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CU Denver PBHL 2001 - Epidemiology

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PBHL 2001 1st Edition Lecture 3EpidemiologyEpidemiology is the study of the distribution and determinants of disease frequency in human populations. It investigates known and unknown diseases, infections and chronic, by counting the number of cases. It is about what is going on above the population. It started as the study of epidemics, now it is used for health. Person-to-Person Characteristics: Age, Gender, Social Economic Status, Environment: Sanitation, Neighborhoods, Occupation, Climate, Culture, Seasons (Flu)How diagnosis is made in populations. Investigates causes and trends of diseases. It is an observational science. It observes humans versus medicine which studies in laboratories.Person: Who is getting the disease?Time: When are they getting it?Place: Where are they getting it?Epidemic SurveillanceEndemic is when a disease is at a stable levelEpidemic happens when the disease peaksPandemic is an epidemic happening worldwide (Ex: After WWI the flu)Mortality: Refers to death ratesMorbidity: Refers to diseaseJohn Snow: Father of epidemiology He focused mainly on the place when he conducted his experiment on Cholera in London in 1848 Epidemic surveillance requires that certain diseases be reported as soon as they are diagnosed(Ex: AIDS/HIV)Outbreak InvestigationShoe Leather Epidemiology (Getting out into the field in order to find answers):1. Verify diagnosis2. Make case study3. Find cases4. Ask who, where, when 5. Look for common exposureCase DefinitionSensitivity: How can you identify all possible cases of the illness? (Prone to more false positives - wider net)Specificity: How can you identify ONLY the ACTUAL cases of the illness? (More false negatives - smaller net)Epidemiology and Chronic DiseaseIdentify risk factors vs causesObserve long-term trends The Framingham Heat Study does this by tracking people who were healthy and unhealthy in determining how prone they would be to heart disease (This is a cohort study).Disease FrequencyCount number of people with disease and relate to the population at riskTwo ways to measure frequency:Incidence: The rate of NEW cases of a disease in a defined population and period of time.Prevalence: Total number of cases EXISTING in a defined population and time. If causes or risk factors increase, incidence and prevalence will too.If ability to diagnose increase, incidence and prevalence will too. Prevalence depends on incidence and prognosis- how long people live with the disease Epidemiologic Study DesignsGoal is to determine an association between an exposure and a disease Prospective vs RetrospectiveCross-Sectional (snapshot) or Longitudinal (over time)Experimental (intervention studies)Cohort StudyCase-Control StudyExperimental StudyTwo groups: Experimental and ControlWatch over time and compare outcomeExperimenter chooses who is in what groupUsed to evaluate which treatment is more effective (Ex: Fluoride in water where kids had less tooth decay)Cross-Sectional StudyNot observing change but just a point in timeFinds links and relationshipsLooking at different points in time and finds trendsCohort StudyChoose large number of healthy people, collect data on exposure, and track outcome over timePeople are choosing their own exposure and it is just being watched (Ex: Framingham Heart Study)Case-Control StudyChoose people with diseaseChoose healthy control group as similar to those with diseaseInterview and find out about previous exposure Rigor in the Research ProcessRigor: Appear to standards of scientific significanceDesign of the Study: What you will ask and what you will studyApply for Funding: Get funds to support the research processPublish Results: Experts review material, revise, and then it will be


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CU Denver PBHL 2001 - Epidemiology

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