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Epidemiology Key Terms & Measures. Fran C. Wheeler, Ph.D School of Public Health University of South Carolina Columbia, SC 29208 (803) 777-5054 [email protected]

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epidemiology key terms measures
EpidemiologyKey Terms & Measures

Fran C. Wheeler, Ph.D

School of Public Health

University of South Carolina

Columbia, SC 29208

(803) 777-5054

[email protected]

slide2

Developed as part of an Enhanced AHEC Community Partnership for Health Professions Workforce and Educational Reform project funded by the Health Resource and Service Administration (HRSA)

objectives
OBJECTIVES
  • epidemiology and role as foundation for public health
  • common measures of disease frequency
  • strengths and weaknesses of study designs
epidemiology
Epidemiology
  • Study of distribution of determinants and antecedents of health and disease in human populations
  • Application of results to control of health problems
from hippocrates to john graunt
From Hippocratesto John Graunt
  • Fifth century BCE, Hippocrates pointed to the need to understand the environment and the risks it posed to understand the experience of disease
  • 1662, John Graunt analyzed weekly reports of births and deaths in London, quantifying patterns of disease in the population
from william farr to john snow
From William Farrto John Snow
  • 200 years later, Dr. William Farr was made responsible for medical statistics in the Office of the Registrar General for England and Wales
  • A mere 20 years later, John Snow completed his study of cholera
modern experiences
Modern Experiences
  • Evaluation of risk factors for chronic diseases using case controls
  • Long term population studies using cohorts
  • Design of clinical trials to evaluate interventions
three essential components
Expected level

Endemic

Sporadic

Epidemic

Pandemic

Three Essential Components
  • Disease distribution
  • Disease determinants
  • Disease frequency
epidemiologic studies
Epidemiologic Studies
  • Descriptive
  • Analytic
descriptive studies
Descriptive Studies
  • Frequency of occurrence of particular condition
  • Patterns of occurrence according to person, place and time
analytic studies
Analytic Studies
  • Observational studies
    • case-control studies
    • cohort studies
      • prospective
      • retrospective
  • Experimental studies
case control study
Case Control Study

Exposure

Disease

?

?

Key

Basis for selection of group for study

= present = absent

prospective cohort study
Prospective Cohort Study

Exposure

Disease

?

?

Key

Basis for selection of group for study

= present = absent

retrospective cohort study
Retrospective Cohort Study

Exposure

Disease

?

?

Key

Basis of selection of group for study

= present = absent

analytic studies15
Analytic Studies
  • Observational studies
  • Experimental studies
    • Intervention studies
    • Clinical trials
basic presentation of results
Basic Presentation of Results

All rates and ratios discussed can be calculated from this

interpreting results measurement errors
Bias

information

selection

Confounding

extraneous factors

Effect modification

statistical interaction

Interpreting Results: Measurement Errors
interpreting results cause effect relationship
Strength of the association

Consistency

Temporality

Plausibility

Biological gradient

Interpreting Results: Cause-Effect Relationship
prevalence
Prevalence= number of existing cases divided by total population

Visual examination survey

310 X 100 = 12.5%

2477

Prevalence
incidence
Incidence
  • Incidence = number of new cases in a given period of time divided by the total population at risk
    • Bacteremia among contraceptive users
      • 27/483 X 100 = 5.6%
rates commonly used in epidemiology
Crude

Category specific

Age adjusted

Rates Commonly Used in Epidemiology
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