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poplhlth > miscellanous > Flashcards

miscellanous Flashcards

1
Q

ramboman

A

non random error; recruitment, allocation, maintenance, blind or objective measure of outcome, analysis,

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2
Q

5 dimensions of access and by who

A

acceptability, accessibility, accommodation, affordability, availability by pechansky and thomas

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3
Q

acceptability definition

A

psychosocial barrier; relationship between how doctors + environment (neighbourhood, rooms, other patients) make the patient feel

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4
Q

accessibility

A

geographical barrier; relationship location of patient and the services - travel time, distance, cost, transport

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5
Q

accommodation

A

organisational barrier; how services are managed in relation to patient need - open hours, easy to get in contact, waiting time

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6
Q

affordability

A

financial barrier; relationship between cost of service and willingness of patient to pay - bill date, health insurance

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7
Q

availability

A

existence barrier; relationship between volume/type of healthcare services and volume/type of patient need - could you get help all other factors aside, knowledge of services

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8
Q

randomised control trial objective and application

A

investigate effects of different interventions on incidence of disease; can also measure prevalence

new treatment/therapy

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9
Q

cohort study objective and application

A

investigate associations between risks/prognostic factors and incidence of disease

causes of diease

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10
Q

cross sectional study objective and application

A

investigate associations between risk factors and prevalence of disease

measuring prevalence in population

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11
Q

ecological study (rct, cohort, cross-sect) objective and application

A

investigate associations between interventions/risk factors and prevalence/incidence in different groups of populations (countries)

incidence/prevalence international trends and causes of disease

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12
Q

allocation of different study types

A

only rct randomly allocated into exposure/comparison/placebo groups

cohort and cross sect allocated to exposure or comparison by some measured commonality

eco can be random or non random allocation

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12
Q

experimental or observational study types

A

experimental only rct can influence

observational cohort and cross sect no influence

eco can be either

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12
Q

follow up measure study types?

A

rct and cohort both measure incidence after follow up period

cross sect measures prevalence at time of allocation
‘
eco either

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13
Q

most to least expensive studies

A

rct > cohort > cross sect > eco
because eco usually uses data alr collected

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14
Q

rct strength

A

randomisation reduces confounding as EG and CG are similar at the start so exposure is only difference

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15
Q

cohort strength

A

-more ethical and more representative of population than rct
-clear timeline so less recall bias (outcome measured after exposure)

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16
Q

cross sect strength

A

-no maintenance error
-faster than rct and cohort
-best design for assessing prevalence

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17
Q

eco strength

A

-fastest/cheapest study
-useful when majority of populations exposed
-large size = efficient for rare outcomes and usually low random error

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18
Q

confounding common in which studies

A

cohort, cross sect, eco

not in rct because random

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19
Q

maintenance error in which studies

A

rct, long cohort

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20
Q

unshared weaknesses study types

A

rct - too small (cost), unethical

cross sect - uncertain timeline (possible reverse causality/temporal association problem)

eco - measurement error

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21
Q

unrepresentative error in which studies

A

rct - only motivated volunteers

cross sect - sample needs to be relevant and representative

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22
Q

most to least (random error) often combined systemic reviews and meta-analysis

A

rct > cohort > cross sect = eco

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23
Q

goal of epidemiology

A

measure frequency of disease in diff populations to find out causes/how to improve

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24
Q

equity PROGRESS

A

Place of residence
Race/ethnicity/culture/language
Occupation
Gender/sex
Religion
Education
Socioeconomic
Social Capital

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25
Q

social capital meaning

A

shared values between people; ability to get resources/favours etc from personal connections

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26
Q

causes of causes order

A

reversed! start from outcome work backwards:
access to healthcare –> income –> employment status —> educational attainment –> access to education –> discrimination –> belong to marginalised group

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27
Q

Lorenz curve

A

-plots income of population: cumulative - percentage share of wealth on y axis, percentage share of population on x axis
-larger Gini coefficient, ratio A/(A+B), = larger inequity

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28
Q

why reduce inequities

A

unfair, avoidable, cost effective, affects everybody

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29
Q

implications of health inequities

A

unequal society
less social cohesion
less trust
more stress
reduced economic productivity
poorer health outcomes

30
Q

Bradford Hill Framework criteria

A

Not all needed to confirm cause!
temporality
strength of association
reversibility
biological gradient
biological plausibility
consistency of association
specificity of association

31
Q

temporality

A

-ESSENTIAL to establish causal relation
-first cause then disease

32
Q

strength of association

A

stronger the association the more likely to be causal after other known biases (selection, information, confounding) are removed

33
Q

reversibility

A

under controlled conditions, change of exposure leads to change in outcome

34
Q

biological gradient

A

-dose response
-increased exposure = increased outcome

35
Q

biological plausibility of association

A

-biological evidence?
-does it make sense?

36
Q

consistency of association

A

-multiple studies produce similar/same results/ replicated findings
-with different investigators, times, places, methods

37
Q

specificity of association

A

-weakest criteria because many diseases share causes (e.g. smoking –> lung cancer, CVD, etc) and can have multiple causes (lung cancer <– smoking, expose to asbestos)
-cause leads to a single effect
-effect has single cause

38
Q

exposure/outcome relationships in triad

A

-epidemiological triad (agent, host, environment)
-usually not 1:1

39
Q

Rothman’s causal pie model structure

A

sufficient causes - the whole pie, need all for disease to occur

component cause - each slice is a contributing factor, not enough to cause disease on its own

necessary cause - a component cause which must be present to cause disease

40
Q

pie model problem

A

assume all causes will definitely cause the disease (deterministic) but causes may just increase probability of disease (probabilistic).

sufficient cause - prob =1
necessary cause - raises prob from 0
component cause - each gained increases probability

41
Q

counterfactual definition of causation

A

general statement encompassing deterministic and probabilistic

“A makes a difference to B”

42
Q

Systemic review

A

epidemiological study design where studies have been researched/recruited by systemic processes
Systemic - addresses same question, unpublished studies used by directly contacting potential researchers

43
Q

Meta-analysis

A

-math analytical technique used to combine studies with low bias/non random error to reduce random error
-studies best systemic, but can be non-systematic

44
Q

random error due to…

A

-disease too uncommon
-large numbers of occurence, need very large participation numbers
-difficult so usually study too small and lots of random error.

45
Q

observable diseases which study

A

cohort - can observe the disease occurring (cancer)

cross sect - difficult to observe disease occuring (asthma, obesity)

46
Q

reverse causality/temporal association problem in which studies?

A

mainly cross sect, some cohort if exposure measured after outcome

47
Q

white head model level 3

A

General environmental, socioeconomic, cultural conditions
-natural environments
-built environments
-cultural
-biological (toxins)
-ecosystem (climate change, footprint)
-political (how improve poplhlth)

48
Q

level 2 whitehead model

A

the community and living working conditions
-family/friend influence
-work/pay
-unemployment, education, housing, water/sanitation, agriculture food production

49
Q

level 1 whitehead

A

individual constitutional factors, can’t change (age, sex, genes, disorders) and individual lifestyle factors, choices

50
Q

what is SEP and factors to measure it

A

socioeconomic position - status, class, stratification

education (core factor), occupation and income, assets/wealth and housing

51
Q

Measures of SEP

A

Area - deprivation, access

Population - Gross Domestic Product per capita, income, education/literacy

52
Q

why measure area deprivation

A
  • material “don’t have” is easier to measure than wealth as ppl more likely to be honest abt what they don’t have than have.
53
Q

preston curve

A

-life expectancy on y axis, GDP per capita/income on x axis
-higher GDP = higher life expectancy
-look like T without left side horizontal line
-compares countries on curve

54
Q

key recruitment error

A

external validity error, selection bias
top of triangle = setting (date, large population, place), bottom triangle = eligible population, tip = responders.

<70% of eligible population respond = significant recruitment error as non-representative

55
Q

does every study calculate ego and cgo?

A

no

56
Q

RRR and RRI

A

RRR=relative risk reduction when RR < 1; calculate percentage decrease (1-RR x100)

RRI= relative risk increase when RR > 1; calculate percentage increase (RR-1 x 100)

57
Q

NZdep dimensions

A

Communication, incomex2, employment, qualifications, owned home, living conditions, support, living space

2018/2013 only communication and living conditions different criteria

58
Q

NZdep communication 2018

A

no access to internet at home

59
Q

NZdep communication 2013

A

people aged <65 with no access to internet at home

60
Q

2018 2013 NZdep income

A

people aged 18-64 receiving means tested benefit
people living in equivalised households with income below an income threshold

61
Q

employment 2018 2013 NZdep

A

people aged 18-64 who are unemployed

62
Q

qualifications 2018 2013 NZdep

A

people aged 18-64 without any qualifications

63
Q

owned home 2018 2013 NZdep

A

people not living in their own home

64
Q

support 2018 2013 NZdep

A

people aged <65 living in a single parent family

65
Q

living space 2018 2013 NZdep

A

people living in equivalised households below a bedroom occupancy threshold

66
Q

2013 living conditions NZdep

A

people with no access to a car

67
Q

2018 living conditions NZdep

A

people living in dwellings that are always damp and/or always have mould greater than A4 size

68
Q

when to use incidence vs prevalence

A

incidence - ez observe events occurring so measure did it happen or not (categorical)

prevalence - hard to observe it occurring so just measure extent (numerical) that can be sorted into categories

69
Q

EGO and CGO vs RR and RD

A

EGO and CGO are measures of occurrence while RR and RD are measures of effect

70
Q

Random error four main types

A

Random sampling error - will never be fully representative

random measurement/assessment error - diff measures will be taken each time due to other factors

random inherent biological - whats being measured itself will vary from moment to moment so diff results

random allocation error - rct groups may differ by chance alone so small studies likley more error

71
Q

youth dependency ratio and structural aging

A

youth dep: <15 non working / >15 working

struc aging: shrinkage of ages <44

72
Q

social determinants of health

A

same for both individual and population health but measured differently.
income, employment, education, housing/neighbourhood, societal characteristics, autonomy/empowerment

73
Q

types of allocation error

A

CONFOUNDING and measurement error

74
Q

threshold effect

A

line which crossed over means will happen/is something, under the line means won’t happen/is not something. SEP has no threshold because “rich” and “poor” varies between lower and higher SEP populations

75
Q

ecological fallacy

A

when characteristics of a population are mistakenly attributed to every individual int hat population. high crime rate in neighbourhood makes people think every resident in neighbourhood will be a criminal

stereotypes

poplhlth (28 decks)

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