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Public Health Concepts, Week 5

by: Samantha Notetaker

Public Health Concepts, Week 5 PHC4101

Marketplace > University of Florida > Epidemiology > PHC4101 > Public Health Concepts Week 5
Samantha Notetaker
GPA 3.8

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About this Document

Notes covering week 5. This includes chapter 6. Chapter 5 was included in last weeks notes.
Public Health Concepts
Deepthi Varma
Class Notes
25 ?




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This 4 page Class Notes was uploaded by Samantha Notetaker on Friday September 23, 2016. The Class Notes belongs to PHC4101 at University of Florida taught by Deepthi Varma in Fall 2016. Since its upload, it has received 20 views. For similar materials see Public Health Concepts in Epidemiology at University of Florida.

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Date Created: 09/23/16
2016 Public Health Concepts PublicHealthConcepts Chapter 6: Problems and Limits of Epidemiology Epidemiologic studies – finds the causes of diseases Problems with Studying Humans Studying humans is great and all… but humans are not as easy to control as animals People don’t always follow directions, they drop out, and they lie Plus, people are very different from each other, so it would be hard to control or keep track of every different variable  Intervention study (randomized control) – similar to rat experiment. Hard to do because you can’t control humans  Cohort study – Large groups of people. Problem: people live their lives differently o Book example: studying diet. People with a healthy diet probably do other healthy things, such as not smoking, that would factor in to the study  Case-control study – problem: people’s memory may not be that good and people get embarrassed to admit to things All in all – people are unreliable Studying people makes things difficult, BUT it’s still possible  Sources of Error Stuff in the news can sometimes contradict itself, and can make people not want to trust it Cause = random variation (“variability of a process caused by irregular or erratic fluctuations” Larger groups of people are needed for studies that have a weaker connection between exposure and disease  Also, Larger groups of people for studies make them more convincing Confounding Variables – deals with exposure and how it effects the development of a disease  Sometimes when doing studies, such as the coffee-pancreatic cancer study in the book, the cause of an effect can be misrepresented due to other factors not accounted for. Bias! Specifically, selection bias  Choosing people for a study  Basically, statistics. Types of bad samples: convenience, voluntary response, not random  People drop out or become lost or unable to contact during studies that last a long time  People LIE These biases can be seen in all three studies listed above (proving even more difficulty) Proving Cause and Effect Using the word “risk” because cause cannot be proven  Some studies show more evidence than other studies…. But nothing is for certain Dose-response (pg. 84) shows more promise of giving a cause for an effect Validity is dependent on Consistency Epidemiologic Studies of Hormone Replacement Therapy - Confusing Results Example from the book: Women used to think that taking an estrogen-progesterone pill was helping them in all kinds of ways only to find out decades later that it was increasing the risk of breast cancer, heart attack, stroke, and blood clots  Problems with the previous studies saying the pill was totally fine showed much bias and various ignored outside factors Ethics in Epidemiology Apparently…. You can’t abuse people.  Even if they are prisoners or people in mental institutions  Or even if it’s funny In 1972, unethical experiments were no longer allowed and there were now a set of rules to be followed when experimenting with people  One big change included a trial being halted if one group showed better or worse effects than the other Even with all the new rules, people still question if clinical trials are ethical at all But what if some people would rather take their chances with treatment than die without doing anything? Can we deny them the possibility of a cure? Is that ethical?  Some treatments can actually do more harm than good (as in the example of tonsillectomies on page 88)  People want treatment, and in studies that involve placebos people worry that they may be one of the people receiving the placebo Conflicts of Interest in Drug Trials Sometimes money takes priority when there is a new drug introduced that could make a lot of money even if it is not as effective as stated or not as safe.  Some FDA approved drugs raised suspicions and caused a new requirement for certain drugs to have a caution label Some companies try to hide the negative effects of their drugs  Example on page 90 In some cases, companies have bribed physicians for positive feedbacks So basically, doing studies with people can be difficult because people are so different and some people are not truthful. Also, people can be deceiving, sometimes bend the truth (pretty much lying), and only care about the money.


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