Module 12 Flashcards

1
Q

what does analytic epidemiology examine?

A

the relationship between hypothesized causes and health outcomes
-why/how or cause and effect
- describes the DETERMINANTS of health-related states and events
-quantifies the association between exposures and outcomes to ID casual relationships

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2
Q

what are risk factors?

A
  • factors or events associated with the disease or health state or event of interest
  • are not necessarily direct causes of disease or injury but are associated with the development of the disease or injury
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3
Q

what are example of risk factors? (7)

A
  • Poverty (persons living at 100% FPL)
  • Neighborhood: physical and psychological barriers
  • Race (self reported, race for addressing disparities related to various health risk factors)
  • Education
  • genetic
  • hereditary
    -environmental
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4
Q

Bradford Hill Criteria for Causation

A
  • Strength of association
  • Consistency
  • Specificity
  • Temporal relationship
  • Biological gradient
  • Plausibility
  • Coherence
  • Analogy
  • Experimental evidence
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5
Q

define: risk

A
  • A measure of disease frequency
  • The probability that an event will occur
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6
Q

calculation of absolute risk

A

Absolute Risk = Number of people who get the disease during a designated period/
Population of interest at the start
of the designated time period

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7
Q

T/F: Absolute risk and incidence proportion are the same thing

A

true

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8
Q

Incidence proportion is the terminology used to describe _____

A

populations

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9
Q

Risk is the terminology used to describe ______

A

individuals

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10
Q

what is attributable risk?

A
  • Attributable risk is the amount of disease that can be attributed to a specific exposure

***aka risk difference

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11
Q

what are risk ratios used to compare?

A

used to compare the occurrence of disease in one group with the occurrence of disease in another group

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12
Q

what are two common methods used to compare occurrences of diseases in groups?

A
  • Commonly used measures are
  • Risk Ratio or Relative Risk Ratio (RR)
  • Odds Ratio (OR)
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13
Q

what is relative risk?

A
  • Relative risk is a measure of association between the exposure to a particular factor and the risk of a particular disease or outcome
  • it estimates the magnitude of the association between the exposure to a particular factor and the risk of a particular disease or outcome
  • risk ratio or relative risk ratio is preferably used in cohort studies–> prospective studies
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14
Q

Interpretation of the Relative Risk Statistic: RR= 1

A
  • Incidence of the outcome in the exposed group is equal to the risk in the non-exposed group
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15
Q

Interpretation of the Relative Risk Statistic: RR >1

A
  • Incidence of the outcome in the exposed group is greater than the risk in the non-exposed group
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16
Q

Interpretation of the Relative Risk Statistic: RR <1

A
  • Incidence in the outcome in the exposed group is lower than the risk in the non-exposed group
17
Q

Interpretation of the Odds Ratio: OR=1

A
  • Exposure to the factor does not affect the odds of the outcome
18
Q

Interpretation of the Odds Ratio: OR >1

A
  • Exposure to the factor increases the odds of the outcome
19
Q

Interpretation of the Odds Ratio: OR <1

A
  • Exposure to the factor decreases the odds of the outcome
20
Q

what is the level of evidence determined by?

A
  • determined by the type of the study design used to obtain the evidence
  • The study design influences that quality or ‘strength’ of the evidence produced
21
Q

The hierarchy (or pyramid) of evidence ranks study designs: the designs on the top (2)

A

The designs on the top (meta-analyses, randomized controlled trials) provide the strongest or highest levels of evidence

22
Q

The hierarchy (or pyramid) of evidence ranks study designs: the designs at the bottom (2)

A

The designs at the bottom (case reports, cross sectional studies) produce the weakest level of evidence

23
Q

Study Designs in Epidemiology: systematic reviews (2)

A
  • Meta-analyses
  • Integrative reviews
24
Q

Study Designs in Epidemiology: Experimental studies

A
  • Randomized trials
  • Non-randomized trials
25
Study Designs in Epidemiology: Observational studies
- Cohort studies - Case-control studies - Cross-sectional studies
26
Systematic Reviews: Meta-Analyses
-“Study of studies” - Very powerful methodology - Stringent criteria for inclusion in the analysis - Quantitative analysis to combine and compare results of the studies - Method used in Cochrane Reviews and AHRQ Reviews
27
Randomized Controlled or Clinical Trials
* Prospective study * Experimental design * Always has an intervention * Randomization to treatment groups * Control of the intervention
28
examples of Randomized Controlled or Clinical Trials
- Almost all studies of medications - Most studies of devices - Many studies of interventions
29
Nonrandomized Trials: Quasi-Experiments
* Prospective study * Experimental design * Always has an intervention * Control of the intervention - No randomization to treatment groups - Comparison group may be different from the intervention group
30
Prospective Cohort Studies
* Prospective study * Observational study * No intervention * Exposure are documented * A group (cohort) of disease-free individuals is identified at one point in time and then followed over a period of time to determine whether the outcome (disease) occurs
31
Retrospective Cohort Studies
* Have a historical perspective - Requires access to information about the subjects before the exposure to disease causing factors and before the onset of disease occurs - Often able to accomplish this when there are comprehensive medical records
32
case-control studies
* Retrospective study design * Studies people who already have the disease and looks backward at exposures * Two groups of individuals are studied - A group that has the disease under study (cases) - A group that does not have the disease under study (controls) * Their health information is then examined to determine whether there are risk factors that may be related to their current disease
33
what are cases ?
a group that has the disease under study
34
what are controls?
a group that does not have the disease under study
35
Cross-sectional Studies
* A study population is assessed at a single point in time * Participants are asked about their current disease state and their exposures to certain factors * Descriptive study * Known as prevalence studies * Very weak study design
36
Case Reports and Case Series
* Descriptive study design * May generate hypotheses about causation
37
the bottom of the pyramid
- opinion - experience - theory