health Service planning

Question 3

What is epidemiology necessary for

Answer 3

To allow appropriate planning of health services

Question 4

What are the three main types of epidemiological study

Answer 4

Descriptive (observational) ​

Analytic (observational) ​
-Case-control​
-Cohort​

Intervention / experimental

Question 5

How is disease frequency measured

Answer 5

Prevelance
Incidence

Question 6

What is prevelance

Answer 6

A measurement of all individuals affected by the disease within a particular period of time or point in time​

Question 7

What is incidence

Answer 7

Incidence is a measurement of the number of new individuals who contract a disease during a particular period of time

Question 8

What is the prevelance and incidence of diabetes vs common cold

Answer 8

Diabetes:
High prevelance (because the prevalence is the cumulative sum of past year incidence rates)
Low incidence

Cold:
Low prevelance
High incidence (because many people get a cold each year, but few people actually have a cold at any given time)

Question 9

What are the advantages of studying samples and not whole populations

Answer 9

reduces no. of individuals to be sampled​

reduces cost​

higher response rate​

higher quality of information collected

Question 10

What is a systemic sample

Answer 10

indivs. selected at regular intervals from population list

Question 11

What is a stratified sample

Answer 11

ensures small sub-groups adequately represented​

Question 12

What is a cluster sample

Answer 12

use of groups as sampling units, e.g. school classes

Question 13

What is multi-stage sampling

Answer 13

Combines multiple sampling techniques

Question 14

What are some sampling techniques

Answer 14

Simple random sample ​

Systematic sample​

Stratified sample​

Cluster sample​

Multi-stage sampling

Question 15

What are common erroes in survey methodology

Answer 15

Sampling bias / selection bias​

Response bias / information bias​

Measurement error​

Observer variation (intra- or inter-)​

Loss to follow-up

Question 16

What are the properties of an ideal index

Answer 16

clear, unambiguous, not subjective​

ideally correspond with clinically important stages of the disease​

indicate treatment need​

within the ability of examiners​

reproducible​

not time-consuming​

acceptable to patient​

amenable to statistical analysis​

allow comparison with other studies

Question 17

What are limitations of the DMF index

Answer 17

Teeth extracted for reasons other than caries

Influenced by access, e.g. interproximal surface​

Difficulty in differentiating fissure-sealant from restorations – underestimate caries​

Influenced by past disease activity​

Threshold criteria of disease can vary (must specify)​

Cannot be used for root caries

Question 18

What is very early stages of decay

Answer 18

Sub-clinical decay

Question 19

What is early stage of decay

Answer 19

Decay in enamel (visible)

Question 20

What is established decay

Answer 20

Decay in dentine (visible)

Question 21

What is severe decay

Answer 21

Pulpal decay

Question 22

What is BASCD

Answer 22

British Association for the Study of Community Dentistry​

Question 23

What does SHBDEP stand for

Answer 23

Scottish Health Boards’ Dental Epidemiological Programme​

Question 24

What replaced SHBDEP

Answer 24

National dental inspection programme (NDIP)

Question 25

What does the NDIP aim to inform

Answer 25

parents of their child’s dental health status (Basic NDIP) ​ advise Scottish Government, NHS Boards, and other organisations of the oral disease prevalence in children in their area (Detailed NDIP – Epidemiology survey)

Question 26

What does NDIP target

Answer 26

Children in P1 and P7

Question 27

What is the NDIP basic

Answer 27

Offered to every child in P1 and P7 classes of local authority schools every year​ Proportion of school rolls inspected 85-90%​ Generates letter to parent​ Overall state of dental health of child​ Conveys degree of urgency with which appointment for attendance at dentist suggested for child​ Not a detailed examination of each surface of each tooth

Question 28

What is the detailed NDIP

Answer 28

more rigorous and comprehensive assessment ​ Calibration of examiners​ records status of each tooth surface in accordance with international epidemiological conventions (i.e. d3mft: caries into dentine)​ Uses same clinical inspection criteria as SHBDEP ​ can therefore look at trends from 1987 re P1 children ​

Question 29

What are the specific goals of NDIP

Answer 29

to inspect a representative sample of the P1 or P7 LA school population in any year​ to determine current levels of established tooth decay ​ to illustrate the impact of deprivation on the dental health of 5 & 11 year old children in Scotland

Question 30

What does TF4 mean

Answer 30

Flurosis index (high levels of flurosis)

Question 31

What is the IOTN

Answer 31

Index of orthodontic treatment need

Question 32

What is the purpose of the IOTN

Answer 32

Assesses need and eligibility of children for NHS orthodontic treatment on dental health grounds ​ Selects those children who will benefit most from treatment; fair way to prioritise limited NHS resources ​

Question 33

When would a child be eligible for NHS orthodontic treatment

Answer 33

Above or equal to Grade 3 dental health component and high aesthetic component

Question 34

What indices are used to identify periodontal disease

Answer 34

Plaque indices, e.g.​ - Debris Index (Green & Vermillion, 1960)​ - Plaque Index (Silness & Loe, 1964)​ Gingivitis indices, e.g.​ - Modified Gingival Index (Loe, 1967)​ - Lobene Index (Lobene, 1986)​ Periodontitis indices, e.g.​ - Basic Periodontal Examination (B