Public Health Exam 1

Wha is the attack rate?

# of people in whom an illness develops over total # at risk

Components of Evidence-Based Medicine

- clinical judgment - relevant scientific evidence - patients' values and preferences

How are Guidelines developed?

1. Clinical question 2. Choose an outcome variable of interest 3. Find + synthesis ALL evidence 4. Rate confidence in treatment effect 5. Make recommendation

Principles of evidence based medicine

1. Examining totality of evidence 2. Not all evidence is equal 3. Evidence is never enough to drive clinical decision making

What are components of a good clinical guideline?

1. Informed by multiple sources of high level evidence 2. Include the evaluation of alternative options

Nationally notifiable diseases are determined by?

1. costs 2. severity 3. infectiousness

What organization is responsible annual report on national healthcare quality & disparities/minority health, implementation of medical tech, comparative health systems performance, and medical errors & safety?

AHRQ

National Quality Guidelines Organizations

AHRQ CMS

What are the 5 As of the evidence cycle?

Ask (clinical question) Acquire (clinical evid) Appraise Apply Act

What are the core functions of public health?

Assessment Assurance Policy development

What are some good resources for preappraised research?

BMJ Evidence, Updates, NEJM Journal Watch, Cochrane

What is a person who harbors an organism but is not infected as measured by serologic studies or by evidence of clinical illness. This person can still infect others

Carrier

What did John Snow study

Cholera

The habitual presence of a disease in a given area. The usual occurrence of a given disease within a defined area.

Endemic

The occurrence in a community or region clearly in excess of normal expectancy, and derived from a common propagated source

Epidemic

# of cases occurring over time

Epidemic Curve

The study of the distribution of health-related states and events in populations

Epidemiology

Name of the Pyramid that displays factors that affect health

Freidan Pyramid

What is the single best thing everyone can do to minimize the spread of infections?

Handwashing

Father of field epidemiology

John Snow

What are secondary or pre-appraised studies? These are at the top of the Hierarchy of Evidence

Meta-Analysis Systematic Review

What format do you use when developing a clinical question?

PICO

Worldwide epidemic

Pandemic

What does PICO stand for?

Population Intervention Comparison Outcome

What are the health outcomes of a group of individuals, including the distribution of such outcomes within the group?

Population Health

What is preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals?

Public Health

What emphasizes cross-sector collaboration and environmental policy and systems-level actions that directly affect the social determinants of health?

Public Health 3.0

What is used for some Non-Preappraised Research?

Pubmed, googlescholar

What factor has the largest impact on health?

Socioeconomic factors ex: poverty, education, housing, inequality

What fills the gap between community's needs and community's assets?

State gov, local gov, NGO, philanthropy, faith community, banks, businesses, other private sector, community members

Examples of Secondary Evidence

Systematic reviews and meta-analyses. Reviews of primary literature that help to translate research into practice

What are Clinical guidelines

Systematically developed statements intended to aid clinicians in optimizing or improving patient care. Encouraging the use of proven benefits.

How do you determine the idea study type for your question? What are some question types?

Therapy Diagnosis Prognosis Etiology/harm

Example of a Carrier

Typhoid Mary

What system grades the evidence? What is the grading scale?

USPSTF - A, B, C, D, I

What are some good resources for summaries & guidelines?

UpToDate, DynaMed, Best Practice

Clinical guidelines are NOT

a replacement for clinical judgement or a protocol

Examples of Primary Evidence

individual, original research studies that are non-synthesized

What is the total number of deaths from a disease in 1 year over the total persons in the population at midyear?

mortality

Epidemiology is an _______________ science

observational