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Principles of Epidemiology (H SC 500 )

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California State University, Long Beach

Academic year: 2016/2017

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Robert H. Friis and Thomas A. Sellers Epidemiology for Public Health Practice, Fifth Edition Robert H. Friis and Thomas A. Sellers

Summary and Study Guide for Unit I: Chapters 1-

Partial List of Terms Discussed in This Unit

Acculturation Age-specific rates Attack rate Bimodal Biological clock phenomenon Breeder hypothesis Causality Changes in cause of death from 1990 to present Characteristics of epidemiology Descriptive epidemiology Determinant Disappearing disorder Dose-response relationship Downward drift Dynamic population

Epidemic Epidemiologic approach Epidemiology Fixed population Geographical Information Systems Graph interpretation Hippocrates Incidence John Snow John Graunt Koch Koch’s Postulates Landmarks in epidemiology Metropolitan statistical area Mill’s Cannons Morbidity

Robert H. Friis and Thomas A. Sellers Mortality Multi-modal Nativity Natural experiment New epidemic disorders Null hypothesis Operations research Persisting disorder Point epidemic Population Prevalence Primary prevention Proportional mortality ratio Protective factor Quantification

Rate Residual disorder Risk factor Seasonal/cyclic fluctuations Secondary prevention Secular time trends Selective factor Social causation Space and time clustering Specific rate Standardized mortality ratio (SMR) Tertiary prevention Uses of epidemiology William Farr

Robert H. Friis and Thomas A. Sellers

Secondary: Occurs during pathogenesis phase Designed to reduce the progress of disease Examples: screening programs for cancer and diabetes. Tertiary: Takes place during late pathogenesisDesigned to limit disability from disease. Also directed at restoring optimal functioning (rehabilitation) Example: physical therapy for stroke patients, halfway houses for alcohol abuse recovery, and fitness programs for heart attack patients 5. What is an epidemic? “The occurrence in a community or region of cases of an illness (or an outbreak) clearly in excess of expectancy...” Relative to usual frequency of the disease 6. Who was John Snow? John Snow was an English physician and anesthesiologist. He investigated a cholera outbreak that occurred during the mid-19th century in Broad Street Golden Square, London.

Linked the cholera epidemic to contaminated water supplies
Used a spot map of cases and tabulation of fatal attacks and deaths

Define the terms attack rate and secondary attack rate. Attack Rate: Alternative form of incidence rate. Used for diseases observed in a population for a short time period. ILL ILL+ Well
Define each of the following terms: a. Incidence rate: describes the rate of development of a disease in a group over a certain time period. Incidence Rate= ¿of new

cases a time period Totsl populationatrisk duringtime periodx(multiplier) b. Mortality rate: the rate of death (various reasons) in a population compared to births over a certain time period.

x 100 (during a time period

Robert H. Friis and Thomas A. Sellers c. Prevalence: the number of existing causes of a disease or health condition in a population at SOME designated time. d. Case fatality rate Numberof deathsdue¿disease x during a given time intervalNumberof newcasesof thatdisease

e. Proportional mortality ratio The population due to a specific disease or cause divided by the total number of deathsproportional mortality ratio (PMR) is the number of deaths within a in the population. PMR= Mortalitydue¿a specificcauseduringatime periodMOrtality due¿ ¿allcausesduringthat time peri x 100 9. Under what circumstances would the incidence of a disease equal (or be similar to) the prevalence? What different types of inferences can be made from incidence and prevalence data? The Prevalence (P) of a disease is proportional to the incidence rate (I) times the duration (D) of a disease. [ P ID] If the duration of disease is short and incidence is high, prevalence becomes similar to incidence. Short Duration- cases recover rapidly or are fatal Ex- Common Cold If the duration of a disease is ling and the incidence is low, prevalence increases greatly relative to incidence Ex- HIV/AIDS Prevalence

Explain the difference between morbidity rates and mortality rates. Morbidity Rate- measures the rate at which people get designated illnesses Mortality Rate- refers to the deaths that occur in a population or other group that is cause- specific.

Robert H. Friis and Thomas A. Sellers 15. Define the following terms and indicate how they differ:

a. Age-specific rates: a rate for a specified age group. The numerator and denominator

refer to the same age group. one divides the frequency of a disease in a particular age stratum by the total number of persons within that age stratum to find the age-specific rate.

b. Age-adjusted rates: indirect method of standardization does not require knowledge of the actual age- specific incidence or mortality rates among each age group for the population to be standardized. By applying the rates of disease from a standard population (the 2000 population) to the observed structure of the population of interest, one is left with an expected number of cases (or deaths) in the study population if the rates of disease were the same as in the standard population

Define the term cyclic variation.

Cyclic Variations are increases and decreases in the frequency of diseases and health conditions over a period of years or within each year.

Distinguish between descriptive and analytic epidemiology. Descriptive Epidemiology- used to identify a health problem that may exist. Characterize the amount and distribution of disease.
- Provide a basis for planning, provision, and evaluation of health services
- Creation of hypotheses.

Robert H. Friis and Thomas A. Sellers Analytic Epidemiology- follow descriptive studies, and are used to identify the cause of the health problem. 18. What is the difference between clinical and epidemiologic approaches in describing disease? In the Clinical setting, epidemiologic methods are used to make a prediction about a health outcome for an individual based on scientific studies of groups of similar patients. Clinical epidemiology is integral to evidence-based medicine. Epidemitself is the study of disease in a population goals of determining the frequency iology and distribution of the disease as well as risk factors for the disease.

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