Module 3 (Data and Statistics) Flashcards
What are Sir Bradford Hill’s Criteria for research?
These are his criteria for causation (establishing epidemiologic evidence of a causal relationship between a presumed case and an observed effect).
They include:
consistency, specificity, temporality, biological gradient (dose-response relationship), plausibility, coherence, experiment, analogy
What is sensitivity versus specificity?
Sensitivity: tests with few false negatives (used more in public health data to avoid missing individuals with condition associated with the disease)
Specificity: tests with few false positives
What are common rates used within public health?
Birth rates
Mortality rates
Crude rates (use a raw number, data frequently adjusted for comparison purposes)
Infant mortality rate
Maternal mortality rate
Age adjusted
Gender specific
What is the International Classification of Diseases? (ICD)
Published by the World Health Organization (WHO), this is used throughout the world to provide a common classification of diseases, conditions, and causes
Currently in ICD-10 version, but 11 will be out soon
What is YPLL?
Years of Potential Life Lost; measures early deaths (before expected life expectancy); can indicate failures or priorities for greater emphasis
What is cost / benefit analysis?
Demonstrate that an intervention provides a positive return
(often calculated through monetary means)
(E.g. calculating the costs of MMR vaccinations for children versus costs of treating those with the disease yielded a 13 to 1 ratio of benefit to cost)
Help policy makers decide the best course
What are common sources of local data?
birth certificates, death certificates, notifiable diseases, infant mortality statistics, other vital statistics
What is the National Vital Statistics System?
the oldest and most successful example of inter-governmental data sharing in Public Health and the shared relationships, standards, and procedures form the mechanism by which NCHS collects and disseminates the Nation’s official vital statistics.
Purpose: to answer the question, “Are people living healthier lives?”
Formed around 1880
What are the functions of the US Census?
The census is mandated by the US Constitution and serves as the denominator for most public health data, including:
age, sex, race, ethnicity
education, housing, health insurance (American Community Survey)
American Housing Survey
What section of the US Constitution mandates the US Census?
Article 1, Section 2 (in determination of # of leaders):
“Section 2
The House of Representatives shall be composed of Members chosen every second Year by the People of the several States, and the Electors in each State shall have the Qualifications requisite for Electors of the most numerous Branch of the State Legislature.
No Person shall be a Representative who shall not have attained to the Age of twenty five Years, and been seven Years a Citizen of the United States, and who shall not, when elected, be an Inhabitant of that State in which he shall be chosen.
Representatives and direct Taxes shall be apportioned among the several States which may be included within this Union, according to their respective Numbers, which shall be determined by adding to the whole Number of free Persons, including those bound to Service for a Term of Years, and excluding Indians not taxed, three fifths of all other Persons. The actual Enumeration shall be made within three Years after the first Meeting of the Congress of the United States, and within every subsequent Term of ten Years, in such Manner as they shall by Law direct. The Number of Representatives shall not exceed one for every thirty Thousand, but each State shall have at Least one Representative; and until such enumeration shall be made, the State of New Hampshire shall be entitled to chuse three, Massachusetts eight, Rhode Island and Providence Plantations one, Connecticut five, New-York six, New Jersey four, Pennsylvania eight, Delaware one, Maryland six, Virginia ten, North Carolina five, South Carolina five, and Georgia three.
When vacancies happen in the Representation from any State, the Executive Authority thereof shall issue Writs of Election to fill such Vacancies.
The House of Representatives shall chuse their Speaker and other Officers; and shall have the sole Power of Impeachment.”
What are some of the major national health surveys?
National Maternal and Infant Health Survey
National Health Interview Survey (NHIS)
National Health and Nutrition Examination Survey (NHANES)
Behavioral Risk Factor
National Survey on Drug Use and Health (NSDUH)
Surveillance Survey (BRFSS)
Youth Behavioral Risk Factor Survey
What can one access through Georgia’s OASIS database?
vital statistics
hospital data
behavioral survey
population
Specific data like counts and ranks
Tools like making maps
Pandemic Versus Epidemic Versus Endemic
An epidemic is a disease outbreak that is rapidly spreading in a limited region. A pandemic is an epidemic that is actively spreading to multiple regions across the globe.
Though an endemic is a constant presence in a community, it differs from a pandemic because the virus is somewhat contained and not spreading out of control and not stressing the health care infrastructure, therefore we can more easily prevent and treat it.
What is the p value?
It expresses the probability that the observed result could have occurred by chance alone.
A p value of .05 means that if an experiment were repeated 100 times, the same answer would result 95 of those times, while 5 times would yield a different answer.
What is a confidence interval?
a range of values within which the the true result probably falls. The narrower the confidence interval, the lower the likelihood of random error.
These are often expressed as margins of error. e.g. when a politician’s supported is estimated at 50% plus or minus 3%.
What is lead time bias?
This occurs when increased survival time after diagnosis is counted as an indicator of success.
What is overdiagnosis bias?
This occurs when symptoms detected by screening are not likely to progress to the next stage (life-threatening), but remission or survival is still considered a measure of success.
What are crude rates versus adjusted rates?
Crude rates are raw data
Adjusted rates use statistical calculation to make the populations being examined equivalent to one another (often used for age adjustments).
E.g. crude mortality in Florida is much higher than crude mortality in Alaska, but the average age of Floridians is also much higher than the average age of Alaskans.
What is a risk assessment?
A formal process which identifies events and exposures which may be harmful to humans and estimates the probabilities of their occurrence as well as the extent of harm they may cause.
What is cost / effectiveness analysis?
Compare the effectiveness of one intervention to another
E.g. It may be so expensive to give prevent heart attacks in men by prescribing cholesterol drugs – it may be more effective to provide cardiac care for those who do suffer an attack. (ethics questions…)
Help policy makers decide the best course
What is the federal agency that collects, analyzes, and reports data on the health of Americans?
National Center for Health Statistics (NCHS)
What are some examples of vital statistics?
births, deaths, marriages, divorces, spontaneous fetal deaths, and abortions
What is the US Census?
a national survey that provides data not only on the geographic distribution of the population and its sex, age, and ethnic characteristics, but also on a wide variety of social and economic characteristics.
Part of the Department of Commerce
What is the Behavioral Risk Factor Surveillance Survey (BRFSS)?
A study collected by the federal government in conjunction with the states which obtains information on health-related behaviors.
Specifically, it asks about risk factors (high blood pressure, high blood cholesterol, diabetes, and weight), health related behaviors (diet, physical activity, cigarette smoking, alcohol use, seatbelt use, drinking and driving), and preventative medical care (mammograms, PAP smears, colon cancer screenings, immunizations, etc.)
