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ch. 2 evidence based public health (NOT DONE) - Coggle Diagram
ch. 2 evidence based public health (NOT DONE)
evidence based approach
5 basic questions
Problem: what is the health problem?
Etiology: what is/are the contributory causes?
Recommendations: what works best to reduce the health impacts?
Implementation: how can we get the job done?
Evaluation: how well does the intervention work in practice?
Called the PERIE process
Types of investigations:
case control, cohort, randomized control trials
actions
should be grounded in
recommendations
that incorporate evidence
built upon studies from interventions
Evidence-based interventions
based on quality of evidence and magnitude of impact
describing health problems
Burden of disease
occurrence of disability and death due to a disease
Morbidity
: disability
Mortality
: death
Course of disease
how often the disease occurs
how likely it is to be present currently
what happens once it occurs
Rates
Any type of measurement that uses a numerator and denominator
numerator measures the number of times an event occurs
denominator measures the number of times an event could occur
often use entire population in denominator, but sometimes we use the
at risk
population (ex. women for cervical cancer)
Incidence
: measures the chances of developing a disease over a period of time
relationship between incidence and mortality rate is important because it estimates the chances of dying from a disease once it is diagnosed (
case fatality
)
Prevalence
: number of individuals who have a disease at a particular time divided by the number of individuals who could potentially have the disease
tells us the
proportion
of individuals who have the disease at a point in time
useful when trying to asses the total impact/burden of a health problem in a population + can help identify need for services
distribution of disease
Epidemiologists
investigate person and place to see if they can find
associations
in the frequency of disease
called
group associations
Risk indicators
seen when certain factors occur more frequently in groups with disease vs groups without
reasons differences could be artifactual
differences/changes in the interest in identifying the disease
differences/changes in the ability to identify the disease
differences/changes in the definition of the disease
establishing causes
Group association
Use information on groups/population without having information on specific individuals
called
population comparisons
Contributory causes
etiology = reasons
3 definitive reasons:
"cause" is associated with "effect" at the individual level
"cause" precedes the "effect" in time
altering the "cause" alters the "effect"
How to establish contributory causes?
Four criteria:
strength of the relationship
dose-response of the relationship
consistency of the relationship
biological plausibility