Global Determinants Of Health, Intro to Epidemiological Study Designs

Question 1

What is Population science?

Answer 1

Study of People and Populations

Question 2

What are the 3 Causes and 3 Consequences

Answer 2

Causes:

Epidemiology: Study of disease in populations
Demography: Study of size and shape of populations
Statistics: Study of data in numerical form

Consequences:

Public Health
Health Promotion
Disease Prevention

Question 3

Define Epidemiology

Answer 3

The study of the distribution and determinants of health related states, and the application of this study to the control of health problems

Question 4

What are the 4 stages of the Demographic Transition Model

What are their characteristics in terms of birth/death rates and pop. Growth

Answer 4

1: Pre-Transition
- High birth rates, High fluctuating death rates
- Low population Growth

2: Early Transition
- Birth rate stays high, Death rate begins to fall
- Rapid Population growth

3: Late Transition
- Birth rate starts declining
- Population growth slows down

4: Post-Transition
- Low Birth, Death rates
- Negligible population growth

Question 5

What factors affect Population Health?

Name 3 of these

Answer 5

Socio-Demographic factors

• Demographic Transition
• Economic Transition
• Behavioural and Lifestyle factors

Question 6

What factors affect Burden of Disease, Disability and Ageing

Name 3 of these

Answer 6

Population Factors

• Age sex specific rates
• Population size
• Population shape

Question 7

What do we use to make inferences about populations

What 3 things should this be, with respect to the population

Answer 7

Samples

• Unbiased
• Precise
• Representative

Question 8

What are the 3 Global Determinants of Health

Answer 8

Global Warming
Socio-Demographic Factors
Population Factors

Question 9

Define Evidence Based Medicine

Answer 9

Conscientious, Judicious and Explicit use of Current Best Evidence in making decisions about the care of individual patients

Question 10

What 3 things influence choosing the appropriate treatment for a patient

Answer 10

Clinical experience on the condition
External evidence
Patient’s concerns/ values

Question 11

Compare the processes in Deductive and Empirical approaches

Answer 11

Deductive:
Identify the basic processes
Deduce the best procedures
Apply to clinical situation

Empirical:
Identify the basic processes
Postulate alternative procedures
Experimentally test ideas

Question 12

What’re 2 types of studies

Answer 12

Qualitative

Quantitative- Observational and Experimental

Question 13

What are the 2 best methods of obtaining evidence

Answer 13

Systematic review of random trials
Then
Randomised control trials

Question 14

Name 2 Epidemiological Study Design

Compare their sub-studies

Answer 14

Analytical:

• Cohort studies—> Analysis can be rate OR odds ratio
• Case control study—> Analysis can ONLY be odds ratio

Descriptive:

• Ecological study—> Unit of analysis is groups
• Cross sectional study—> Unit of analysis is individuals

Question 15

Compare Descriptive and Analytical Epidemiology

Answer 15

Descriptive: Sampling to infer back to population
Rarely achieve a perfect sample

Analytical: To compare “like for like” samples
Rarely achieve “like for like’ samples

Question 16

How does an Ecological study work?

How is one conducted

Answer 16

• Count cases by groups
• Identify groups to study
  Define characteristics to be studied (Exposure and Outcome)

Decide whether analysis involves counting categorical (Nominal/ Ordinal-Order matters-) OR measuring continuous data

Gather data on group level characteristics

Question 17

What are 4 issues with Ecological Studies

Answer 17

• Defining characteristics
• Variation in measurement
• Chance (Random Error)
• Ecological Fallacy (Confounding): Falsely inferring individual-level association from group level association

Question 18

How does a Cross-Sectional Study work?

How is one conducted?

Answer 18

Count cases

Who do you want to generalise to- Theoretical Population
What population can you access- Study Population
Who do you want in your study- Sampling Frame
Who is in your study- The Sample

Question 19

What are 3 issues with Cross-Sectional studies

Answer 19

• Chance
• Responder/ participant bias
• Sampling bias

Question 20

How is a Case-Control study conducted

Answer 20

Find cases who have the outcome 
Find controls (Non-cases) who have the outcome 

Compare levels of exposure between Cases and Controls

Question 21

What are 4 issues with Case-Control studies

Answer 21

• Chance
• Confounding
• Selection bias
• Information bias

Question 22

Compare the 2 types of Cohort Study

Answer 22

Concurrent/ Prospective- Collect data at a current point in time
Historical/ Prospective- Go back in time to collect data

Question 23

How is a Cohort study conducted

Answer 23

Identify outcome-free individuals
Group individuals according to level of exposure
Compare exposure rates for each group

Question 24

What are 4 issues with a Cohort Study?

Answer 24

• Confounding
• Chance
• Information Bias
• Loss to follow-up (People may drop out of study)