Term
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Definition
| a factor that promotes disease - can be multiple disease agents per disease. ex: obesity can be related to genetics and lifestyle. |
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Term
| any organisms or substance where an infectious agent lives and multiplies |
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Definition
| reservoir -- human, animal, environment |
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Term
| how an infectious agent is spread |
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Definition
| mode of transmission -- resp droplets |
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Term
| the time during which an infectious agent may be transmitted |
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Definition
| period of communicability -- can be on an individual basis (while fever lasts) or a population basis (fall/winter best time to get flu) |
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Term
| 2 methods of disease transmission |
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Definition
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Term
| how are pathogens transmitted directly? |
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Definition
| touching, kissing, bites, coughing , sex |
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Term
| how are pathogens transmitted indirectly? |
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Definition
| fomites, contaminated food or water, vectors (insects) |
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Term
| type of indirect transmission whereby pathogens are transmitted via fomites |
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Definition
| vehicle-borne transmission |
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Term
| type of indirect transmission whereby pathogens are transmitted via contaminated food |
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Definition
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Term
| type of indirect transmission whereby pathogens are transmitted via an intermediate organism such as the mosquito or bird |
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Definition
| vector-borne transmission |
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Term
| 10 steps to investigating an outbreak |
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Definition
| verify the diagnosis and know the inclusion criteria, verify the distribution (how does the incidence rate compare to the endemic state?), define the distribution (# of cases), examine the distribution of cases in terms of person place and time, consider variables, develop a hypothesis based on existing knowledge and biological plausibility, investigate and analyze, recommend prevention and control measures, report the investigation, prevent future outbreaks |
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Term
| primary causes of foodborne outbreaks |
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Definition
| improper holding temps, poor employee hygiene, inadequate cooking, contaminated equipment, food from unsafe sources |
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Term
| what 3 places usually have the highest number of reported cases of foodborne illness |
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Definition
| delis, cafeterias, and restaurants |
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Term
| the first known case of a disease |
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Definition
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Term
| the individual who introduces the disease into a family or group under study, not necessarily the first diagnosed case in a family or group |
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Definition
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Term
| the subjects who got the disaes from the index or co-primary cases |
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Definition
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Term
| primary attack rate = __% upon diagnosis of the index case |
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Definition
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Term
| the rate of infection among exposed persons after exposure to the index case... describes the spread of disease within a group excluding the index case and co-primary cases |
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Definition
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Term
| why does the attack rate model end? |
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Definition
| because people either get immunity to the disease or die and can't spread it to other |
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Term
| after a subject's body is invaded by a pathogen, how long is it before they become ill? |
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Definition
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Term
| the most successful disease intervention is done when? |
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Definition
| during the incubation period |
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Term
| another word for incubation? |
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Definition
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Term
| length of ___ is a good marker for diagnosis |
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Definition
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Term
| ___ epidemics extend over several incubation periods. ex? |
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Definition
| propagated or progressive -- swine flu |
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Term
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Definition
| investigating a foodborne outbreak at every possible instance of contamination |
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Term
| the resistance of a group of hosts to invasion of an infectious disease based on the immunity of a high proportion of individual group members |
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Definition
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Term
| demography is the study of populations with reference to: |
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Definition
| population size, gender, growth, age, distribution, vital stats, mortality, fertility, and migration |
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Term
| what 3 subsets of demography have the biggest influence on population distribution |
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Definition
| mortality, fertility, migration |
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Term
| __ and __ are the most basic characteristics of a population distribution |
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Definition
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Term
| women in undeveloped countries outlive men by __ years, where as in developed countries, they outlive men by ___ years |
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Definition
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Term
| what does a sex ratio over 100 tell us? |
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Definition
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Term
| Less developed countries have more males/females than more developed |
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Definition
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Term
| the average number of years a person is expected to live. this tends to be an under or over estimate? |
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Definition
| life expectancy -- underestimate |
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Term
| can life expectancy be calculated at any age? |
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Definition
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Term
| ____ refers to the average age a newborn baby is most likely to live if current mortality trends persist |
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Definition
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Term
| if you live to be __, you can expect to live longer according to mortality trends |
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Definition
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Term
| what country has the longest life expectancy? |
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Definition
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Term
| ___ is the average number of additional years a person of age X is likely to live if current mortality trends persist |
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Definition
| life expectancy at a given age -- can help you determine potential years of life lost -- calculated based on a lifespan of 65 years |
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Term
| why isn't life expectancy at a given age useful for people over 65? |
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Definition
| it's based on a lifespan of 65 years |
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Term
| primary vs. secondary data |
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Definition
| primary - data you collect yourself, secondary - data you get from an outside source |
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Term
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Definition
| voluntary response (hard to get representative sample of pop), response bias (people answer how they think you want them to), inadequate incentives for participants, low response rate, time consuming, inadequate supervision |
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Term
| problems with data from hospitals |
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Definition
| hospital admissions are selective, hospital records are usually not designed for research, diagnosis could be incorrect, population at risk may be defined incorrectly |
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Term
| 2 biggest problems with morbidity reports |
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Definition
| under-numeratio and misreporting |
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Term
| 10 kind of cases that require an autopsy |
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Definition
| fire deaths, homicides, suicides without clear evidence of intent, drivers in single-car accidents, pilots, occupational death, unwitnessed accidents, cases where civil litigation may arise, and sudden infant deaths |
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Term
| how often is the census taken? |
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Definition
| every 10 years over a 3 year period |
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Term
| a monthly survey of about 50,000 households conducted by the Census Bureau |
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Definition
| Current Population Survey (CPS) |
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Term
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Definition
| birth, death, marriage, divorce, separation |
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Term
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Definition
| links several sources of data on the same person - birth certificate, marriage license, death certificate, etc |
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Term
| the death certificate is required upon burial and is the responsibility of who? |
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Definition
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Term
| the death certificate outlines 3 causes of death; |
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Definition
| immidiate (CHF), intermediate (high blood pressure), and underlying (type II diabetes) |
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Term
| the census bureau data are all primary/secondary sources |
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Definition
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Term
| 2 types of tax-financed public assistance programs |
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Definition
| medicaid (for low-income and the disabled) and VA |
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Term
| the national survey of family growth (NSFG) gives information on what? |
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Definition
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Term
| National Center for Health Statistics sources of Info |
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Definition
| National Health interview survey (NHIS), National Health and Nutrition Examination Survey (NHANES), National Ambulatory Medical Care Survey (NAMCS), National Hospital Discharge Survey (NHDS), National Vital Statistics System (NVSS), National Master Facility Inventory (NMFS), |
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Term
| ____ is the principal source of info on the health of US residents, is completed at the beginning of each ___, and is based on a sample of ___ face-face interviews |
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Definition
| NHIS (national health interview survey), decade, 40,000 |
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Term
| How many different NHANES and what is the difference among them? What year were they published? |
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Definition
| 3 - focus on different problems in the time period in question .. first one was published in 1971, last one is 2005 |
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Term
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Definition
| national ambulatory medical care survey - office physicians complete a 1 page survey about patients over a 1 week period about patient demographics, diagnosis, payment, etc. |
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Term
| what survey focuses on the "walking wounded" |
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Definition
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Term
| who is not included in the NHDS (national hospital discharge survey) |
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Definition
| people who died in the hospital |
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Term
| what is the purpose of NMFIS (national master facility inventory survey)? |
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Definition
| avoid duplication of services or specialties in a given area |
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Term
| the purpose of ___ is to detect changes in disease trends and to initiate appropriate control measures |
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Definition
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Term
| surveillance includes what 5 practices |
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Definition
| systematic collections and evaluations of morbidity and mortality reports, special reports from field investigations of epidemics and individual cases, isolation and identification of infectious agents, data concerning the availability and use of vaccines, toxins, insecticides, etc, info regarding immunity levels in the population |
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Term
| the presumptive identification of an unrecognized disease or defect by the application of tests, examinations, or other procedures which can be applied rapidly to sort out apparently well persons from apparently diseased persons |
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Definition
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Term
| a screening test is not a ____ |
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Definition
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Term
| 4 phases of the screening process |
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Definition
| administer a short screening test, interview, biological medical physiological etc screening, administer a research questionnaire -- cost increases with each phase, and number of people decreases |
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Term
| screening tests are designed to be... |
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Definition
| applied to large groups, innocuous or non-intrusive, safe, brief and simple, inexpensive, carreid out by a trained person, acceptable to the person being screened, reliable, and valid |
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Term
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Definition
| reliability - gives same result every time you take it... validity - measures what it's supposed to measure |
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Term
| criteria for disease selection for screening |
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Definition
| the condition should be an important health issue that is treatable, the disease should be diagnosable after screening, the prognosis should be improved if the disease is detected, there should be a recognizable symptomatic stage, there should be an accepted treatment for the disease, facilities for diagnosis and treatment should be available |
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Term
| when should you NOT screen for a particular disease? |
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Definition
| the disease is rare or untreatable, the diagnosis cannot be made with certainty, the screening and diagnosis are more harmful than no screening, the results of screning are not reliable, the test lacks high sensitivity and specificity, the screening and diagnosis costs more than the treatment |
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Term
| how do you know whether to do column or row work when calculating false positives and negatives? |
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Definition
| test will say, "based on true status" = column work ... "based on % of pos tests" = row work |
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Term
| in screening, what are type I and type II erros? |
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Definition
| Type I = false positive, Type II = false negative |
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Term
| 2 most important terms in a screening test and why? |
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Definition
| sensitivity and specificity -- bc they're used to calculate validity |
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Term
| upon repeat screening, you test the negatives again... when do you test the positives again? |
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Definition
| if you're using a better test the second time |
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Term
| how does moving the cut point for inclusion criteria up and down affect negatives and positives? |
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Definition
| up = more FNs and TNs, less FPs and TPs ... down = more TPs and Fps, less Fns and TNs, |
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Term
| how does moving the cut point for inclusion criteria up and down affect sensitivity and specificity? |
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Definition
| up - increases Sp and decreases Se |
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Term
| how does moving the cutoff up or down affect sensitivity and specificity? |
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Definition
| up- sensitivity down, specificity up ... down- sensitivity up, specificity down |
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Term
| variation in screening is a function of what 4 things? |
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Definition
| number of observers, number of patients, number of observations, administer's knowledge of the test |
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Term
| increased Sp has what effected on PPV and FP? |
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Definition
| increase PPV, decreased FP |
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Term
| when would you want to test for a disease, even if prevalence is very low? |
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Definition
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Term
| lower prevalence has what effect on PPV, TPs, and FPs |
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Definition
| decrease PPV, increase TP, increase FP |
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Term
| What are two ways to decrease FPs? |
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Definition
| increase prevalence and increase Sp |
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Term
| what tests could be done to help identify the disease-causing agent in a case such as the methodist episcopal picnic? |
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Definition
| white blood cell counts (increased), blood culture and stool culture to show bacteria, platelet count (decreased), ELISA test to show antigen, fluorescent antibody study |
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Term
| what is a type III error in screening? |
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Definition
| program implementation error |
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Term
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Definition
| shows the distribution of the time and onset of disease |
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Term
| to incriminate a certain food for causing a foodborne outbreak, what evidence is necessary? |
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Definition
| high susceptibility to contamination, eaten by most of the sick, person who made it proven to be a typhoid carrier |
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Term
| In the foodborne outbreak case study, the macaroni salad was identified as the most probable suspect. But not everyone who got sick ate it. Explanation? |
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Definition
| people could have gotten it just by putting the mac salad on their plate but not eating it... or maybe something else was contaminated that was prepared by the same person |
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Term
| best way to prevent a foodborne outbreak? |
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Definition
| handwashing before preparing food. |
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Term
| if validity is 70%, what does that mean? |
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Definition
| the test will correctly identify TP and TNs 70% of the time |
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