GPH 714, Week 4 Notes
GPH 714, Week 4 Notes GPH 714
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This 3 page Class Notes was uploaded by Danielle Kraack on Friday August 26, 2016. The Class Notes belongs to GPH 714 at University of New England taught by Jennifer Gunderman in Fall 2016. Since its upload, it has received 3 views. For similar materials see Principles of Public Health in Master of Public Health at University of New England.
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Date Created: 08/26/16
Week 4 Learning Outcomes: ● Identify examples of public health data and describe how it is used. o Prevalence and incidence rates ▪ Incidence - The rate of new cases in a defined population over a defined period of time ● Measures the probability that a healthy person in that population will develop the disease during that time ● Useful for identifying the cause o Example - Thalidomide in the 1960s ▪ Prevalence - The total number of cases existing in a defined population at a specific time ● Useful for assessing the societal impact of a disease and planning for healthcare services o Distribution of the disease answers the who, when, and where ▪ Who - Characterizes victims by age, sex, race, SES ● Leads to hypotheses on transmittal ● Example - AIDS epidemic - Gay men and intravenous drug users ▪ When - Crucial in tracking an outbreak ● Epidemic curves can show outbreak and incubation periods ● Example - Legionnaires’ disease in 1976 ▪ Where - Statistics on causes of death in other countries can be very suggestive in generating hypotheses about the causes of disease ● Example - Fluoridation of water led to less cavities ▪ Gives clues to the determinants o Studies ▪ Descriptive Epidemiology ● The analysis of a cause of disease or source of an outbreak using the determinants ● Prospective vs Retrospective ▪ Intervention Studies ● Only form of experimentation done on people o Usually for a new treatment or preventative measure ● Clinical trials o Most convincing are randomized and double-blind ▪ Cohort Studies ● Large numbers of healthy people are questioned about their exposures o Then they are observed over time to see if they get the disease they’re exposed to ● Designed to determine association between exposure and disease o Relative Risk ▪ 1.0 - No association ▪ >1.0 - Increased risk ▪ <1.0 - Decreased risk ▪ Case-control studies ● Start with people who are already ill and look back to determine their exposure o More efficient than Cohort ● Odds ratio - Estimate of what the relative risk would be if the Cohort Study were done ● Identify concepts and terms used in epidemiology and biostatistics. o Epidemiology - The study of the distribution and determinants of disease frequency in human populations o Incidence Rate ▪ The rate of new cases in a defined population over a defined period of time o Prevalence Rate ▪ The total number of cases existing in a defined population at a specific time o Epidemic Curve ▪ Track outbreaks and incubation periods o Descriptive Epidemiology ▪ The analysis of a cause of disease or source of an outbreak using the determinants o Prospective ▪ Monitor a group moving forward o Retrospective ▪ Looking into the past for causes o Intervention Studies ▪ Clinical trials done to test a new treatment for a disease or a preventative measure o Randomized ▪ Subjects are assigned to treatment/control groups randomly o Double-Blind - ▪ Neither subject nor doctor know which group the subject is in o Cohort Studies ▪ Large numbers of healthy people are questioned about their exposures and then observed over time to see if they get the disease(s) they are exposed to o Relative Risk ▪ Shows association between exposure and disease o Case Control Studies ▪ Start with people who are already ill and look back to determine their exposure o Odds Ratio ▪ Estimate of what the Relative Risk would be if a Cohort Study were done o Confounding Variables ▪ Factors that are associated with the exposure and that may independently affect the risk of developing the disease o Bias ▪ Systematic error o Selection Bias ▪ Not using a true random sample o Reporting Bias ▪ When subjects of a reporting group and a control group systematically report the same o P Value ▪ Used to express the degree of probability or improbability of a certain result in an experiment o Confidence Interval ▪ A range of values within which the true result probably falls o Law of Small Probabilities ▪ The most improbable things are bound to happen occasionally o False Negative ▪ To find no effect when there actually is one o False Positive ▪ When the study finds an effect that isn’t real o Sensitive Test ▪ Yields few false negatives o Specific Test ▪ Yields few false positives o Adjusted Rates ▪ Adjusted so they can be compared to other rates o Risk Assessment ▪ Identifies events and exposures that may be harmful to humans and estimated the probabilities of their occurrence as well as the extent of harm o Dread ▪ The more dreaded the risk, the less acceptable o Knowability ▪ Unknown risks are less acceptable that known risks o Cost-Benefit Analysis ▪ Weighs the estimated cost of implementing a policy against the estimated benefit o Cost-Effective Analysis ▪ Compares the efficiency of different methods of attaining the same objective