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Flashcards in Health and Society Deck (29):
1

What's the best way fo measure burden?

death (most common, easiest), illness, costs, time (years of life lost)

2

disability adjusted life year

principle 1 - the only differences in the rating of a death or disability should be due to age and sex, not to income, culture, location, social class

principle 2 - everyone in the world has right to bes life expectancy in world

DALY = YLL + YLD

3

What is meant by disability?

impairment - symptoms at organ level

disability - objective alteration of behavior or performance at individual level

handicap - change dinteraction at the social/environmental level

4

schema for assessing non-fatal health outcomes

disease -> impairment -> handicap

5

What is the estimated level of disability?

IHD - 28.8 (worse than below the knee amputation)

Stroke 60.9 (around the level of unipolar depression, tetanus)

6

What are the leading causes of death globally?

Ischemic heart disease and storke

7

What are some major problems with data collected for NCD mortality?

major problems with death registrations in many coutnries

ex. over 80% of countires in Africa are not registered

8

political reasons why NCDs might be neglected

apathy - difficult/complex to tackle, myth that risk factors only account for 50% of deaths

inadequate funding

NCDs are invisible

9

What was the problem with the Denmark fat tax?

tax was levied on the carcass instead of the cut of beef

10

What are the top three NCD funders?

WHO, Welcome Trust, Bloomberg + Gates

11

five types of political incentives

political - squeaky wheel

economic - seek to shift priorities

organizational - sustaining status quo

symbolic - maintaining MDGs

scientific

12

Possibilities of polypill

80% reduction in CVD events

increased adherence

less reliance on physicians

lower cost

13

Problems with polypill

primary vs. secondary prevention

emphasis on pills > lifestyle > policies

dose titration, side effects

lower margins

14

What are the top three sources of salt in the US diet?

bread

cured meat/cold cuts

pizza

15

Why is salt so heavily used in food?

flavor

safety - antimicrobial

processing - changes how other ingredients behave

economics - profitability

16

Class I treatment effect

benefit >>> risk

should be performed

17

Class IIa treatment effect

benefit >> risk

reasonable to perform

18

Class IIb treatment effect

benefit >/= risk

may be considered

19

Class III treatment effect

no benefit or harm

should not be performed

20

Level A evidence

multiple populations

data derived from multiple RTCs or meta-analysis

21

Level B evidence

limited populations

data derived from a single RCT trial or non-randomized studies

22

Level C evidence

very limited data

expert consensus of opinion, case studies, or standard of care

23

What are the gaps in research and translation?

efficacy and effectiveness

moving new therapies to the bedside

making sure the quality, outcomes, and effectiveness are good

24

performance measurements

structure measures - quality of staff and equipment

process measures - the process of treatment

outcomes measures - benefit of treatment

25

What are performance measures used for?

quality improvement

public reporting

accountability

26

attributes of satisfactory performance measures

useful in improving patient outcomes - evidence-based, interpretable, actionable

measure design - denominator precisely defined, numerator precisely defined, validity, reliability

measure implementation - feasibility

27

primordial prevention

prevention of risk factors in the first place in disease free individuals

28

secondary prevention

interventions geared to early detection and prompt treatment of disease, preferable before the development of clinical symptoms

29

tertiary prevention

interventions geared towards minimizing the effects of disease or disability by preventing complications and premature deterioration