McFarland: Intro to Population-Based Health Epidemiology

Question 1

What was the question the study question in the article on acute coronary syndrome?

Answer 1

Are there differences in access to care among male and female patients with premature acute coronary artery syndrome?

Question 2

What type of epidemiological study did the authors use?

Answer 2

observational - prospective cohort study

Question 3

What is an analytic study?

Answer 3

it investigates the hypothesized relationship in an available dataset between risk factors and outcome

Question 4

Why are cohort studies advantageous compared to other designs?

Answer 4

they can examine many outcomes

Question 5

What is the “exposure” in this study? What is the “outcome?”

Answer 5

gender; access to care

Question 6

What is prevalence? What is incidence?

Answer 6

the number of existing cases of a disease/the total number in population

the number of new cases of a disease/the total number in population

Question 7

What is the cumulative incidence?

Answer 7

number of new cases of disease/number in candidate population

Question 8

What is the incidence rate?

Answer 8

number of new cases of a disease/person-time of observation

Question 9

What is the exposure odds ratio?

Answer 9

odds of being exposed among cases/odds of being exposed among controls

**ad/bc

Question 10

What does strength of association refer to?

Answer 10

stronger associations are more likely to be causal

Question 11

What is temporality?

Answer 11

is there evidence that exposure preceded disease

Question 12

What is the biological gradient/dose response?

Answer 12

Does disease risk increase with increased exposure level?

Question 13

What is plausibility?

Answer 13

Does the association make sense?

Question 14

What is consistency?

Answer 14

Do different studies yield the same results?

Question 15

What is internal validity?

Answer 15

Are the results free of bias?

Question 16

What is external validity?

Answer 16

Are the results generalizable?

Question 17

How can you increase external validity?

Answer 17

random sampling
larger sample sizes
high response rate

Question 18

Which is more important in an epidemiologic study, internal or external validity?

Answer 18

internal!

Question 19

Three ways in which you can evaluate bias?

Answer 19

1. identify the source
2. estimate the magnitude/strength
3. assess the direction

Question 20

What is selection bias?

Answer 20

preferential or uneven selection of subjects

Question 21

What is loss to follow up?

Answer 21

when participants drop out of the study

Question 22

What is the healthy worker effect?

Answer 22

phenomenon of workers usually exhibiting overall death rates lower than those of the general population due to the fact that the severely ill and disabled are ordinarily excluded from employment.

Question 23

Occurs when there is a different level of accuracy in the information provided by compared groups

Answer 23

recall bias

Question 24

A systemic difference in soliciting, recording or interpreting information that occurs in studies using a person or telephone interviews

Answer 24

interviewer bias

Question 25

All cases are not detected at the same stage of the disease (ex: in cancer)

Answer 25

lead-time bias

Question 26

If a subject knows that he/she is being observed, their behavior or response can change

Answer 26

Hawthorne effect

Question 27

In a pre-test/post-test situation, the subjects tend to remember some of the previous questions and they do better regardless of the intervention

Answer 27

repeat-testing bias

Question 28

This is a variable that is associated with the exposure and associated with the outcome (independently of the exposure); it is not an intermediate variable in the causal pathway

Answer 28

confounding variable

Question 29

What did the article conclude about differences in health care access among men and women?

Answer 29

younger adults with ACS, both men and women, had differing access women with anxiety, men and women with no chest pain, feminine gender and identity roles all were at increased risk for poor access to care

Question 30

List the top 10 leading causes of death in the US

Answer 30

``` heart disease malignant neoplasms chronic lower respiratory disease stroke unintentional injury Alzheimer's disease diabetes mellitus influenze and pneumonia nephritis and nephrosis suicide ```

Question 31

Leading cause of death in Nevada

Answer 31

heart disease

Question 32

Higher prevalence of heart disease among these populations

Answer 32

blacks older adults low SES