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BDS2 PMHP > Introduction to Epidemiology > Flashcards

Introduction to Epidemiology Flashcards

(56 cards)

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1
Q

What is epidemiology

A

the study of populations in order to determine the frequency and distribution of disease

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2
Q

what does epidemiology help to identify

A

risk factors for disease and determining optimal treatment approaches to clinical practice and preventative medicine

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3
Q

what are the major roles of epidemiology

A

monitor infectious and non-infectious diseases
study natural history
investigations of disease risk factors
health care needs assessment
developing of preventative programs
evaluation of interventions and their effectiveness
health service planning

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4
Q

how is epidemiology used to monitor infectious diseases

A

monitor flue outbreaks which helps in planning for provision of flu

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5
Q

what is the natural history of disease

A

the course a disease takes in individual people from its pathological onset until its eventual resolution or death

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6
Q

what do we look at when studying natural history of diseases

A 
are they:
self limiting 
chronic 
fatal
unknown
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7
Q

what does investigations of disease factors consist of

A

o Looking at the causes/determinants of diseases

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8
Q

what does epidemiology help in health care needs assessments

A

o What care services are required by particular population groups

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9
Q

how does epidemiology help in development of preventative programs

A

o Based on knowing risk factors of diseases and attempting to prevent exposure to these factors

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10
Q

what are the 3 main types of epidemiology studies

A

descriptive
analytic (observational)
intervention/experimental

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11
Q

what is descriptive epidemiology

A

measures of disease frequency and it is either prevalence or incidence

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12
Q

what is prevalence

A

o Measurement of all individuals affected by the disease within a particular period of time or point in time – a cross sectional point in the population

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13
Q

how is prevalence calculated

A

o Number of affected individuals (cases) divided by the total number of persons in population and is expressed as a percentage or fraction

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14
Q

what is prevalence obtained from

A

cross sectional studies or derived from registers

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15
Q

what is prevalence used as

A

an estimate of how common a condition is within a population over a certain period of time or point in time

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16
Q

what is incidence

A

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

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17
Q

how is incidence calculated

A

o Number of new cases or events during a specific period of time in a defined population

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18
Q

how is incidence estimates obtained

A

obtained from longitudinal studies or derived from registers

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19
Q

how is incidence expressed

A

o Expressed as a fraction

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20
Q

do we use incidence or prevalence for chronic incurable diseases

A

they have low incidence but high prevalence

we usually use prevalence - allows us to help in management

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21
Q

do we use incidence or prevalence for short duration curable conditions

A

they have high incidence but low prevalence because many people get a cold each year but few people actually have a cold at any given time so prevalence is low

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22
Q

what are the main variables for descriptive studies

A

Time, place, person OR when, where, who

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23
Q

what are the aims of time, place, person

Study These Flashcards
A
  • Identify changes in incidence or prevalence over time OR
  • Determine incidence or prevalence of disease in different geographical areas OR
  • Determine incidence/prevalence of disease in groups of individuals with different characteristics
24
Q

what are the advantages of sampling

Study These Flashcards
A
  • Reduces number of individuals to be sampled
  • Reduces cost
  • Higher response rate
  • Higher quality of information collected
25
what must samples be
The sample must be representative of population being investigated. The aim is to avoid bias.
26
what are the sampling techniques
``` simple random sample systemic sample stratified sample cluster samples multistage sampling ```
27
what are simple random samples
o Use of a table of random numbers
28
what is a systemic sample
o Individuals selected at regular intervals from population list
29
what is a stratified sample
o Ensures small sub-groups adequately represented
30
what is a cluster sample
o Use of groups as sampling units e.g school classes
31
what is multi-stage sampling
o Combines above techniques
32
what are the error
- Sampling bias/selection bias - Response bias/information bias - Measurement error - Observer variation (intra- or inter-) - Loss to follow up
33
what is response bias
o If you are not monitoring who is responding it could only be a certain group responding so you miss out groups in the population
34
what is observer variation
o When examining it has to be the same
35
how do we avoid measurement error when measuring disease
we use an appropriate index
36
what are the properties of an ideal index
- Clear, unambiguous, not subjective - Ideally correspond with clinically important stages of the disease - Indicate tx need - Within the ability of examiners - Reproducible - Not time consuming - Acceptable to patient - Amenable to statistical analysis - Allow comparison with other studies
37
what are dental indices
DMF index | dmf/def index
38
what are the limitations of the DMF index
- teeth extracted for reasons other than caries - influenced by access e.g interproximal surface so could underestimate - 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
39
what is the study used for epidemiology of dental caries in children
Descriptive cross-sectional epidemiology | NDIP in scotland
40
what does NDIP use
It uses cross sectional, descriptive dental surveys of school children It has larger samples than UK decennial surveys It involves standard examination criteria and trained and calibrated examiners
41
what is the aim of NDIP
It aims to inform: - Parents of their child’s dental health status (basic NDIP) - Advise Scottish government, NHS boards and other organizations of the oral disease prevalence in children in their area
42
what are the target groups for NDIP
p1 and 7
43
what happens in NDIP
- There is basic inspection for all children in p1 and p7 every year - There is detailed inspection (epidemiology) for a sample of children every year o Alternates each year between P1 and P7 - NHS board can add additional year groups
44
what is the basic inspection in NDIP
- Offered to every child in p1 and p7 classes of local authority schools - Proportion of school rolls inspected = 85-90% - Generates letter to parent o Overall state of dental health of child o Coveys degree of urgency with which appointment for attendance at dentist suggested for child - Not a detailed examination of each surface of each tooth
45
what does the detailed inspection consist of in NDIP
- More rigorous and comprehensive assessment - Calibration of examiners - Records status of each tooth surface in accordance with international epidemiology conventions (i.e d3mft: caries into dentine) - Uses same clinical inspection criteria as SHBDEP o Can there look at trends from 1987 re P1 children
46
what are the specific goals of the NDIP
- 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
47
how are the NDIP epidemiology surveys calibrated
- Number of children e.g 10 selected for calibration exercise o High proportion should have caries - Potential dental epidemiology examiners then all examine and chart each child - Compare results and assess inter-observer variation - Outlier dental examiners not able to participate in epidemiological programme
48
what are the indices of fluorides
- Fluorosis index - TF index - Tooth surface index of fluorosis - SCOTS index
49
what does the index of ortho tx need do
Assesses need and eligibility of children for NHS ortho treatment Selects those that will benefit most
50
what are the 2 components of the index of orthodontic treatment need
dental health component | aesthetic component
51
what is the dental health component
o Goes from grade 1 which is almost perfection to grade 5 which is severe dental health problems
52
what is the aesthetic component
o Scale of 10 colour photographs showing different levels of dental attractiveness o AC used for border-line cases with grade 3 DHC. If high AC score, NHS treatment is permissible
53
what are the indices for periodontal disease
plaque indices gingivitis index periodontitis indices
54
what are the plaque indices
o Debris index | o Plaque index
55
what are the gingivitis indices
o Modified gingival index | o Lobene index
56
what are the periodontitis indices
o Basic periodontal examiniation

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