Unit 9 – Use of Unit 9 – Use of Epidemiology in Public Epidemiology in Public

HealthHealth

Copyright Kaplan University 2009Copyright Kaplan University 2009

Chapter 16 – Specific Areas of Chapter 16 – Specific Areas of ProtectionProtection

Immunity – Immunity – • Passive immunityPassive immunity• Active immunityActive immunity• Herd immunityHerd immunity

VaccinationsVaccinations

Do adults need them? Why?Do adults need them? Why? Vaccinations: used to prevent Vaccinations: used to prevent

diseasesdiseases• PolioPolio• Hepatitis A, BHepatitis A, B• FluFlu• PneumoniaPneumonia• Measures, Mumps, RubellaMeasures, Mumps, Rubella

Chapter 17 – Secondary Chapter 17 – Secondary PreventionPrevention

What is it?What is it?• Early detection of diseaseEarly detection of disease• ScreeningScreening

Identifying people whom there is high Identifying people whom there is high probability of finding diseaseprobability of finding disease

Why is it important?Why is it important?

Why do we screen people as a Why do we screen people as a means of preventing disease?means of preventing disease?

Health Risk AssessmentsHealth Risk Assessments

Use questionnaires to evaluate Use questionnaires to evaluate information concerning individuals in information concerning individuals in clinical or medical practiceclinical or medical practice

Promoted by clinicians Promoted by clinicians Tend to collect basic information Tend to collect basic information

such as BP, height, weight, such as BP, height, weight, cholesterolcholesterol

Chapter 18 – Tertiary PreventionChapter 18 – Tertiary Prevention

DefinitionDefinition• Limit physical and social consequences Limit physical and social consequences

of injury or disease after it has occurredof injury or disease after it has occurred Two categoriesTwo categories

• Disability limitation: halting the Disability limitation: halting the progress of disease or limiting damage progress of disease or limiting damage caused by injurycaused by injury

• Rehabilitation: Focuses on reducing Rehabilitation: Focuses on reducing social disability produced by given level social disability produced by given level of impairmentof impairment

Chapter 19 and 20Chapter 19 and 20

These chapters should be These chapters should be approached as self studyapproached as self study

They are reference style chapters They are reference style chapters which can be used to understand the which can be used to understand the implications of public health, implications of public health, epidemiology, and statistics. epidemiology, and statistics.

FINAL EXAM REVIEWFINAL EXAM REVIEW

Know how to calculate the following:Know how to calculate the following:• Odds RatioOdds Ratio• Relative RiskRelative Risk• Attributable RiskAttributable Risk• MeanMean• MedianMedian• ModeMode

The _______ is used to determine the The _______ is used to determine the probability of two things being trueprobability of two things being true• Addition RuleAddition Rule• Independence RuleIndependence Rule• Product RuleProduct Rule• Subtraction RuleSubtraction Rule

One way in which researcher can One way in which researcher can judge how useful screening or testing judge how useful screening or testing produce is involves:produce is involves:• Evaluation of number of correct test Evaluation of number of correct test

resultsresults• This cannot be doneThis cannot be done• Statement is false except in cohort studies Statement is false except in cohort studies

of 200 or moreof 200 or more• Testing conducted in opposite areas of Testing conducted in opposite areas of

geographic locationsgeographic locations

Unusual occurrence of disease is Unusual occurrence of disease is known as a/anknown as a/an• CohortCohort• Epidemic time curveEpidemic time curve• PriorityPriority• EpidemicEpidemic

Systematic distortion of study data is Systematic distortion of study data is known as:known as:• ValidityValidity• ModifierModifier• Recall BiasRecall Bias• Measurement BiasMeasurement Bias

Application of Bayes Theorem to Application of Bayes Theorem to patient care generally results in:patient care generally results in:• Greater sensitivityGreater sensitivity• Greater specificityGreater specificity• Higher costsHigher costs• Improved selection of diagnostic studiesImproved selection of diagnostic studies

Decision Node:Decision Node:• Point where clinicians await outcomesPoint where clinicians await outcomes• Point where clinicians have to make Point where clinicians have to make

decisiondecision• Only related to undesirable outcomesOnly related to undesirable outcomes• Only related to desirable outcome Only related to desirable outcome

interpretationinterpretation

Reasoning which is learned from Reasoning which is learned from math including geometry is known math including geometry is known as:as:• ProductiveProductive• InductiveInductive• DeductiveDeductive• None of aboveNone of above

Developing a list of possible Developing a list of possible candidates for cause of disease and candidates for cause of disease and obtaining initial evidence that obtaining initial evidence that supports one or more of candidates supports one or more of candidates is known asis known as• Research designResearch design• Hypothesis testingHypothesis testing• Hypothesis generatingHypothesis generating• Descriptive ResearchDescriptive Research

Value of alpha serves as protection Value of alpha serves as protection against which of the followingagainst which of the following• False negativeFalse negative• Inadequate sample sizeInadequate sample size• Selection biasSelection bias• Type I ErrorType I Error• Type II ErrorType II Error

Please familiarize yourself Please familiarize yourself with…with…

Examples of tertiary preventionExamples of tertiary prevention Herd immunityHerd immunity Passive immunityPassive immunity Bayes TheoremBayes Theorem Nominal variableNominal variable Cohort studiesCohort studies BiasBias Type II errorType II error

How many steps are in the creating How many steps are in the creating of decision treeof decision tree• 44• 55• 66• 77

What is example of tertiary What is example of tertiary prevention?prevention?• Hospice careHospice care• Occupational therapy after strokeOccupational therapy after stroke• Post exposure to prophylaxis for rabiesPost exposure to prophylaxis for rabies• Treatment for hypertensionTreatment for hypertension

Which of the following is test of Which of the following is test of statistical significance?statistical significance?• Student t-testStudent t-test• MeansMeans• BothBoth• NeitherNeither

____ publishes immunization ____ publishes immunization schedulesschedules• Local health departmentLocal health department• State health departmentState health department• CDCCDC• USDAUSDA• WHOWHO