Epidemiology 101 Chapter 4

What is one of the major types of case registries?

Case registries are used to track patients with specific diseases such as cancer

NHANES (National Health and Nutrition Examination Survey)

Collection of information from physical examination coupled with interviews. - Physical examinations, lab tests, DNA repository, and interviews o Nutrition monitoring o Children's growth and development o Overweight and diabetes o Infectious disease monitoring

Describe the components of a surveillance system.

Communicable disease surveillance and infectious disease surveillance, non infectious disease surveillance, behavioral risk factor surveillance

Distinguish between a cause that is sufficient but not necessary and one that is necessary but not sufficient. Be sure to give examples.

- A cause can be sufficient but not necessary Example: skipping an exam in the course would be sufficient cause for failing it though students can fail it other ways as well - A necessary cause represents a condition that must be present for the effect to follow Example: It is necessary to take college courses to get a degree. Take away the courses and there is not degree.

How could descriptive epidemiologic studies examine the following health issues? • The obesity epidemic in the United States • Increases in the prevalence of type 2 diabetes among adolescents • Abuse of prescription narcotic drugs

- A. obesity: studies the obesity trends over a time period in US, examines obesity prevalence in various subgroups, develop "public health programs" and "health care policy" targeting obesity - B. Type 2 diabetes: Study the disease trends over years in teenagers, examines diabetes prevalence among teenagers of various subgroups, identify the "health care needs of the teenagers" - C. Narcotic drugs: Study the pattern of drug abuse over the years in a group of people, examine and compare prevalence of drug misuse among subgroups, plan health interventions

What are notifiable diseases?

- Any disease that is required by law to be reported to government authorities. - Examples: gonorrhea, hepatitis A, B, and C, mumps, syphilis

Describe the Behavioral Risk Factor Surveillance System. How does it differ from a surveillance system for infectious diseases?

- a health program that includes the behavioral risk factor and it's association with chronic disease used in US to monitor at state level.... worlds largest ongoing health survey - infectious diseases surveillance system is used to collect data from healthcare provides and send the report to state healthcare, then to CDC, then to WHO

Identify examples of websites where you might obtain epidemiologic data

-Online Source of Epidemiological information, -Online source, -CDC, -Medline, - World Health Organization Statistical Information System, -Embase

Distinguish between a point estimate and a confidence interval estimate.

-Point estimate gives a particular value as an estimate of population parameter -Interval estimate gives us a range of values which is likely to contain the population parameter

What is the difference between a parameter and a statistic?

-Statistics describes a sample -Parameter describes a population

Registry

A centralized database for collection of information about a disease

Deterministic model

A model in which all uncontrollable inputs are known and cannot vary.

What is meant by the term health disparities?

Differences in the occurrence of diseases and adverse health conditions in the population

Three uses for descriptive epidemiologic studies are:

Helps to examine trends of health conditions in a population Provide a data source for health care needs, planning, and evaluation Identify health problems that can be further analyzed by analytical epidemiology methods.

Do you have any suggestions for improving life expectancy in the United States?

Improve health care service quality, eliminate health care disparities, increase health and disease related knowledge in population to improve health behavior

Discuss the limitations of data collected from surveillance systems.

Lack of reporting, data incompleteness

How does life expectancy at birth in the United States compare with that in other countries?

Life expectancy at birth represents the number of years a new-born is expected to survive if the mortality trends prevalent at the time of birth remain unchanged throughout its life.

What are some examples of racial/ethnic classifications used to describe health characteristics? Name two conditions that vary according to race/ethnicity.

Lower frequency of asthma reported among Hispanics Non-Hispanic whites and non-Hispanic blacks less frequently report they have no usual source of medical care than do Hispanics Difficulties in physical functioning are highest among adults classified as Native Hawaiians and Pacific Islanders Incidence of gonorrhea is higher among non-Hispanic blacks than other groups.

What could be done to raise the life expectancies of residents in the countries that have the three lowest levels? Life expectancy at birth

Lowest life expectancy: Afghanistan, Guinea-Bissau, Chad. Control new-born and maternal mortality Provide food assistance programs to eliminate nutritional deficiencies Promote health programs for communicable and parasitic diseases

What is the purpose of surveillance systems?

Provides and interprets data to facilitate the prevention and control of disease.

Name three characteristics of time that are used in descriptive epidemiological studies

Secular trends, point epidemics, cyclic trends

Describe the types of information that can be obtained from the vital registration system of the United States.

Vital events, vital registration system, death statistics, birth statistics

Differences between "case reports" and "case series"

a case report includes a single or few cases of health conditions, case series includes a number of similar or related disease cases occurring consecutively case report could include reports of unusual or rare disease, case series could report an emerging condition or disease

Case Reports

accounts of a single occurrence of a noteworthy health-related incident or small collection of such events Examples: Imported rabid dogs, adverse reactions due to cosmetic surgery in United States

Indicate how case reports and case series are similar

both are types of descriptive epidemiological studies both include description of individual cases of diseases, exposures, health conditions, or treatments

SEER program

comprises an integrated system of registries in strategic locations across the United States. Examples of information collected include demographic characteristics of cancer patients, their primary tumor site, cancer markers

NHIS (National Health Interview Survey)

contact up to 40,000 households and obtain data on as many as 100,000 respondents. conducted by NCHS - Personal interviews surveys about: o Health status and limitations o Utilization of health care o Health insurance o Access to care

Vital Events

deaths, births, marriages, divorces, and fetal deaths

Secular trends

gradual changes in frequency of a disease over long time periods. Secular trends occur due to changes in disease causing factors, lifestyle, and health care programs over years Example: CVD in United States have declined from 1970 to 1988.

point epidemics

health conditions occurring in a group of people in a common location after almost simultaneous exposure to an etiologic factor Example: Cholera epidemic of London in 1854, due to transmission of bacteria through contaminated water

Stochastic process

incorporates some elements of randomness. A cause is associated with the increased probability that an effect will happen

Case Series

larger collection of cases of disease, often grouped consecutively and listing common features Example: Reported cases of primary meningoencephalitis

Cyclic trends

pattern like variation in frequency of a health condition or disease within a year or over years. Example: Malaria cases increase in cyclic trends in rainy season

Reportable and notifiable diseases

physicans and other healthcare providers must report cases of certain diseases, known as reportable and notable diseases to health authorities

Public Health Surveillance

systematic and continuous gathering of information about the occurrence of diseases and other health phenomena

syndromic surveillance

using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response