Module 3 cheat sheet Q's

Question 1

Health promotion

Answer 1

acts on the determinants of wellbeing in the population and enables people to increase control over and improve their health.

Usually pre disease

Question 2

Health protection

Answer 2

focus in environmental hazard (pre and during disease)

Question 3

Disease prevention

Answer 3

looks at ways of preventing disease or consequences

Question 4

Primary screening

Answer 4

acts before disease aims to limit incidence

Question 5

Secondary screening

Answer 5

acts at early stages, aims to reduce more serious consequences

Question 6

Tertiary screening

Answer 6

acts after diagnosis, aims to reduce the progress of more seriousness consequences

Question 7

Population based intervention advantages

Answer 7

Addresses underlying cause
large potential benefit for whole population
behaviorally acceptable

Question 8

Population based intervention disadvantages

Answer 8

small benefit to individual and population
poor individual & physician motivation
less favorable benefit: risk ratio
will not change health differentials

Question 9

High risk individual strategy advantages

Answer 9

individuals and physicians are motivated and its appropriate for them

cost effective use of limited resources

favorable benefit benefit :risk ratio

Question 10

High risk individual strategy disadvantages

Answer 10

Screening difficulties
limited potential for individual and population
Behaviorally inappropriate

Question 11

Bradford hill 7 criterias

Answer 11

Temporality
Strength of association
Consistency of association
Biological gradient
Biological plausibility
reversibility 
Specificity of association

Question 12

Temporality

Answer 12

exposure must precede outcome

Question 13

Strength of association

Answer 13

Strength of statistical evidence in the absence of known biases

Question 14

Consistency of association

Answer 14

replication of findings by multiple studies

Question 15

Biological gradient

Answer 15

Incremental changes in exposure are correlated with incremental changes in disease rate

Question 16

Biological plausibility

Answer 16

logical association between exposure and disease

Question 17

Reversibility

Answer 17

removing the exposure changes the outcome

Question 18

Specificity of association

Answer 18

a single cause has a single effect (less common)

Question 19

State the factors involved in rothmans causal pie

Answer 19

sufficient cause
componient cause
necessary cause

Question 20

sufficient cause

Answer 20

a combination of factors which when together will invariably produce the disease

Question 21

component cause

Answer 21

contributes towards the disease

Question 22

necessary cause

Answer 22

a component cause that must present if a specific disease is to occur

Question 23

What is prioritizing

Answer 23

allows us to allocate funding to services that are more effective in improving health, because there are limited resources and a finite amount of funding

Question 24

How are prioritization established

Answer 24

using evidence based measurements

community expectations/ values

consider human rights, social justice and obligations tot he treaty of Waitangi

Question 25

What are the three epidemiological measures used in priorisation

Answer 25

years of potential life lost to death (YLL) years lived with disability (YLD) population Attributable risk (PAR)

Question 26

Attributable risk

Answer 26

another word for risk difference. for high risk interventions we target the risk factor with the greatest AR

Question 27

Population Attributable risk

Answer 27

amount of extra disease in a population which is attributable to a specific risk factor which we could prevent if we completely removed the risk factor. For population based interventions we target the risk factor which has the greatest PAR as this will benefit most people

Question 28

Population Attributable risk equation

Answer 28

PAR= PGO- CGO

Question 29

Describe Screening

Answer 29

Attributes of a suitable screening test ``` reliable safe simple affordable Acceptable Accurate (high sensitivity and specificity) ```

Question 30

Specificity

Answer 30

likehood of a negative test in those who dont have the disease. It is high if the proportion of true negatives in high fixed characteristic of a test

Question 31

How do you calculate Specificity

Answer 31

d/ (B+d)= true negatives without disease

Question 32

Sensitivity

Answer 32

likelihood of a positive test in those with the disease. It is high if the proportion of true positives is high A fixed characteristic

Question 33

Sensitivity equation

Answer 33

a/(a+c)= true positives/ total with disease

Question 34

Describe Postitive predicted value (PAR)

Answer 34

The proportion who really have disease, of all who test positive The probability of having the disease if the test is positive

Question 35

How is PAR calculated

Answer 35

a/(a+b)= true positives who test positive

Question 36

Describe Negative Predicted Value

Answer 36

proportion of people who are free of disease of all who test negative (the probability of not having the disease if the test is negative)

Question 37

How is NPV calculated

Answer 37

d/(c+d)= true negatives who test negative

Question 38

What is lead time bias | SCREENING

Answer 38

increase in survival time caused by a difference in the time between diagnosis and death when screening compared to clinical diagnosis. Patients dont live longer, just screening lengthens the time that they know they have the disease. This may give a false impression of success of the screening program

Question 39

What is Length time Bias | SCREENING

Answer 39

Occurs when there is a disease that can progress at a rapid or slow rate, with equal incidence of each version of the of the disease.

Question 40

OTTAWA character basic strategy

Answer 40

Enable Advocate Mediate

Question 41

Describe OTTAWA | enable

Answer 41

provide opportunities for all individuals to make healthy choices people cannot achieve their fullest health potential unless they are able to take control of those things

Question 42

Describe OTTAWA | advocate

Answer 42

Create favourable political/ economic/ social/ cultural/physical environments by promotion health and focusing on achieving equity

Question 43

Describe OTTAWA | Mediate

Answer 43

Health personnel have a major responsibility to mediate and form compromises.

Question 44

OTTAWA Strand develop personal skills

Answer 44

Increases the options available to peop;e to exercise more control their own health and make choices conductive to health( through individual empowerment, providing information and education for health)

Question 45

OTTAWA Strand Strengthen community action

Answer 45

Community empowerment: ownership and control of their own endeavors and destinies and their abilities to priorities health interventions and issues relevant to them

Question 46

OTTAWA Strand Reorient Health services

Answer 46

Healthcare must be responsive to needs of patient and families(their culture, aspirations, capacities, resources and social norms) Include a health promotion angle as well as being curative Requires strong attention to health research

Question 47

OTTAWA Strand Build healthy public policy

Answer 47

Placing health in the agenda of policy makers in all sectors- policy must reflect the changing needs of communities and individuals Coordinated action to create policies that foster equity