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Epidemiology ch. 12
Terms in this set (33)
focuses on patients and the application of epidemiologic methods to assess the efficacy of screening, diagnosis, and treatment in clinical settings.
Clinical Epidemiology is used to identify...
Used to identify the health consequences of employing a test or administering a treatment.
Used to suggest or detect disease among individuals in a population without signs or symptoms of the health problem.
Tuberculin skin test
Beck Depression Inventory
Papanicolaou test (Pap smear, Pap test, cervical smear, or smear test)
Prostate-specific antigen (PSA) test
-The disease or condition being screened for should be a major medical problem
-Acceptable treatment should be available for individuals with diseases discovered in the screening process
-Access to health care facilities and services for follow-up diagnosis and treatment for the discovered disease should be available
-The disease should have a recognizable course, with identifiable early and latent stages
How well the test actually measures what it is supposed to measure.
How well the test performs in use over time(its repeatability).
The amount of screening the test can accomplish in a time period.
The ability of the test to correctly identify those with the disease
The ability of the test to correctly identify those without the disease
The ability of a test to predict the presence or absence of a disease
Two additional measures for appraising screening and diagnostic evidence are
-Likelihood Ratio Positive (LR+)
-Likelihood Ratio Negative (LR-)
Positive Likelihood ratios
The level of confidence we can have that a person who obtains a score in the affected range truly does have the health problem
Negative Likelihood ratios
The confidence that a score in the unaffected range comes from a person who truly does not have the health problem
Prediction or forecast of the course of a disease based on anticipation from the usual natural history of the disease or peculiarities unique to the case
tell the doctor the likely behavior of the cancer and its responsiveness to treatment
Measures of Prognosis (2)
1. Case fatality rate - the proportion of newly diagnosed cases that die from a given disease in a specified time period.
2. Survival rate - Proportion of persons surviving regardless of cause of death.
Cox Proportional Hazards Regression model
-Useful for analyzing survival data
-Indicates the probability that a person will experience an event
-Allows you to estimate the relative risk, adjusted for potential prognostic factors, thereby minimizing the threat of confounding.
The difference in time between the date of diagnosis with screening and the date of diagnosis without screening
Lead Time Bias
When lead time is counted in the survival time of patients, it gives a misleading picture of the benefit of treatment.
Choosing data that distorts the outcome of a test
May make a test look better or worse than it really is in terms of survival
Occurs when screening identifies an illness that would not have shown clinical signs before a person's death from other causes
-Makes screening efforts look good because of increased identification of abnormalities
-Individual may undergo unnecessary treatment, with its accompanying risk
Avoiding bias-Randomized Controlled Trial
Through randomization, different prognostic factors are balanced out between groups, and the "true" screening or treatment effect can be determined
A relatively new field that seeks to understand the end results of clinical practices and interventions
-Combines information about the care people are getting
-Important in developing better ways to monitor and improve clinical care
-Involves the application of epidemiologic methods to improve the quality and value of patient care
-Involves assessment of the efficacy of screening, diagnosis, and treatment strategies in clinical settings.
The study of the distribution and determinants of health-related events in human population an the application of this knowledge to improving the health of communities.
Epidemiology as a multidisciplinary enterprise
The complex interrelationships of factors that influence disease and heath at both the individual level and the community level; it provides the basic tools for the study of health and disease in communities.
used to descrie health and disease phenomena and to investigate the factors that promote health or influence the risk or distribution of disease. This knowledge can be useful in planning and evaluating programs, policies, and services, as week as in clinical decision making.
Explain the interrelationships between agent, host, and environment. and the interactions of multi-level factors, exposures, and characteristics affecting risk of disease.
Involves intervention to reduce the incidence of disease by detect disease by promoting health and preventing disease process of developing.
Includes programs (such as screening) designed to deter disease in the early stages, before signs and symptoms are clinically evident, to intervener with early diagnosis and treatment.
Provides treatments and other interventions directed toward persons with clinically apparent disease, with the aim of lessening the course of disease, reducing disability, or rehabilitating.
rely on rates and proportions to quantify levels of morbidity and mortality. Prevalence Proportions provide a picture of the level of existing cases in a population at a given time. Incidence rates and proportions measure the rate of new case development and provide an estimate of the risk of disease.
Provide information on the distribution of disease and health states according to personal characteristics, geographic region, and time. This allows for practitioners to target programs and allocate resources more effectively and provides a basis for further study.
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