Using Evidence to Ensure Public Health Flashcards Preview

Contemporary Practice of Medicine > Using Evidence to Ensure Public Health > Flashcards

Flashcards in Using Evidence to Ensure Public Health Deck (23):
1

Determinants of Health

Socioeconomic, Enviornmental, Genetics, Health Care

2

Assessment

Monitor health status and invesitgate health problems to protect people from health hazards

3

What US fed cabinet department is responsible for public health?

Department of health and human services

4

Incidence and what increases it?

New cases during a time interval...more liberal case definitions and improved diagnostic methods

5

Prevalence and what increases?

Number with a given disease at a given time divided by pop atrisk

Does not distinguihs new from established

Txs preventing death will increase

6

Adv and disadv to crude mortality

Easy

Underestimates true difference and should be higher in older populations

7

Case fatality

Proportion of death from a certain cause over certain time

Standardizes data based upon specific condition

Only meaningful for short periods

Screening decreases fatalities...even if not better outcomes

Poor access to care increases fatality...even if good txs

8

Infant mortlaity rate

Proportion of live born infants who die by 1 yr

Most sensitive indicator of overall societal health

9

Life expectancy

Overall measure of pop health...not affected by age composition of the population

Altered by rare events

Not estimate of future expereince

May not reflect individual demographic differences

10

QALY

Health related to quality of life scale

Captures both morbidity and mortality

Allows comparison of health system and health interventions

Std for health impacts and cost effectiveness analysis

Not translatable into a patient experience

11

Policy Development

Give people information

Engage community

Develop Policies

12

Assurance

Enforce public health law

Help ppl recive services

Maintain a competent health workforce

Evaluate and imrpvoe programs

13

System Managment

Contribute to and apply the evidence base of public healt h

14

T0, 1,2,3,4,

Basi science

Humans

Pts

Practice

Community

15

Case control benefits

INexpensive, Timely, high yield for rare or long-term outcomes

16

Selection bias

Study sample not representative of population at risk

17

Confounding

A factor distorts the effect of another related factor

18

Recall and interviewer bias

Inaccurate memory
Information bias
Different collection

19

Benefits of cohort studies

Generalizable...accurate slice of a population

Best study design if randomization is not possible...the observational design least susceptible to bias

20

Cohort study problems

Selection bias, confounding, interviewer bias

Surveillance bias - more aggressive diagnostic approahc in one group

Loss to follow up...those lost have different outcomes than those who remain (less than 5 is little, 5-20 could be biased, more than 20 often substantial bias)

21

Def of a confounder

Factor associated with both exposure and outcome

THink age with smoking intensity and dz

22

Strength
Temporality
Reversibility

Size of effect not due to plausible confounding

Cause precedes the outcome

Reduction in exposure decreases effect

23

Biologic plausibility

Dose-response

Consistency

Similarity

Link

Effect increase with exposure

Relationship is repeated

Similar exposure lead to similar dz