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Lecture 1

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Lecture 1

  1. 1. INTRODUCTION TO EPIDEMIOLOGY Nouf M. Alkusayer © 2015 1
  2. 2. Objectives • Define Epidemiology – Origin of the term “Epidemiology” • Difference between: Epidemic, Endemic, Pandemic • Uses of Epidemiology • Levels of prevention 1
  3. 3. “Epidemiology is primarily concerned with identifying the important factors or variables that influence a health outcome of interest.”1 Definition 1
  4. 4. “Epidemiology is the study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states and the application of this knowledge to control the health problems .”2 Definition 2
  5. 5. Distribution: Terminology Frequency or occurrence over space and time Disease : Absence of health Population : Total number of people in a specific area or having a similar characteristic
  6. 6. “Epidemiology is the study of health and disease in a population.” 3 -The population dimension is a distinctive characteristic of epidemiology, why? - We tend to think of medicine dealing with health and disease in individuals rather than population, - Health & diseases of a population is less prominent in the minds of most people. Definition 3 A more general definition :
  7. 7. The basic premise of epidemiology is… • Disease does not occur at random, but rather in patterns that reflect the operation of underlying factors.
  8. 8. Origin Epidemiology  “epidemic”, derived from the Greek: Epi = on Demos = population Logos = discourse / study
  9. 9. What is the difference? • epi (among) + demos = epidemic • en (in) + demos = endemic • pan (all) + demos = pandemic
  10. 10. What is the difference? • Epidemic: Occurrence of disease in excess of the expected rate. Epidemiology is the “study of epidemics”. • Endemic: The usual, expected rate of disease over time. • Pandemic: A worldwide epidemic. Epidemics that affect several countries or continents.
  11. 11. Example of Epidemic
  12. 12. Uses of Epidemiology7 1) To study the history of disease  Useful for studying future ‘projections’ and predictions of trends  Useful for planning health services and public health 2) Community diagnosis  Studying the presence, nature, and distribution of health and disease among population. As well as the dimensions of these in incidence, prevalence and mortality (will come back to those terms) 3) To study and assess the available health services  Forming comparative studies between populations based on 1) The determination of needs and resources of a population 2) Analysis of the available services 3) Finally, evaluation of the available services
  13. 13. Uses of Epidemiology7 4) To estimate the individual's chances and risks of disease.  The estimation is based on the common experience  The risk of individual’s risk affects risk of populations/groups 5) Completing the clinical picture  Identification of all types of cases in proportion and their diagnostic processes  Cause-effect relationships are determined  E.g. smoking frequently cause higher risk for lung cancer 6) Identify syndromes  Establishing criteria to define syndromes  E.g. Down syndrome, sudden death in infants, etc.
  14. 14. Uses of Epidemiology7 7) To determine the causes of health and disease  Finding the causes can be through studying the differences of health/disease rates between different groups  Determination of disease sources or causes allows us to control, prevent, eliminate disease, injury, disability, or death rates.
  15. 15. Levels of prevention3 Primary Secondary Tertiary
  16. 16. Levels of prevention3 Primary The prevention of disease from occurring. E.g. needle exchange programs to prevent the spread of HIV, vaccination programs, smoking prevention programs, etc.
  17. 17. Levels of prevention3 Secondary The prevention of progression of early-staged disease (i.e. people who carry the agent but are not symptomatic yet) E.g. Treating asymptomatic HIV-infected patients with antiretroviral agents to delay the onset of AIDS. Screening tests such as for cervical cancer via Pap smears.
  18. 18. Levels of prevention3 Tertiary The prevention of disability from advanced/complex/long-lasting diseases and the rehabilitation of the individual to functional capacity. E.g. Cardiac or stroke rehabilitation programs
  19. 19. Example of the 3 levels of prevention

Editor's Notes

  • How to define disease, exposure, control variable from a real research paper?
    Contineous and categorical variables.
  • ActivEpi Companion Textbook by David Kleinbaum
  • Distribution: Frequency or occurrence over space and time
    M. Porta, A dictionary of Eidmeiology …..
  • tRodolfo Saracci a very short intro..
    Distribution. Epidemiology is concerned with the frequency and pattern of health events in a population. Frequency includes not only the number of such events in a population, but also the rate or risk of disease in the population. The rate (number of events divided by size of the population) is critical to epidemiologists because it allows valid comparisons across different populations.
  • tRodolfo Saracci a very short intro..
  • Epidemiology for Public Health Practice
     By Robert H. Friis, Thomas A. Sellers
  • In historical study of the health of the community and of the rise and fall of diseases in the population; useful ‘projections' into the future may also be possible.
    For community diagnosis of the presence, nature and distribution of health and disease among the population, and the dimensions of these in incidence, prevalence, and mortality; taking into account that society is changing and health problems are changing.
    To study the workings of health services. This begins with the determination of needs and resources, proceeds to analysis of services in action and, finally, attempts to appraise. Such studies can be comparative between various populations.
    To estimate, from the common experience, the individual's chances and risks of disease.
    To help complete the clinical picture by including all types of cases in proportion; by relating clinical disease to the subclinical; by observing secular changes in the character of disease, and its picture in other countries.
    In identifying syndromes from the distribution of clinical phenomena among sections of the population.
    In the search for causes of health and disease, starting with the discovery of groups with high and low rates, studying these differences in relation to differences in ways of living; and, where possible, testing these notions in the actual practice among populations.
  • To estimate, from the common experience, the individual's chances and risks of disease.
    To help complete the clinical picture by including all types of cases in proportion; by relating clinical disease to the subclinical; by observing secular changes in the character of disease, and its picture in other countries.
    In identifying syndromes from the distribution of clinical phenomena among sections of the population.
  • In the search for causes of health and disease, starting with the discovery of groups with high and low rates, studying these differences in relation to differences in ways of living; and, where possible, testing these notions in the actual practice among populations.
    Taken from Morris JN, Uses of Epidemiology.4
    http://ije.oxfordjournals.org/content/30/5/1146.full
  • Check for a collective example

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