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KP331 > Week 11 > Flashcards

Week 11 Flashcards

1
Q

What is epidemiology?

A

the study of health and disease in populations

distribution and determinants of disease frequency in human populations

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2
Q

What did Hippocrates contribute to epidemiology?

A

first known description of tetanus, typhus, tuberculosis, etc.

suggested human disease related to external and personal environments

qualitative data

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3
Q

What did Galileo Galilei contribute to epidemiology?

A

combined observation and measurement of phenomena with experimental design to test theories/laws

quantitative data

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4
Q

What did John Graunt contribute to epidemiology?

A

analyzed weekly reports of births and deaths

first to quantify patterns of disease
- noted high infant mortality, season variations in mortality, etc.

lead to advances in mathematical tools dealing with chance and probabilities

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5
Q

What did Pierre-Charles Alexandre Louis contribute to epidemiology?

A

pioneered fundamental principle between effect of treatment/substance

first case control studies, used numerical methods to produce statistical evidence

found practice of bloodletting was ineffective and dangerous

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6
Q

What did William Farr contribute to epidemiology?

A

system of routine compilation of numbers and causes of death

compared mortality rates with several different characteristics

  • frequency and distribution
  • normal curve (bell)
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7
Q

What did John Snow contribute to epidemiology?

A

often referred to as father of epidemiology

formulated and tested hypothesis concerning origin of cholera epidemic

tracked the cholera outbreak, postulated it was transmitted by contaminated water, made observations that supported hypothesis

produced enough knowledge to enable disease-prevention measures even before it was known to be cholera

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8
Q

What is cholera?

A

acute bacterial infection in small intestine

severe diarrhea, vomiting, muscular cramps, and dehydration -> electrolyte depletion

spread by water and food contaminated by feces of persons previously infected

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9
Q

What did Rudolf Virchow contribute to epidemiology?

A

father of modern pathology

medicine is a social science and politics is medicine on a large scale

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10
Q

What did Joseph Goldberger contribute to epidemiology?

A

epidemiology to identify infectious and non-infectious agents

ex. Pellagra (neurological disease) -> vitamin deficiency

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11
Q

What had happened to epidemiology by the end of WW2?

A

in most economically advanced countries, burden of non-communicable diseases > communicable diseases

  • CVD and cancer of unknown origin
  • micro-organisms largely controlled through hygiene measures, vaccinations, and antibiotics

broadened scope of epidemiology
- ex. heart attack at a molecular level and societal level

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12
Q

What are the 3 main types of research are included by epidemiological study today?

A

observational studies
experimental studies
intervention studies

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13
Q

What are observational studies?

A 
what happens in a group of people
record health-related events
ask questions
take measurements of the body/on blood
don't actively intervene
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14
Q

What are experimental studies?

A

dominant in biomedical studies

in-vitro (test tube) or in-vivo (organism)

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15
Q

What are intervention strategies?

A

smaller component of epidemiology (10-20% of research)

ex. vaccine trials in a population

larger component of medical/biological studies

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16
Q

What is descriptive epidemiology?

A

describes health and disease and their trends over time in specific populations

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17
Q

What is etiological epidemiology?

A

searches for hazardous or beneficial factors influencing health conditions

ex. toxic pollutants, poor or beneficial diets, behavioural habits, micro-organisms

18
Q

What is evaluative epidemiology?

A

evaluates the effects of preventive interventions

quantitatively estimates risks of specific diseases for persons exposed to hazardous factors

19
Q

What is health services epidemiology?

A

describes and analyzes the work of health services (i.e. effectiveness)

20
Q

What is clinical epidemiology?

A

describes natural course of a disease in patient population

evaluates effects of diagnostic procedures and of treatments

21
Q

What are confounders?

A

another factor that confuses exposure-outcome relationship

may appear like one thing causes another, but may not be the case due to confounding variable interfering

“secret cause”

22
Q

What are the key assumptions of epidemiology?

A

majority of human disease does not occur at random

causal and preventive factors of human disease can be identified through investigation of different populations and subgroups of individuals within a population

23
Q

What is a hypothesis?

A

a statement derived from a theory that predicts the relationship among variables representing concepts, constructs, or events

a suggested solution to the problem, predicts an outcome

must be testable

“if…then…”

24
Q

What do we ask to determine distribution?

A

when
where
who

across different populations, different subgroups, different observational periods

25
Q

What are the components needed to test epidemiologic hypotheses?

A

disease frequency
- quantification of existence or occurrence of disease

determinants of disease
- integral in describing disease patterns and in the formulation of hypotheses pertaining to possible causal or preventive factors

26
Q

What is the primary unit of concern in epidemiology?

A

groups of persons (not separate individuals)

must be studied in order to answer questions relating to aetiology and prevention of disease

and to allocate effort and resources in health care facilities/communities

27
Q

What is count?

A

number of people in the group studied who have particular disease or characteristic

simple counts can be dangerous basis for comparison between groups because doesn’t consider group size

28
Q

What is ratio?

A

expression of a relationship between 2 numbers

can be presented as proportions or rates

100:150 children:adults
=
1:1.5 children:adults
= 
0.66:1 children:adults
29
Q

What is proportion?

A

type of ratio where numerator is added to denominator and resulting proportion is expressed as a percentage

100/250 x 100%

30
Q

What is rate?

A

type of proportion that involves time relationship

prevalence and incidence

31
Q

What is prevalence?

A

number of cases at one time

snapshot of an existing situation

PR = number of persons with disease/total number in the group

typically expressed as rate per 100 or per 1000 (multiply equation)

32
Q

What are the 2 types of prevalence?

A

point prevalence = one time

period prevalence = over time

33
Q

What is incidence?

A

number of new cases that occur during a given period

IR = number of persons with disease/number of people at risk

typically expressed as rate per 100 or 1000 (multiply equation)

34
Q

What is validity?

A

measure of data quality

extent to which a test measurement or other device measures when it is intended to measure

35
Q

What is reliability?

A

measure of data quality

extent to which a test device or measurement produces the same results with different investigators

36
Q

What are the 2 strongest types of scientific study?

A

meta-analyses/systematic reviews

randomized control trials

37
Q

What are the main contributors to population health?

A

public health ->

clinical medicine (individual/tertiary)

prevention and early diagnosis (collective/secondary)

people’s empowerment
(collective/primary)

38
Q

What are systematic reviews?

A

systematic approach of reviewing literature

minimizes effects of bias and random errors

more objective appraisal of evidence
- scrutinize each to assess quality

results can be combined in meta-analysis

39
Q

What is meta-analysis?

A

summarizes risk estimates

clear results may emerge that have not been found in single RCT

most valuable for clinical application
- evidence based medicine

40
Q

What is number needed to treat (NNT)?

A

methods for comparing treatment options

number needed to treat for one person to be “saved”

ex. risk of stroke in hypertensive subjects over 3 years = 20%

treatment A reduces risk to 4% (16% reduction)
- 16/100 subjects avoid adverse outcome

NNT = 100/16 = 6.25
- need to treat 6.25 people for one person to be saved

41
Q

What is the diagnostic decision tree?

A

assists in formulating a diagnosis

breaks down steps for diagnostic process
- can involve many tests, difficult for HCP to choose best course of action without a framework

prevent biases

KP331 (13 decks)

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