policy

steps in risk assessment (5)

1. Hazard identification 2. Dose-response assessment 3. Exposure assessment 4. Risk characterization 5. Risk management (or mitigation)

ideal screening test (4)

1. needs to be high in sensitivity 2. high in specificity 3. high in predictive value (+) 4. high in predictive value (−)

distinguish policy from law

a law restricts everywhere, a policy restricts only certain places

predictive value (-)

an analogous measure for those screened negative by the test

Most reliable data is from a _________

randomized control trial

________is needed to pass most laws

research

screening tests- desirable qualities (4)

1. Condition screened needs to be important 2. Screening test should have a high cost-benefit ratio. 3. Condition needs to be sufficiently prevalent 4. An effective treatment should be available Screening tests need to demonstrate reliability and validity

Health policies are linked with the development of laws such as (4)

1. Licensing (licensing medical practitioners) 2. Setting standards (allowable levels of contaminants in food) 3. Controlling risk (requiring the use of child safety seats) 4. Monitoring (surveillance of infectious disease)

the policy cycle (5)

1. Policy definition- defining the problem for which the policy actors believe is necessary 2. Agenda Setting- setting priorities, deciding when and who will deal with the problem 3. Policy Establishment- formal adoption of policies, programs and procedures designed to protect the society from public health hazards 4. Policy Implementation- focuses on achieving objectives set forth in the policy decision 5. Policy Assessment- determination wether the policy has met defined objectives and related goals • Where would you place the policy actors, advocates, stakeholders, citizens, policy makers, and interest groups in the policy cycle? Remember they can be in more than one step.

Epidemiologists provide quantitative evidence regarding proposed health policies & can provide input regarding the need for and efficacy of policies... (3 functions)

1. Serve as expert witnesses in litigation 2. Testify during legislation hearings 3. Work as advocates- health-related coalition

examples of health policy (4)

1. Water quality 2. Health promotion 3. Environmental protection 4. Surveillance (epidemiologic, cancer registries)

Ideally, policy-makers select alternatives that (2)

1. minimize health risks 2. maximize desirable health outcomes and other benefits

the gold standard in sensitivity

A definitive diagnosis that has been determined by biopsy, surgery, autopsy, or other method

policy

A plan or course of action, as of a government, political party, or business, intended to influence and determine decisions, actions, and other matters

cost-effective analysis

A procedure that contrasts the costs and health effects of an intervention to determine whether it is economically worthwhile

selective screening

A type of screening applied to high risk groups; likely to result in the greatest yield of true cases and to be the most economically efficient

inertrest group

Group of persons working on behalf of or strongly supporting a particular cause, such as an item of legislation, an industry, or a special segment of society

policy actors

Individuals who are involved in policy formulation (members of legislature, citizens, lobbyists, representatives of advocacy groups)

stakeholders

Individuals, organizations, members of government affected by policy decisions

decision analysis

Involves developing a set of possible choices and stating the likely outcomes linked with those choices, each of which may have associated risks and benefits.

health policy

Pertains to the health arena (in provision of health-care services, dentistry, medicine, or public health) -not always a law

legitimization

Process of making policies legitimate, acceptable to society

validity

The ability of the measuring instrument to give a true measure of the entity being measured; accuracy

sensitivity

The ability of the test to identify correctly all screened individuals who actually have the disease

specificity

The ability of the test to identify only non-diseased individuals who actually do not have the disease

evidence-based public health

The adoption of policies, laws, and programs supported by empirical data (reduces uncertainty in decision making)

risk

The likelihood of experiencing an adverse event

risk assesment

The process for identifying adverse consequences and their associated probability

It is possible for a measure to be _______and_________, but not __________and__________

invalid and reliable; valid and unreliable

reliability

the ability of a measuring instrument to give consistent results on repeated trials

screening for disease

the presumptive identification of recognized disease or defects by the application of tests, examinations, or other procedures that can be applied rapidly.

predictive value (+)

the proportion of individuals screened positive by the test who actually have the disease