PUBH 6003 Weeks 1-10 exam review

Epidemiology - correct answer -study of how diseases are distributed in populations -the factors that influence or determine these distributions Epi is commonly called - correct answer the basic science of public health what are the hallmarks of science - correct answer data results what are the hallmarks of public health - correct answer •Discovering how diseases spread in a population (distribution) •Evaluate efficacy of preventative, therapeutic, and intervention activities •Measure the efficacy of health measures •Study disease trends over time •Plan for future health care need what types of science is epi - correct answer observational What does epi provide for EBM? - correct answer evidence what are the public health goals of epi? - correct answer protecting the health of entire populations (small, large, neighborhood, region, etc..) prevent problems from happening or recurring How do public health professional prevent problems from happening or recurring? - correct answer implementing educational programs recommending policies fixed population - correct answer members can only leave via death dynamic population - correct answer members can join via birth, migration or an event that makes them a defined member of the population William Jenner - correct answer 1790's William Jenner used pus from cowpox against smallpox resulted in milder smallpox lead to widespread vaccination campaigns First Health Department - correct answer 1799 Boston Paul Revere was first health officer when did the concept of public health develop - correct answer •By the mid 1800s the basic concepts of public health were developed as scientists measured the impact of poverty, personal hygiene, and public sanitation on health Epidemiologic Society of London - correct answer •In the 1850s The Epidemiologic Society of London was formed, consisting of local physicians, ex-military commanders, and civil servants who presented papers related to public health issues germ theory of disease - correct answer Late 1800's from research of disease lead to acceptance of the germ theory Epi's Place in history - correct answer •Newish term •New profession •New academic field of study •Entwined with public health ...and knowledge of disease causation •Began with doctors, but very early contributions from demographers/statisticians •Always "multidisciplinary": might be easy to forget that now Goals of Epi - correct answer -Foundation of public policy -identify etiology and relevant risk factors of disease -intervene to reduce morbidity and mortality -determine extent of disease in community -study history & progression of disease -evaluate preventive and therapeutic measures & modes of delivery Epi and Clinical Medicine - correct answer provide evidence for evidence based medicine -diagnosis -prognosis -selection of therapy or prophylaxis what are statistics - correct answer group measures by definition descriptive epidemiology - correct answer person place time the study variables - correct answer the aspects of person, place and time not already used to define the population what do epi studies describe? - correct answer disease distribution aka population wide patterns Person - correct answer age (most important) sex race / ethnicity SES education demographics genetics (risk factors, diagnostic, markers) employment status / occupation nutritional status positive and negative behaviors physiological measured place - correct answer geographic information: •Environment: political/social •Levels of violence •SES •Health policies/health care access •Data quality •Environment: physical •Climate •Altitude •Population density •Urban/rural Time - correct answer •Of event/diagnosis •Date characteristics may show: •Cyclical trends: short-term, often seasonal •Secular trends: long-term trends over years or decades •Clustering (time and space) •Time since exposure Requires date of exposure in addition to date of diagnosis -date of event -date of birth Time and relationship to age,period, cohort model - correct answer •An event may be directly related to: Age due to: •Biology •Life stage indicator Period due to: •Social/political environment •Physical environment •Timing of exposures Cohort due to: •Shared exposures •Shared culture Time and the relationship to length - correct answer •Length of time from exposure to disease •Length of time from diagnosis to death •Length of time from treatment to remission •Length of time in study These might be included in a descriptive study, but much less commonly. descriptive studies are designed to - correct answer answer who, where, when describe patterns suggest hypotheses analytical studies are designed to - correct answer test hypotheses •Where do we get data about disease/health outcome? - correct answer •Descriptive studies •Vital statistics •Surveillance programs Where does the data first come from? - correct answer •Self-report •Physician (point of care) •Labs •Research measurements •Hospital records •Insurance/administrative sources the international classification of disease - correct answer ICD, codes for illness and diseases •The International Classification of Disease (ICD) coding system •All reported mortality statistics rely on the ICD coding system •Allows for systematic comparison of deaths between countries •Originated in the late 19th century •Designed to standardize the international reporting of causes of death •As of 2021 still the 10th revision (ICD-10), the 11th (ICD-11) was released in June 2018 for review, scheduled to be adopted in 2022 •Definition changes can be controversial; coding changes can be troublesome •Utilized by trained professionals known as nosologists •ICD code updates may not be adopted at the same time in all countries, so it is important to know which version was used where and when artifactual changes in health - correct answer •Changes in codes, medical practice, and reporting standards may result in changed numbers that do not correspond to true changes in the original disease. •These are known as "artifactual" changes because they are man-made. •It can be difficult to separate the artifactual changes from true changes. sources of artifactual changes - correct answer •Data collection •Data accuracy •Case identification •Technological improvements •Health care access (not all artifactual!) •Coding changes •Diagnostic inaccuracy leading to misclassification •Technological changes leading to new, more sensitive diagnostic tests (e.g., PSA test) •Differences in quality of/access to health care: not sure this is "artifactual" •More complete ascertainment of cases •Changes in definition or classification of a disease •Errors in enumerating the population (affects the denominator) Primary Data Sources - correct answer •Primary data sources are collected directly by the researchers. •Questionnaires, interviews, observation, tests •Pros: researcher controls what is collected, defines variables •Cons: time-consuming, wasted resources and participant time if already available Secondary Data Sources - correct answer •Secondary data sources are information already collected, for other purposes. •Ready to use sources: census, public data sets, previous studies, surveillance data •Pros: available, often consistent with other research •Cons: may not have all needed variables, wrong definitions for study, dependent on quality of collection statistics from a sample are? - correct answer estimate true numbers chance is? - correct answer