Module 4 (Evidence and Public Health) Flashcards
What is critical appraisal of evidence?
Critical appraisal is the process of carefully and systematically examining research evidence to judge its trustworthiness, its value and relevance in a particular context.
What is efficacy versus effectiveness?
Efficacy is optimal performance of an intervention under ideal and controlled circumstances
Effectiveness is optimal performance of an intervention under “real world” circumstances
What is translational research?
performed to take interventions found efficacious and test them under “real life” circumstance s
concerned with cost / benefit analysis
What is an intervention?
A means to change outcomes
What is a practice?
Actual application of interventions
What is a program?
an organized effort to effect change
What is data versus information?
Data is raw materials for information (prior to processing)
What are different types of public health evidence?
Biomedical
Social science
Epidemiological
Anecdotal, case reports
Opinions, editorials, news
What is the meta-analysis component of systematic review?
This involves using statistical techniques to synthesize the data from several studies into a single quantitative estimate or summary effect size
(e.g. Cochrane network)
What is the United States Community Preventative Task Force?
The U.S. Community Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. The Task Force works to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services.
Currently has 15 public health and prevention specialists appointed by the CDC.
How does the Community Preventative Task Force classify findings?
Recommends, recommends against, or “insufficient evidence”
What is the “Healthy People” initiative?
a program of a nationwide health-promotion and disease-prevention goals set by the United States Department of Health and Human Services.
Started in 1979; currently on 5th edition (Healthy People 2030) and has 335 measurable objectives
What are some current leading health indicators (LHIs)?
Oral Health Care use
Consumption of calories from added sugars
Drug overdose deaths
Homicide
Exposure to unhealthy air
Food insecurity
Flu vaccination status
Knowledge of HIV status
Having medical insurance
Suicide
What are indicators of public health burden?
metrics such as excess morbidity and mortality
What is actionability?
It takes into account the state of available and
actionable evidence, and the ability to improve health and well-being at a cost that is considered a good
value.
What is a sentinel event?
A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm.
What are the 10 leading causes of death in the US (as of 2018)?
Heart disease
Malignant neoplasm (cancers)
Unintentional injury / accidents
Chronic Lower Obstructive Diseases (e.g. COPD and breathing problems)
Cerebrovascular diseases (stroke, stenosis, aneurism)
Alzheimer’s
Diabetes Mellitus
Influenza and Pneumonia
Nephritis and other Kidney Diseases
Suicide (intentional self harm)
What is Disability Adjusted Life Year (DALY)?
a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. Accounts for both pre-mature death and years of productive life lost.
It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.
What are the leading factors for highest burden of DALY (most years lost)?
Mental health and substance abuse
Cancer and tumors
Circulatory issues
Injuries
Musculoskeletal disorders
Endocrine disorders (diabetes, kidney)
Nervous system
Chronic respiratory
Skin diseases
Sense organ diseases
How does the US compare to other high-income countries in terms of DALY?
It has the highest burden of disease via DALY and is 25% above the comparable country average
What are the “actual” causes of death as determined by Mokdad and co.?
Tobacco
Poor diet and physical inactivity
alcohol consumption
microbial agents (bacteria, fungi)
toxic agents
motor vehicles
firearms
sexual behavior
illicit drug use
In order of smallest to largest impact, what are factors that affect health?
counseling and education (e.g. use condoms, eat healthy)
clinical interventions (e.g. prescriptions for high blood pressure)
long lasting protective interventions (immunizations, colonoscopy)
Changing the context to make default decisions healthy (e.g. fluoridization, iodization, smoke free laws)
Socioeconomic factors (e.g. poverty, housing, education, inequality)
What are accidents versus injuries?
Accident implies random and non-preventable
Injuries occur because of predictable, preventable circumstances
What are primary injury prevention strategies?
Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.
Control agent and environment, emphasize safe practices (host)
