surveillance and epidemiology – Flashcards
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surveillance
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ongoing, systematic collection, analysis, interpretation, and dissemination of data (syndromic, routine health info, categorical) (active, passive) (sentinel systems)
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surveillance uses
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-detection of an epidemic -finding the cause (patient zero) -generate hypothesis to set preventative methods
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active surveillance
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physically go/call/ask/investigate for specific information/cases (proactive)
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active surveillance pros
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-use a team -gain more info -control of info, gain specific info
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active surveillance cons
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-hospitals don't cooperate -more expensive (more people) -could cause panic
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public health surveillance criteria
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-definition of "case" -inclusion criteria -exclusion criteria -classification of specific cases (suspect, probable, confirmed)
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inclusion criteria
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specific symptoms, target groups, geography, regions of increase
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exclusion criteria
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specific traits/people who are not susceptible/effected
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suspect
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showing minor sickness/possible symptoms
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probable
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falls between suspect and confirmed (symptoms/recent interaction with infected person)
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confirmed
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definitely infected
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passive surveillance
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waiting for information to be reported back
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passive surveillance pros
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-no team needed -less expensive -less effort/chance of causing stress
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passive surveillance cons
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-no control of specific information -prolonged action time (for approaching outbreak)
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syndromic surveillance
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surveillance of health data on clinical symptoms (from hospitals)
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routine health information surveillance
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surveillance hospital/statistical reports on diseases, assessments based on happenings
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categorical surveillance
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specific disease symptoms, behaviors, surveying of specific categories (symptoms, people, etc) ex. rates of obesity
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sentinel systems
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program that maps diseases' progress
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sources for surveillance
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-mortality data from death registry or medical association -morbidity data from legally reported diseases -hospitals (discharge diagnosis)
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epidemiology
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the study that uses the information collected from surveillance to study outbreaks/causes and effects of disease -2 kinds:descriptive/Analytical epidemiology
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descriptive epidemiology
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-determines the distribution of disease in a population through: person, place, time, and incidence -allows evaluation of trends in health and disease -provides basis to plan, provide, and evaluate health services -identifies areas to be studied by analytical epidemiology (basically determines who is effected and where the disease is moving)
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Descriptive Epi criteria
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-how many cases -incidence -prevalence
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incidence
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(over a time span) occurrence of new disease/mortality within a defined period of observation in a specific population
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incidence rate
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the number of new cases/population at risk
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prevalence
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the number of existing cases within defined period in a specified population (the percentage of people sick) (check packet for examples)
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descriptive Epi describing distribution
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-person -place -time
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person
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sex, ethnicity, vmi, mortality, migration/nativity, age, culture, socioeconomics, religion, political views, education, sexual activity, birth control/healthcare
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place
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geographic location, environmental condition, urban, suburbs, migration, rural, international
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time
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cyclical (seasons)
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point epidemic
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one time epidemic then never again
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secular trends
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changes over time
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cyclical
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fluctuations
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Descriptive epi determinants (bring out change in health condition)
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behavior infections genetics(predisposition to diseases) geography(tropics=malaria) environment(clean water) medical care (availability of healthcare) socioeconomic (money for health, vaccines, homeopathics) culture
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Analytical Epidemiology
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used to determine underlying causes of health-related events (how and why) -allows testing of hypothesis -cohort studies/relative risk -case-control studies used to support or refute data
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cohort studies (analytical epi)
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compare exposed groups to not-exposed groups, can be used to calculate relative risk (how long it takes to contract/spread disease)
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relative risk
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probability of event when exposed/probability of event when not exposed (John Snow 20% risk of cholera from tidal thames)
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case control
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have to control bias and alternate causation factors, there is a high use of additional tests
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descriptive Epidemiological breakdown
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who, what, when, where, why -rule out chance and bias
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analytical epidemiological breakdown
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-why and how control for: chance and bias
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causal inference
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making conclusions about whether or not certain actions caused or were correlated/associated with the contraction of a disease -association vs. causality
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association
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is correlation, goes alongside causation but not actually causing a disease
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causality
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actually causing a disease
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criteria of causality
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-strength of association -temporality -consistency -biological gradient -coherence -analogy
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strength of association
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-often cause is associated with effect at an individual level -the stronger the association, the more likely it is causation
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temporality
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time -what are the steps -cause proceeds effects
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consistency
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-association observed repeatedly in different individuals (smoking and causing cancer)
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biological gradient
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-dose-response curve, higher dose creates higher risk or level of disease -how much bacteria intake is required to be at risk? (smoke more, more at risk for lung cancer)
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coherence
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-coheres with what we know, coherence between epidemiological and laboratory findings
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analogy
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-description of the end results ex. thalidomide and rubella cause birth defects, therefore another drug or virus could also cause birth defects
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Implementation of Intervention criteria
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-when -where -how
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when (intervention implementation)
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(intervention implementation) primary-before disease secondary-early stages of disease tertiary-later stages of disease (often educational)
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where (intervention implementation)
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(intervention implementation) -individual -at risk group -general population/community
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how (intervention implementation)
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(intervention implementation) -information (education) -motivation (incentives) -obligation (what makes intervention required)
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efficacy
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(quality of evidence of disease control) an intervention increased positive outcomes/benefits in the population ON WHICH IT IS INVESTIGATED (emphasis on study group) ex. we study specific college students' sickness, we implement intervention for specific college students' sickness
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effectiveness
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(quality of evidence of disease control) an intervention has been shown to increase the positive outcomes or benefits in the population setting IN WHICH IT WILL BE USED (emphasis on population) ex. we study college students, but implement intervention for all college students
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magnitude of impact
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-how much the disability of death, due to disease, can be removed by the intervention -net benefits (society gains individual rights)
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net benefits
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benefits-the harms of an intervention
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communicate findings
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-to whom -how -where -why
