Term
| Real reasons for differences in rates or trends |
|
Definition
- changes in rates of disease due to changes in behavior
- differences between populations in relevant demographic characteristics associated with environmental or behavioral risk factors
- differences in genetic factors between populations
|
|
|
Term
| artifactual reasons for observed differences in rates and trends |
|
Definition
- diagnostic inacuracy leading to misclassification
- new and more sensitive diagnostic tests (ex: PSA)
- differences in quality of health care/access to health care
- more complete ascertainment of cases
- changes in definition/classificatoin of disease (ICD)
- errors in enumerating population (affects denominator)
- interviewer bias
- respondent error in surveys
|
|
|
Term
|
Definition
- underlying cause is what is used for compiling mortality statistics
- registration of all deaths required by law in most developed countries
- cause of death information normally comes from physician in attendance
- if suspicion of foul play, suicide, or accidental death, refer case to coroner or medical examiner
- information is recorded in hierarchy workin from immediate to underlying cause
|
|
|
Term
|
Definition
- all reported mortality stats rely on ICD coding system
- ICD codes and groups causes of death and also clinical diagnoses
- originated in late 19th century
- designed to standardize the international reporting of cause of death
|
|
|
Term
| classification of nonfatal cases of disease |
|
Definition
- perinatal birth certificates
- medical care use
- legally reported- case reports (national notifiable disease system)
- registry exists- registry data
- clinical records
- inpatient hospital records
- outpatient care records
- lab records of tests
- medication (drug data)
- no medical care use (household survey)
- immunization
- health behavior
- other
|
|
|
Term
|
Definition
- registration of births legally required in most developed countries
- upper public part of certificate contains identifying and demographic info about baby and parents
- lower confidential part is retained by the vital stats offices
|
|
|
Term
| notifiable disease reporting system |
|
Definition
- sponsored by CDC and state health department
- over 45 ID's selected for reporting
- case definitions for each reportable disease are developed
- reporting is passive
- under reporting of less severe diseases
|
|
|
Term
|
Definition
- registries gather data from multiple sources on individual cases of disease
- some are population based (SEER)
- some are hospital or clinic based (trauma, birth defects)
|
|
|
Term
| clinical records (definition, examples) |
|
Definition
- patient specific data from clinical examinations, diagnostic tests, and procedures
- disadvantages
- records remain paper based in most clinics
- patient confidentiality an issue/compliance with HIPAA regulations
- accessing the records could be difficult
- incomplete, illegible
|
|
|
Term
|
Definition
- generated as byproduct of clinical care (ex: health insurance claims)
- easier to access
- usually are computerized and standardized
- may be prone to both systematic and random errors
|
|
|
Term
|
Definition
- covers diseases/conditions that are almost always initially treated in hospital
- systems use hospital discharge data
- abstracts usually include demographic info, date, length of hospitalization, diagnoses, surgeries, vital status upon discharge
- ex: VA records, Medicare data, NCHS's discharge survey
|
|
|
Term
| national houshold surveys used |
|
Definition
- National Health Interview Survey (NHIS)
- National Health and Nutrition Examination Survey(NHANES)
- Behavioral Risk Factor Surveillance System (BRFS)
|
|
|
Term
|
Definition
- data source
- topical modules
- collects data on emerging problems or speciic health problems
- ex: cancer, DM, healthy people 2010
- components
- core questionnaire
- collect minimal info on
- health behavior
- chronic, acute conditions
- health care utilization
- health status and limitations
- periodic modules
|
|
|
Term
| NHIS: questions asked about what |
|
Definition
- health status and disability
- insurance coverage
- access to care
- use of health services
- immunization
- health behaviors
- family practices
|
|
|
Term
|
Definition
- estimate number and percent of persons in population and designated subgroups with selected diseases and risk factors
- monitor trends of in prevalence, awareness, treatment, control of selected diseases
- monitor trends in risk behaviors and environmental exposure
- analyze risk factors for selected diseases
- study the relationship between diet, nutrition, health
- explore emerging public health issues
- establish national probability sample of genetic material for future genetic testing
- establish, maintain national probability sample of base line info on health and nutrition status
|
|
|
Term
| NHANES: eligible population |
|
Definition
- civilian, non institutionalized household populations
- all ages
- residents of all states and DC
|
|
|
Term
|
Definition
- monitor flu vaccine shortage
- reduce binge drinking of North Dakota
- developing Colorado arthritis program
- promote physical activity in Montana
- assess disaster need in Florida
|
|
|
Term
| purpose of outbreak investigation |
|
Definition
- determine cause of disease
- prevent spread of disease
|
|
|
Term
| steps in outbreak investigation |
|
Definition
- establish existence of epidemic
- confirm dx
- develop case definition
- ID/count cases to determine who is a risk
- describe the cases by time, place, person
- develop a hypothesis and evaluate against established facts
- plan/conduct an analytic study
- implement control and prevention efforts
- prepare and disseminate a report
|
|
|
Term
|
Definition
- histogram or bar chart plotting the number of cases of disease versus calendar time
- primary tool of outbreak investigation
- provide clues about source of outbreak and incubation period
- choose appropriate time inerval so you can see the development of epidemic
|
|
|
Term
| How can an epidemic curve help in an outbreak |
|
Definition
- epi curve can provide info on following characteristics of an outbreak
- pattern of spread
- magnitude
- outliers
- time trend
- exposure and/or disease incubation period
|
|
|
Term
|
Definition
- common source
- intermittent exposure- epi curve with irregular peaks that reflect th etiming and the extent of exposure
- continuous exposure- cause gradual ride (possibly to plateau rather than peak)
- period of exposure may be brief or long
- point source
- propagated
- mixed
|
|
|
Term
| point source outbreak pattern |
|
Definition
- sharp upward slope and gradual downard slope
- common source outbreak in which the period of exposure is brief, and all cases occur within one incubation period
|
|
|
Term
| propagated outbreak pattern of spread |
|
Definition
- spread person to person or vector born
- can last longer than common source outbreaks
- may have multiple waves
- classic epi curve for a propagated outbreak has progressively taller peaks, an incubation period apart
|
|
|
Term
|
Definition
- compares exposure experiences of those who have contracted disease with those who have not
|
|
|
