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Epidemiology midterm 1 > midterm 1 > Flashcards

midterm 1 Flashcards

1
Q

Who is Hippocrates?

A

father of medicine, FIRST EPIDEMIOLOGIST

He observed occurence and associated factors.

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2
Q

Who is Thomas Sydenham?

A

the first to identify and classify diseases based on manifestations rather than using Hippocratic approaches

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3
Q

Who is Ignaz Semmelweis?

A

Studied puerperal fever (childbed fever). found that if physicians wash hands after autopsy, maternal mortality dec.

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4
Q

Who is John Graunt?

A

introduced systematic methods for describing disease occurence and death
developed life expectancies and life tables.
EVALUATED BILLS OF MORTALITY (the weekly mortality statistics in london)TO IDENTIFY TREND IN DEATH

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5
Q

Who is William Farr?

A

one of the first demographers
helped design and analyze london census. SIGNIFICANT ROLE IN VITAL STATISTICS SYSTEM IN LONDON.
****founder of MODERN epi who applied vital statistics to epi problems.

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6
Q

Who is John Snow?

A

father of FIELD epidemiology. Showed link between high mortality due to cholera and water companies.

Developed and used Spot maps (geographical distribution of deaths)

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7
Q

what is epidemiology?

A

study of distribution and determinants of health related states and events in populations and the application of this study to control health problems.
distribution and determinants taken together refer to frequency, pattern, factors related to occurence of health events

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8
Q

endemic

A

occurring at or near the USUAL rate of occurrence

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9
Q

Epidemic

A

occurence in clear EXCESS of normalcy

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10
Q

Pandemic

A

an epidemic that affects several countries/ continents

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11
Q

what is the working assumption of disease occurence?

A

disease does not occur randomly but is a function of disease and population

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12
Q

what does the epidemic triad consist of?

A

agent, environment and host.

  • sometimes time is included as fourth agent. Interaction between triad can result in disease.
  • removing one factor can impede disease transmission
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13
Q

what is a reservoir?

A

is an organism or environment where the agent resides or is harbored

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14
Q

Inapparent carriers

A

never manifest disease but can transmit (ex: poliomyelitis)

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15
Q

incubatory carriers

A

will eventually manifest disease and can transmit (ex: measles and HIV)

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16
Q

convalescent carriers

A

remain infectious even after recovering from illness (ex: salmonella)

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17
Q

infectivity

A

the ability of a pathogen to establish an infection

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18
Q

pathogenicity

A

ability of an organism to CAUSE disease (harm the host)

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19
Q

virulence

A

Harmful quality possessed by microorganisms that can cause diseases

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20
Q

qualitative

A

determined by virulence factors

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21
Q

quantitative

A

degree of damage caused by a microbe to its host

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22
Q

what is herd immunity?

A

the resistance of a group to an attack by a disease to which a large proportion of the members of the group are immune.
**100 % individual immunity is not required to achieve community level (herd) immunity

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23
Q

what are the requirements for herd immunity?

A

1) disease must be restricted to a single host species
2) prior infections provide full immunity
3) random mixing occurs

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24
Q

factors that determine optimal level of herd immunity (ex: percentage immune required for herd immunity)

A

1) level in infectiousness (the greater the infectiousness the greater the percentage required)
2) population density (the greater the density, the greater the percentage required)

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25
Q

what do you do if you cant immunize a large percentage?

A

target those indiv at highest risk (immunocomprimised, young, etc)

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26
Q

List all of the stages of the natural history of disease

A

stage 1- susceptibility–PRIMARY PREVENTION
stage 2-subclinical disease-SECONDARY PREVENTION
stage 3-clinical disease-SECONDARY/TERTIARY
stage 4-recovery, disability, death-TERTIARY

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27
Q

List all the levels of prevention

A

1) primary prevention
2) secondary prevention
3) tertiary prevention

28
Q

what is primary prevention?

A

activities that help PREVENT the disease

29
Q

what is secondary prevention?

A

identification and treatment of asymptomatic persons who have already developed risk factors or preclinical disease but in whom the condition is not clinically apparent.

30
Q

what is tertiary prevention?

A

early treatment of disease and prevention of complications

31
Q

what happens to herd immunity as vaccine rates dec?

A

herd immunity decreases.

32
Q

what is rural penalty?

A

geographical isolation from urban centers/health care results in lower vaccination rates

33
Q

definining a population

A

can be fixed, closed or dynamic.
fixed: shared experience/event. individuals remain in population after experience/event

closed-shared expereince/event. individuals remain in group after experience/event. No in-migration or out migration during study period

dynamic-determined by individuals current status/profile. membership not permanent. In-migration and out migration allowed.

34
Q

what are the three most important/common measures of population health/wellbeing?

A

1) prevalence proportion
2) cumulative incidence (risk)
3) incidence density (rate(

35
Q

what is morbidity?

A

any disease, injury, disability in a population

36
Q

prevalence(commonness )

A

is a measure of morbidity used to estimate the extent of health outcomes and health-related behaviors in populations. estimates the BURDEN of health condition

**note that prevalence is NOT A RATE, because it gives no info on freq.

37
Q

disease prevalence(prevalence proportion)

A

measure of burden of disease in a population during a specified period of time
how to calculate:
sum of new and existing disease cases in a population at a specified time DIVIDED by total number of persons in a population at SPECIFIED TIME. Can be expressed as a percentage since it is a proportion

38
Q

List the three different kinds of prevalence that can be calculated

A

1) point prevalence
2) period prevalence
3) cumulative life prevalence

39
Q

what is point prevalence?

A

short period of time such as 1 month, most frequently used (“snapshot”)

40
Q

what is period prevalence?

A

longer period of time (“time lapse photography”)

41
Q

what is cumulative life prevalence?

A

lifetime (ex: HEP A vaccination data)

42
Q

what is prevalence a better estimate of?

A

it is a better estimate of disease burden in a population rather than crude/overall number of disease case

43
Q

list some factors that can increase prevalence proportion

A

1) increases in number of new cases (increased incidence)
2) decline in death due to that health outcome (dec case fatality)
3) development of new therapies that prolong life but do not treat disease (increased survival/disease duration)
4) in-migration of people with disease
5) in-migration of people susceptible to disease
6) out-migration of healthy non-affected indiv
7) improved screening/diagnostic techniques

44
Q

what is incidence proportion?

A

it is RISK. **mid year point often used to estimate the total number of individuals at risk over the entire year period.
***Usually done on COHORT studies

45
Q

what are the two main measures of estimating risk in population?

A

1) incidence proportion/cumulative incidence (CI)

2) incidence density

46
Q

artefactual changes

A

impact CI but are not “Real” changes in disease incidence

47
Q

what is incidence density?

A

it is the RATE. it allows us to estimate HOW QUICKLY new disease cases are occurring in an at-risk population during a period of time. INCIDENCE DENSITY IS A RATE NOT A PROPORTION. Also usually done on cohort studies.

*make sure to report with PERSON-TIME in the final answer.

**incidence density AKA rate is more precise and allows for greater flexibilty when dealing with dynamic populations.

48
Q

how do you go about the data in which people left the study leaving unequal periods of observation?

A

label as “censored” observations. then calculate person time that they contributed (obviously will not be as much as others who completed study).

49
Q

measures of morbidity what is the emphasis on?

A

the emphasis is on infant, child and maternal mortality because they measure health/well-being of a nation.

50
Q

infant mortality rate

A

is a key millenium development goal indicator. can be variable because of different definitions of live birth based on country.

51
Q

neonatal

A

associated with events surrounding the prenatal period and the delivery such as the presence of congenital malformations, pre natal care, availability of skilled birth attendants

52
Q

post-neonatal

A

associated with environmental factors.

53
Q

crude mortality rate

A

can think of as an INCIDENCE DENSITY OF DEATH IN A POPULATION. cannot be compared. need to make adjustments based on factors involved. (ex-age adjusted)

54
Q

cause specific mortality rate

A

used to calculate mortality rate for a specific cause/disease

55
Q

age specific mortality rate

A

allows us to compare mortality at different ages

allows us to compare mortality in same group over time,, or between diff countries/areas

56
Q

case fatality rate (CFR)

A

likelihood or risk of dying from disease once individual has been diagnosed with disease. PROPORTION…EXPRESSED AS PERCENTAGE

57
Q

Proportionate mortality ratio (PMR)

A

used to determine what proportion of ALL deaths were due to a specific disease.
useful for understanding what cause is greatest contributor to mortality within a region or defined population
CANNOT BE COMPARED ACROSS DIFFERENT YEARS OR POPULATIONS

58
Q

List the three key factors that differ within and between populations as well as over time, and in turn influence population and mortality risks

A

1) time
2) place
3) person (the most important person-level factor is age distribution)

59
Q

what is age standardization?

A

adjusts age parameter to make it so that we can adequately compare crude mortality rates between different groups (ex: states)
Direct adjustment
indirect adjustment.

60
Q

age specific death rate

A

allows investigation of difference in mortality across age groups that would be lost in the single age-adjusted rate. the downside however is that they result in massive amounts of data so we use age adjusted to make things simpler.

61
Q

age adjusted death rate

A

it is artificial ( it is an INDEX measure)
only compared with other adjusted rate computed using same standard population
unlike age specifc (ASDR) it provides a single estimate that can be easily used for comparitive analysis.

62
Q

when would you use indirect age adjustment?

A

to calculate standardized mortality ratio that will ultimately allow to make valid comparisons.
***age specific mortality rate from standard population are applied to the population of interest to calculate expected deaths. then you calculate total number of expected deaths in target population at end.

**assume that all things being equal, risk of dying in standard population is same as risk of dying in target population.

63
Q

standard mortality ratio (SMR)

A

tells you how many more times likely it is to die in target population when compared to standard population
***ex: SMR of 1.6 suggests that risk of dying is 1.6x higher in bangladesh than in U.S

64
Q

how do you get indirect age adjusted rate from the SMR value?

A

just multiply SMR by crude death rate to obtain INDIRECT AGE ADJUSTED RATE

65
Q

maternal mortality rate

A

deaths among women due to pregnancy or childbirth related complications

66
Q

life expectancy

A

average number of years a given person can be expected to live

67
Q

potential years of life lost (PYLL)

A

provides an estimate of the years of life expectancy that . an be expected to be lost from the expected burden of mortality from a given disease or condition.

Epidemiology midterm 1 (1 decks)

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