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Epidemiology > Exam2 > Flashcards

Exam2 Flashcards

(65 cards)

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0
Q

What is thoroughness

A

The extent to which all cases of a health phenomenon have been identified

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1
Q

What is representativeness and another name for it

A

(External validity)

Generalizability of findings to the population from which the data have been taken

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2
Q

What is HIPAA

A

Health insurance portability and accountability Act

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3
Q

What statistics are derived from vital statistics

A

Mortality statistics

Birth statistics: certificates of birth and fetal death

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4
Q

What data is on a death certificate

A

Demographic information about deceased and cause of death. (Immediate cause and contributing factors)

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5
Q

What are limitations of mortality data

A
  • Certification of cause of data
  • Lack of standardization of diagnostic criteria
  • Stigma associated with certain disease (AIDS, may lead to inaccurate data)
  • Errors in coding by nosologist
  • Changes in coding (revision in the International Classification of Disease)
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6
Q

When are birth certificates unreliable

A

Mothers’ recall inaccurate

Conditions not present at birth

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7
Q

What are reportable disease statistics

A

Federal and state statutes require health care providers to report those cases of disease classified as Reportable and Notifiable

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8
Q

What are reportable disease statistic limitations

A
  • Possible incompleteness of population coverage
  • Failure of physician to fill out required forms
  • Unwillingness to report cases that carry a social stigma
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9
Q

Screening surveys

A

-Conducted to identify individuals who may have infectious or chronic disease

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10
Q

Screening limitations

A

clientele are highly selected (individuals who participate are concerned about the particular health issue

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11
Q

Disease registries such as SEER are good for what type of data

A

Collection of data about disease

Coding algorithms are used to maintain patient confidentiality

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12
Q

SEER Surveillance Epidemiology, and End Results program

A
  • conducted by the national Cancer Institute(NCI)
  • collects Cancer data from different Cancer registries across the U.S.
  • provides information about trends in cancer incidence, mortality, and survival
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13
Q

What are deficiencies in hospital data

A
  • not representative of any specific population
  • different information collected on each patient
  • settings may differ according to social class of patients
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14
Q

What are case control studies good for studying

A

Unusual and rare diseases

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15
Q

What is Dr. office data useful for

A
  • verification of self-reports

- source of exposure data

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16
Q

Absentee data?

A
  • Records of absenteeism from work or school

- useful for rapidly spreading conditions

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17
Q

What have school health program data been used to study

A

Studies of intelligence, mental retardation, and disease etiology

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18
Q

If I wanted info on characteristics of US population where would I go for data

A

U.S Bureau of the Census publication

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19
Q

What is a census tract and how many residents in it

A
  • small geographic subdivision of cities, countries and adjacent areas.
  • Each tract contains about 4,000 residents
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20
Q

Incidence and Prevalence difference

A

Incidence:new cases of disease
Prevalence: refers to all cases of a disease

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21
Q

Difference between observational and experimental

A

Experimental: maintain the greatest control over research : both manipulated and random
Observation: neither manipulated nor random

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22
Q

Difference between quasi and experimental

A

Quasi experimental studies are manipulated but not random (community trials)

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23
Q

What is unit of analysis in ecological study

A

The group

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24
Examples of ecological studies
- A study of childhood lead poisoning in Massachusetts | - The inverse relationship found in the Seven Countries Study between blood pressure and stroke mortality
25
Ecological fallacy
Observation made at group level may not represent the exposure-disease relationship at the individual level
26
Details on cross sectional study and examples
-Are not required to include both exposure and disease. -Some may only measure the distribution of certain exposures. -the unit of observation and analysis is the individual Ex:extent of smokeless tobacco use
27
Uses of cross sectional studies
Collecting data to describe the magnitude and distribution of health problems, data essential for planning health services and administrating medical care facilities.
28
cross sectional studies limitations
- limited usefulness for inferring disease etiology - inability to study disease of low frequency. - because exposure and disease history are taken at the same time one must be carful about the temporality issue
29
What are case control studies and characteristics
A type of analytic study "of persons with the disease of interest and a suitable control group of persons without the disease. -seeks to identify possible causes of the disease by finding out how the two groups differ with respect to exposure
30
How do we determine the best controls
The controls are equal to the cases in all respects other than the disease and the hypothesized risk factor.
31
What is the best measure of association for case control studies
Odds ratio
32
Calculate an Odds ratio and interpret the results
``` AD/BC=OR A=positive yes B=negative yes C=positive no D=negative no ```
33
How do you interpret a score of 1, less than one and greater than one for Odd Ratio
1.0= (null) particular exposure not a risk for disease 2.0= cases were twice as likely as the controls Less than 1.0= a protective factor
34
case control studies advantages
- smaller - quick& easy to complete - cost effective - increase in likelihood of being repeated
35
case control studies limitations
- unclear temporal relationship between exposure and disease - use of indirect estimates of risk - indeterminate representativeness of case and controls
36
Difference between descriptive and analytic studies in terms of the hypothesis
Descriptive: generate hypotheses (what, who, where, when) Analytic: test hypotheses (why, how)
37
What is temporality
Refers to the timing of information about cause and effect
38
What is a cohort
Cohort is defined as a population group, or subset thereof, that is followed over a period of time.
39
What is a cohort effect and an example
The influence of membership in a particular cohort. | Ex: tobacco in the US (fewer than 5% smoked in the 1990's)
40
What are life tables and how does it differ from a period life table
Cohort life table: shows the mortality experience of all persons born during a particular year. Period life table: (current) enables us to predict the future life expectancy of persons born during the year as well as the remaining life expectancy of persons who have attained a certain age.
41
What is YPLL and DALY
YPLL: years of potential life lost -subtracting persons life span from average life expectancy of the population. DALYs: disability adjusted life years -adds time a person has a disability to time lost to early death
42
What are survival curves used for and how are they generated
A method for portraying survival times - time of entry into the study - time of death or other outcome - status of patient at time of outcome
43
Types of Cohort studies
- prospective: present to future - retrospective: past to present - historical prospective: past to future
44
Advantages of cohort studies
Prospective: enables the investigator to collect data on exposure. And the size is under greater control by investigator. Retrospective: makes use of historical data to determine exposure levels at some baseline in the past
45
Types of follow up
Passive follow up ( doesn't require contact with cohort members) Active follow up (investigator in direct contact with the cohort, must obtain data on subsequent incidence of outcome) - mailing - phone calls
46
How do we decide the need for a study in terms of scientific justification
There should be considerable scientific rationale for a cohort study
47
What is the best measure of association for Cohort studies
Relative Risk: the ratio of the incidence of disease in the exposed group to the incidence in the non-exposed group
48
Calculate and interpret relative risk
[A/A+B]/[C/C+D]
49
Cohort study strengths
- permit direct determination of risk - time sequencing of exposure and outcome. - can study multiple outcomes - can study rare exposures
50
Cohort study limitations
- take a long time - costly - subjects lost to follow-up
51
What is validity
The quality of being logically or factually sound
52
Which studies have higher validity
- experimental - controlled experiment/ clinical trial - quasi experiment/ community trial - prospective cohort - retrospective cohort - nested case-control - time series analysis - cross-sectional - ecological - case study - anecdote
53
What is a multicenter trial
An intervention study
54
Clinical trial history examples
- 1537 Ambrose paré battlefield wounds experimental treatment - 1600 East India shipping Company lemon juice protected against scurvy - 1747 James Lind used concurrently treated control group
55
clinical trials
- A planned experiment | - Outcomes in treated group are compared with outcomes in an equivalent control group
56
Characteristics of clinical trials and examples
- Assess the efficacy of a treatment - Carefully designed and rigidly enforced protocol - Random assignment of subjects to study groups - Placebo given to control group
57
Difference between prophylactic and therapeutic trial and examples
Prophylactic trial: evaluates the effectiveness of a substance that is used to prevent disease Therapeutic trial: involves the study of curative drugs or a new surgical procedure to improve patients health
58
Outcomes and clinical endpoints
Outcomes must be measured in a comparable manner. Clinical endpoints: mortality, disability, rehabilitation
59
Double masking
Only the researcher knows what it is that each subject is given. Not the subject nor the one giving it to the subject
60
Phases of trial and number of people
- Phase 1: tests a new vaccine in adults(fewer than 100) - Phase 2: Expands testing to a group of 100-200 subjects - Phase 3: Main test assesses the efficacy of the vaccine in the target population
61
Why do we have unplanned crossover designs
Subject may refuse surgery and need to be moved to medical care and medical care subject may get worse and need immediate surgery
62
Where can we find results of clinical trials
The Consort statement
63
Strength of clinical trials and community trials
- provides the greatest control over: | - Reduces the likelihood that groups will differ
64
Limitations of clinical trials and community trials
- artificial setting - Limited scope of potential impact - Adherence to protocol is difficult to enforce - Ethical dilemmas

Epidemiology (4 decks)

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