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Epidemiology and Foundational Methods & Sources of Error - Coggle…
Epidemiology and Foundational Methods & Sources of Error
There are five basic questions that we ask that make up what is known as the evidence based public health approach.
Problem - what is the health problem.
Etiology. What are the contributory causes?
Recommendations - What works to reduce the health impacts
Implementations - how can we get the job done.
Evaluation - how well do the interventions work in practice.
Sometimes this can lead to mis information, as in there can be mistakes that can lead to more research being done.
health problems
Describe the burden of disease. Which is the occurrence of disability and death due to the disease. Also wether there has been a recent change in that burden of disease. Described in measurements known as rates.
Morbidity is called disability and death is called mortality.
We also need to describe the course of a disease, this asks how often the disease occurs and how likely it is to be present currently and also what happens once it occurs. Described in measurements known as rates
Rate is used to describe any type of measurement that has a numerator and denominator where the numerator is a subset of the denominator. essentially a percentage of the population/ measurement.
Distribution of the disease? this asks questions of who gets the disease, where are they, when does it occur,
Epidemiologists investigate factors known as person and place to see if they can find patterns or associations in the frequency of a disease.
the associations are called group associations or ecological associations. Group may suggest ideas or hypotheses about the cause or etiology if a disease.
Group or individual association does not ensure that a cause and effect relationship exists. We need to consider a confounding variable.
Person includes demographic characteristics that describe people, such as age, sex, race, and socioeconomic factors. Also includes behaviors or exposures.
Place implies geographic location, such as city or state. this matters in the occurrence of the disease. However also includes nonphysical connections between people, such as a university community or a shared internet site. when these occur more frequently in groups with disease this is called risk indicators or risk markers.
Establishing Contributory causes, which is a very specific definition of etiology. Evidence based public health approach relies on epidemiological research to establish a contributory cause, which requires we go beyond group association and establish 3 definitive requirements
The cause is associated with the effect at the individual level. The cause potential cause and effect occur more frequently in the same individual than would be expected by chance.
Cause precedes the effect in time. The cause is resent at an earlier time than the effect.
Altering the cause alters the effect. When the cause is reduced or eliminated the effect is also reduced or eliminated.
The three requirements can be established using three different types of investigations.
Case control studies, most useful for establishing requirement number one of contributory cause. Cause associated with effect at individual level.
Current U.S. healthcare data infrastructure has been designed to meet the needs of medical providers health insurance biling, internal organizational management, and regulatory reporting.
In the last few years, most clinicians in the US had little interest and fewer incentives to advance population health applications by linking their data across silos.
There has been a shoft in government and insurance policies from individual patients to managing larger populations and improving their overallhelath outcomes while maintaining cost efficency.
Communicable disease surveillance and management has been one of the main efforts of public health for decades.
Recent publications have also focused on using new data streams from clinical health systems as a substitute to survey data to minor chronic diseases in the community.
Both medical care providers and public health agencies are icnreasingly using informatics and various tools to create and share digital information both within and across sectors.
In the Us and other industrialized countries there is a need to bridge the divide between medical and public health agencies
recent advances in population health informatics sugges that expanded sources of big data and increased availability of health IY tools serve to increase the integration and coordination of functions of the two sectors to the benefit of the communities.