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Mind Map #4: Evidence-Based Public Health - Coggle Diagram
Mind Map #4:
Evidence-Based Public Health
P.E.R.I.E Process
Problem
Identify what the health problem is.
Burden of disease
Morbidity
Mortality
Course of the disease
Distribution of the disease
Etiolgoy
Case Control Studies
Useful in associating the "cause" with the "effect" at the individual level
Cohort Studies
Useful in establishing the "cause" preceding the "effect"
Those with the cause or risk factor and without it are observed to see if they develop the effect
Randomized Controlled Studies
Useful in establishing that altering the "cause" alters the "effect"
Implementation
Use the When-Who-How approach to determine what intervention to use
Levels
Primary interventions (preventative)
Secondary interventions (occur after the development of a disease or risk factor, but before symptoms appear)
Tertiary interventions (occur after the initial occurrence of symptoms but before irreversible disability)
Types
Information (education)
Motivation (incentives)
Obligation (requirements)
Recommendations
Incorporate evidence
Go beyond efficacy or benefits and consider harms or safety.
Given a score: a measurement of the evidence's quality and the impact's magnitude.
Evaluation
RE-AIM framework
Reach, Effectiveness, Adoption, Implementation, and Maintenance
Supportive criteria → used to argue for a cause-and-effect relationship when the definitive requirements have not been fulfilled
Examples
Strength of the relationship
Dose-response relationship
Consistency of the relationship
Biological plausibility
Confounding variable: a difference in the groups being compared that makes a difference in the measured outcome and is not part of the chain of causation.
Risk indicator → A characteristic, such as gender or age, associated with an outcome but not considered a contributory cause
Types of Cause
Necessary cause: If the “cause” is absent, the disease or “effect” will not develop.
Sufficient cause: If the “cause” is present, the disease or “effect” will occur.
We can see differences in the P.E.R.I.E. process depending on age. Strokes for example have different etiology for young vs. older people, which ripples down to different recommendations and implementation
Prevalence of risk factors may vary as well!