11 Midterm

¡Supera tus tareas y exámenes ahora con Quizwiz!

The denominator of a measure of incidence should include only those who

are considered "at risk" of developing a certain disease-that is the total population from which the new cases should arise.

What are the main differences between clinical focus and epidemiologic focus?

clinical focus treats the patient as an individual, epi focus deals with health problems among populations

Attack Rate is also called

cumulative incidence or incidence proportion

Characterizing health events by person, place and time are activities of

descriptive epidemiology

Name the five components of epidemiology

distribution, determinants, diseases or other health related conditions, populations, and control of health problems

A summary measure is calculated by

dividing the total number of cases of the outcome in the population by the total number of individuals in that population in a given time period

While Incidence Rates directly measures risk, high prevalence

do not necessarily signify high risk; it may reflect an increase in survival (maybe due to a change in virulence or in host factors)

Mortality Rate

expresses the incidence of death in a particular population during a period of time by the total population.

If the incidence of a disease is low, but those affected have the condition for a long period of time, the proportion of the population that has the disease at a particular point in time will be

high relative to the incidence rate.

There is a direct interrelationship between

incidence, prevalence and the mean duration of time of the disease (if any two are known, the third one can be calculated)

Total Mortality Rate

includes in the numerator deaths from all causes

Earlier, in the 1930's, mortality rates declined because of improvements in

living conditions AND largely because of control of infectious diseases and improved nutrition.

If the rate of development of a disease in a population is high, if the duration is short, either through prompt recovery or death, the prevalence will be

low relative to the incidence.

Case-fatality rate

number of deaths from a disease divided by all cases of that illness; is a function of the severity of disease; and represents the proportion of fatal cases among affected individuals and is often expressed as a percentage.

Cause-specific death rate

number of deaths from a stated cause in 1 year / average (midyear) population

Cause-specific mortality

numerator includes the number of deaths from a particular disease or event.

A high infant mortality rate has been taken to indicate unmet health needs and unfavorable environmental factors such as

nutrition, economic conditions, sanitation and medical care and education.

When incidence data is not available, what may be used to estimate the importance of a disease in a population, but with the realization that the it may not be a good estimator of incidence?

prevalence

number of women in state A who died from lung cancer in 2004 / estimated revenue (in dollars) in state A from cigarette sales in 2004

ratio (comparison of 2 quantities with the same units- state A in 2004)

Adjusted Rates

summary rates that have undergone statistical information to permit fair comparison between groups differing in some characteristic that may affect risk of disease.

Morbidity rate

the incidence rate of nonfatal cases in the total population at risk during a specified time period.

If persons who are not at risk for a certain disease are included in the denominator, the resultant measure will

underestimate the true incidence of disease.

Infant Mortality Rate

# deaths in a yr of children less than 1 year / # live births in 1 yr.

Neonatal mortality rate

# of deaths in a year of children less than 28 days old / # live births in that one year (per 1000 births)

Crude death rate

(number of deaths to residents in an area in a calendar year / Ave. pop in the area in that year) per 1000 population

Crude birth rate

(number of live births to residents in an area in a calendar year / Ave. pop in the area in that year) per 1000 population

Proportionate Mortality Ratio equation

(the deaths assigned to the disease in a certain year / the total deaths in the population in the same year) (x's 100)

Proportionate Mortality Ratio

used to demonstrate the proportion of the overall mortality that can be ascribed to a specific cause.

The distinguishing feature of the attack rate is that it is

useful in situations where the development of the outcome of interest rapidly follows the exposure during a time period that is fixed because of the nature of the disease process

By comparing Incidence Rates among populations

we can determine analytically a proposed hypothesis

Birth Rate is expressed per

1,000

Fertility Rate is expressed per

1,000

Infant Mortality Rate is expressed per

1,000

Attack Rate is expressed per

100

Point Prevalence Proportion is expressed per

100

Proportionate Mortality is expressed per

100

Cause-Specific death rate is expressed per

100,000

Incidence Rate is expressed per

100,000

Mortality Rate is expressed per

100,000

Probability of dying for the individuals and Age distribution of the population (the higher the elderly population in a community, the higher the crude death rate in the population).

2 factors that contribute to the magnitude of the crude rates

Neonatal mortality rate is a subset of children who die less than

28 days in a year

Examples of Specific Rates

Age-specific death rate Race- and sex-specific death rate Cause-specific death rate

Crude Rate

Any rate can be expressed for a total population (crude or adjusted) or for a population subgroup (specific rate).

What are 3 core functions of Public Health?

Assurance, Assessment, Policy Development

Dr. John Snow removed the pump handle off the broad street pump to examine if deaths from cholera would decline. Which component of the definition of epidemiology would most directly apply? This is an example of: A. Distribution in person, place, time, B. Intervention to control a health problem C. Identify determinants of cholera

B.

The infant mortality rate in North Carolina was higher than the U.S. infant mortality rate in 2016 (7.2 deaths per 1,000 live births vs 5.9 deaths per 1,000 live births). The populations under study are: A. North Carolina live births B. U.S. live births C. Both A and B D. Infant Mortality Rate

C.

CFR of deaths related to drunk drivers = # deaths due to drunk driving / # cases of drunk driving

Case-fatality rate example

Prevalence Proportion Equation

New and existing cases of the disease or event at a point in time / Total study population at a point in time 𝑥's 10𝑛

Secondary Attack Rate Equation

New cases among contacts of primary cases during a short time period / Population at beginning of time period−primary cases 𝑥's 10𝑛

General Incidence Rate Equation

New cases occuring during a given period of time / Population at risk during the same time period 𝑥's 10𝑛

Cumulative Incidence (attack rate) Equation

New cases occuring during a short time period / Population at risk at beginning of the time period 𝑥's 10𝑛

Incidence Density or Person-Time Rate Equation

Number of cases during observation period / Time each person observed; totaled for all persons 𝑥's 10𝑛

Point Prevalence Proportion Numerator

Number of current cases new and old, of a specified disease at a given point in time. (a measure that reflects burden)

Cause-Specific death rate Numerator

Number of deaths assigned to a specific cause during a given time interval

Proportionate Mortality Numerator

Number of deaths assigned to a specific cause during a given time interval

Infant Mortality Rate Numerator

Number of deaths under 1 year of age during a given time interval

Birth Rate Numerator

Number of live births reported during a given time interval

Fertility Rate Numerator

Number of live births reported during a given time interval

Infant Mortality Rate Denominator

Number of live births reported during the same time interval

Incidence Rate Numerator

Number of new cases of a specified disease reported during a given time interval

Attack Rate Numerator

Number of new cases of a specified disease reported during an epidemic period

Attack Rate

Number of people at risk in whom a certain illness develops divided by total number of people at risk (it's often due to a very specific exposure & It is good for investigating acute epidemics)

number of women in state A who died from heart disease in 2004 / number of women in state A who died from cancer in 2004

Ratio (comparison of 2 quantities with the same units- women in state A in 2004)

What is the definition of Health?

The state of complete physical, mental, and social well-being, not just the absence of disease of infirmity

What is the definition of epidemiology?

The study of the distribution and determinants of health-related states or events in specified populations and the application of this study to control health problems.

may obscure the fact that subgroups of the pop exhibit significant differences in risk

Crude rates

The infant mortality rate in North Carolina was higher than the U.S. infant mortality rate, 7.2 deaths per 1,000 live births vs 5.9 deaths per 1,000 live births, in 2016. The health-related event under study is: A. North Carolina live births B. U.S. deaths at age less than 395 days C. Both A and B D. Deaths among Infants

D.

Mortality Rate Equation

Deaths occuring during a given time period / Population from which death occurred X's 10𝑛

Specific Rates

Detailed rates specific for age and other demographic components (sex or race)

What are the causes of the problem? What works to fix the problem? Is the solution having the intended effect? Does it work in general population? Is there a problem? We think so....

Determinants Intervention Implementation Surveillance

Which of these is not a component of the definition of epidemiology: A. Determinants B. Etiology C. Population D. Intervene to control health problem E. individual patient clinical management

E

Cause-Specific death rate Denominator

Estimated mid-interval population

Mortality Rate Denominator

Estimated mid-interval population

Fertility Rate Denominator

Estimated number of women ages 15-44 years at mid-interval

Incidence Rate Denominator

Estimated population at mid-interval

Point Prevalence Proportion Denominator

Estimated population at the same point in time

Birth Rate Denominator

Estimated total population at mid-interval

Morbidity rate of TB in 1985 can be calculated by dividing the number of nonfatal cases newly reported during that year by the total US midyear population.

Example of Morbidity Rate

It is a fundamental tool for etiologic studies of acute and chronic disease, since they are direct indicators of risk of disease.

Incidence Rates

Provides a direct measure of the rate at which individuals in a given population develop disease and thus provide a basis for statements about probability or risk of disease.

Incidence Rates

A change in prevalence from one time period to another may be the result of changes in

Incidence rates, Changes in the duration of disease or Both

Is good for tracking changes of disease over time; can be determined by cross-sectional studies (less expensive, less time consuming); and will give an idea of the burden of the disease in a population at a given point in time.

POINT PREVALENCE

Health has been defined as consisting of six interactive dimensions- what are they?

Physical, social, mental, emotional, spiritual, and environmental

Attack Rate Denominator

Population at start of the epidemic period

An adequate sample size can be achieved more quickly if existing cases are used rather than waiting for new or incident cases to accumulate.

Prevalence

Can be used to express the burden of some attribute or condition in a population

Prevalence

Most useful for health care providers to assess the public health impact of a specific disease within a community and to project medical care needs for affected individuals, such as number of health care personnel or hospital beds that will be needed.

Prevalence

Useful for monitoring programs for chronic conditions.

Prevalence

Factors (lifestyle, exposures, etc) can affect the occurrence of disease and result in influencing the duration or severity of the illness.

Prevalence disadvantage

Creates a bias

Prevalence disadvantage (it favors the inclusion of chronic over acute disease)

number of women in State A who died from heart disease in 2004 / number of women in State A who died in 2004

Proportion (a type of ratio in which the numerator is included in the denominator)

number of women in state A who died from lung cancer in 2004 / number of women in state A who died from cancer (all types) in 2004

Proportion (type of ratio in which the numerator is included in the denominator)

Displays the percentage of deaths due to the cause under study, usually in a certain age and sex group compared with a different age group in the same sexed population

Proportionate Mortality Ratio

used to emphasize the importance of the contribution of one cause-specific mortality to overall mortality

Proportionate Mortality Ratio

Describe how public health relates to the six interactive dimensions of health?

Public health is "What we as a society do collectively to assure the conditions in which people can be healthy"

number of women in state A who died from heart disease in 2004 / estimated number of women living in state A on July 1st, 2004

Rate (compares disease frequency in different locations, different times, or among different groups of people with different size populations; a measure of risk)

When calculating measures of incidence what things should, in principle, be excluded from the denominator.

Those who currently have or have already had the disease under study or persons who cannot develop the disease for reasons such as age, immunization, or prior removal of organ.

Mortality Rate Numerator

Total number of deaths reported during a given time interval

Proportionate Mortality Denominator

Totally number of deaths from all causes during the same time interval

Low prevalence may reflect

a rapidly fatal process or rapid cure of disease as well as low incidence.


Conjuntos de estudio relacionados

Microbiology Test 3: Chapter 15 practice questions

View Set

Microbiology Final, Micro II Midterm, Micro II Quiz 2, Micro II quiz 1

View Set

Lesson 11: Implementing Secure Network Protocols

View Set

Chapter 27: Growth and Development of the...

View Set

Mental Health - Chapter 5 - Cultural Implications

View Set

Business Law class Chapter 1 terms

View Set