Week 3 Notes (Ch 5&6 Reveiw, Ch 7)
Week 3 Notes (Ch 5&6 Reveiw, Ch 7) PBHL 3100
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This 4 page Class Notes was uploaded by Ali on Wednesday September 23, 2015. The Class Notes belongs to PBHL 3100 at University of Georgia taught by Sabrina Cherry in Fall 2015. Since its upload, it has received 41 views. For similar materials see Intro to Public Health in Public Health at University of Georgia.
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Date Created: 09/23/15
Introduction to Public Health PBHL 3100 Professor Sabrina Cherry University of Georgia Chapter 5 63 6 Review 0 Odds Ratio measure of association 0 An estimate of what the relative risk would have been had a cohort study been done 0 Used for casecontrol studies 0 What are the odds of having the disease for those who are exposed versus those who are unexposed 0 Case Control studies are relatively quick and cheap are ideal for studying rare diseases can show multiple exposures for a disease but cannot show multiple diseases associated with one exposure 0 Question Is the researcher randomly assigning participants to a condition or group 0 Random assignment is used by clinical trial 0 Question Are participants assigned based on exposure or outcome 0 Outcome Casecontrol 0 Exposure Cohort RCT 0 Question to ask when guring out what kind of study would be used What kind of data is being collected 0 Primary data data the researcher collects used for randomized control trial or prospective cohort Case control is normally primary data but not always 0 Secondary data Data someone else collected used for retrospective cohort 0 Problems with studying humans 0 Clinical Trial RCT Ethical issues and subjects may not follow prescribed behavior throughout study period 0 Cohort study Sometimes hard to isolate which of many factors are responsible for health differences 0 Casecontrol study Control group may not be truly comparable also errors in reporting or recall 0 For all studies must worry about differential dropouts attrition 0 Sources of Error 0 Random variation Associations due to chance 0 Confounding variables a variable other than the independent variable that you39re interested in that may affect the dependent variable 0 Bias or Systematic Error Selection bias can occur in controls and cases Reporting or recall bias a person may report higher or lower than the actuality intentionally for various reasons or because of forgetfulness Publication bias only studies that have favorable results or come out as planned may get published 0 Factors that lend to valid results ndings are only as good as a studies design 0 Statistically strong associations 0 Dose response relationship the medicine or exposure correlation with the desired response 0 Known biological reasoning 0 Large study population 0 Consistent results from several studies 0 Sometimes there are con icts of interest in drug trials 0 Drug companies are required to conduct RCTs on all new drugs before they can be FDA approved 0 Harmful side effects have become known AFTER the drug has been approved 0 Evidence that some drug companies suppress negative information is present 0 All clinical trials must now be registered in advance in a public database Chapter Seven 0 Statistics has two de nitions 0 The numbers that describe the health of the population 0 The science used to interpret these numbers 0 Science tends to be very uncertain because most science is of a probable nature 0 Science is on going so contradictory results from epidemiologic studies are common 0 The science of statistics can quantify the degree of uncertainty 0 Probability Scientists quantify uncertainty by measuring probabilities o P Value expresses the probability that the observed result could have occurred by chance alone ps005 is usually taken to mean a result is statistically signi cant A p value of 005 means that if an experiment were repeated 100 times the same answer would result 95 of those times while 5 times would yield a different answer 0 Con dence interval a range of values so de ned that there is a speci ed probability that the value of a parameter lies within it o The law of small probabilities The idea that most improbable things are bound to happen occasionally Example someone inexplicably recovers but this is just random deviation it can not be attributed to and medication or therapy Cluster a consequence of the small probability law where a site will have an unusual concentration of some kind of disease 0 The larger the sample size the more accurate the study and therefore a more accurate probability 0 In public heaths mission to prevent disease and disability secondary prevention early detection and treatment plays an important role 0 Types of screening include HIV test newborn screenings and mammograms to detect breast cancer 0 Sensitivity tests not as speci c and yield few false negatives but many false positives desirable in order to avoid missing anyone who might be affected by that disease 0 Speci c tests conducted to determine if a positive result from a sensitivity test is actually accurate few false positives but more false negatives 0 Life expectancy the average period that a person may expect to live Varies from country to country 0 Years of potential life lost YPLL involves estimating the average time a person would have lived had he or she not died prematurely o Leadtime bias the length of time between the detection of a disease and its usual clinical presentation and diagnosis Essentially the idea that people are living longer with a disease can be contributed to the fact that they are simply being diagnosed earlier because of new screening procedures or improved technology 0 Overdiagnosis bias The diagnosis of quotdiseasequot that will never cause symptoms or death during a patient39s lifetime 0 Raw data primary data that has not been subjected to processing or any other manipulation 0 Birth rates is a measure of the number of live births in a particular population scaled to the size of that population per unit of time 0 Mortality rates is a measure of the number of deaths in general or due to a speci c cause in a particular population scaled to the size of that population per unit of time 0 Crude Rates one giving the total number of events occurring in an entire population over a period of time without reference to any of the individuals or subgroups within the population 0 Adiusted Rates a fabricated summary rate statistically adjusted to remove the effect of a variable such as age or sex to permit unbiased comparison between groups having different compositions with respect to these variables 0 Grouo Specific Rate a rate that applies to a speci c demographic subgroup eg individuals of a speci c age sex or race giving the total number of events in relation only to that subgroup 0 Risk Assessment a systematic process of evaluating the potential risks that may be involved in a projected activity or undertaking o For wellknown risks can be calculated from historical data 0 For poorly understood risks must make many assumptions 0 Risk perception the subjective judgement that people make about the characteristics and severity of a risk 0 nvoves psychological factors 0 Cost bene t analysis weighs the estimated cost of implementing a policy against the estimated bene t usually in monetary terms 0 Costs are easier to calculate then bene ts 0 Often controversial because it is hard to put a monetary value on a life 0 Costeffectiveness analysis compares the ef ciency of different methods of attaining the same objective 0 We can compare multiple options and choose the most viabe route These notes are taken from class slides by professor Sabrina Cherry and supplemented by the book Introduction to Public Health Fourth Edition by Maryjane Schneider
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