Exam 2 Flashcards
Characteristics of time in descriptive epidemiology (1)
-common/point epidemics -shared exposure to
something noxious to a whole group.
-may occur within 1 incubation period for the infectious
disease.
EX Cholera epidemic in London in 1854.
Characteristics of time in descriptive epidemiology (2)
secular time trends
- gradual changes in frequency over long periods of time.
- These give rise to understanding if interventions made on the group, such as diet/exercise/medications/change in habits help to reduce the frequency of it.
I.E. lung cancer rates in the 1960s - 1990s - 2015.
Characteristics of time in descriptive epidemiology (3)
cyclic fluctuations/seasonal trends - increases/decreasesin frequency of disease/health condition over period of year(s).
i.e. birth rates, Flu, ER visits. flu has seasonal increase during cold, peaks/decreases from Feb-May. Give rise to understand why time of year has an effect
Geographic Information Systems (GiS)
- Provide spatial perspective & statistical analysis of geographic distribution of condition
- integrated set of tools within an automated system.
- does NOT create data.
IE find where disease occurrence/mortality is highest in research.
Death Certificates benefits
- demographic information/
- mortality/morbidity overall including cause of death
- indices of public health
- detecting outbreaks of infectious disease
HIPAA
- created standards for electronic exchange/privacy/security of PH information.
- including PHI that can bring any identifiable info.
- relating to provision of HC for a person. payments.
hospital/
S: diagnostic information may be of higher quality than that from other sources;
W:
- difficult to relate cases to population denominator,
- may not be well developed/ complete.
- information may be hard to access
ecological fallacy
- Occurs where an analysis of group data is used to draw conclusions about an individual.
- use statistical data and apply it incorrectly.
- Try too hard to find factual support for their arguments.
EX - A study of a city is used to draw detailed conclusions about the people who live there.
survival curve
portrayys survival time. UTILIZES -- time of entry/ -- death(or other outcome/ -- status of patient at that time. -helps in research on infectious diseases, clinical trials, even psych disorders.
clinics
S: Counts of patients treated;
W: -difficult to determine prevalence rates
- populatipon denominator may be unknown.
- information may be hard to access
physician records
S: useful in ID cases;
W:vary in completeness/quality,
duplication of cases for patients w/ 2+ providers
information may be hard to access
URBAN differences in disease rates as the characteristics of place in descriptive epidemiology.
Mortality and Morbidity: Diseases are more likely to be spread by person to person contact/crowding/poverty associated with urban pollution.
Ex: Lead poisoning has been associated with inadequate housing and is found in inner city areas.
RURAL differences in disease rates as the characteristics of place in descriptive epidemiology
- Unique environmental and cultural factors that could reinforce unhealthful behaviors.
- Region has an impact on the factors affecting.
EX: Southern rural areas- the population is poorer, smoke more, more physically inactive, THEREFORE ischemic heart disease mortality is higher
Urbanization Effects part 1
- Infant, child and young adult mortality- Increased with decreasing urbanization.
- Adult mortality- increased with decreasing urbanization
- Poor or fair health status – Increased with decreasing urbanization.
Urbanization Effects part 2
- Homicide – Mainly in Urbanization
- Health Insurance – Increases with urbanization; was
lowest among individuals in large rural metro counties.
Death certificates Limitations
- chronic illnesses complicate cause of death.
- lack of standardization of diagnostic criteria by medical personnel especially regarding ICD 9/10.
- stigma of knowing patient.
Causation
- Time order (IV DV)
- Strength of association/relationship (linked somehow positive or negative)
- Ruling out confounding factors
- something that looks like a cause but it isn’t
1 Case Study Design
- cannot nail down for C& ;E.
- in-depth investigation of person or a service that is provided.
EX: Large aprtment complex, low to moderate income”
conducted a needs assessment. Nobody wanted to voice their opinions because of fear of raising of rent or getting evicted.
Case Study Design S/W
S: Very in-depth
W: Cannot generalize to the population. Isn’t representative to target population
2 Cross sectional
- Cannot show for C&E but can only show associations.
- Obtain only representative samples to generalize/infer whole population
- Risk Factors and Protective Factors
- Be cautious of language barriers, health literacy
EX: how much do you weigh? How much do you smoke? (reports are inaccurate).
Cross Sectional S/W
S: - can tell about incidence/prevalence of a condition
- can ask other questions to determine causative factors
- relatively quick/ inexpensive
W: -Biased if it does not represent the population.
- cannot prove time order
- not good for rare conditions
- majority of time, material is self reported
3 Retrospective
- Compare those that have/dont have disease
-Usually clinically based study
EX: Think about smoking. Looking back, of those with lung cancer, 75% were smokers. 25% not.
Retrospective S/W
S:
- good for rare diseases b/c it’s clinically based and we have access to ppl with disease.
- observe association
- clinical verification in diagnosis
- relatively inexpensive
W:
- HIPPA & confidentiality breech
- organizing data
- confounding factors that might influence the diagnosis
- not generalizable to the general populations b/c these ppl are sick lol
4 Prospective AKA Longitudinal design
- following people over time- “Boyhood”
- wait for risk factors to take effect for observation
EX: Get a sample of folks living in Oakland
- Do they have the Dx??
- If they have disease you are studying, then they’re KICKED OUT of study
- We only want those that are free of condition.
- Make a questionnaire and make them answer the questions
