Basic measurement in epidemiology
Incidence & Prevalence
Tools of measurement in epidemiology
Epidemiological methods
Descriptive epidemiology.
Distribution of disease in term of Time, Place and Person
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
Screening for diseases from community medicine. It explains the definition of screening, lead time, uses of screening, differences between screening and diagnostic test, criteria for a disease to be screened and criteria for a screening test, cut-off points, etc
Epidemiology is the study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations. It is the cornerstone of public health, and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare. Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies, and, to a lesser extent, basic research in the biological sciences
Study designs, Epidemiological study design, Types of studiesDr Lipilekha Patnaik
Study design, Epidemiological study designA study design is a specific plan or protocol
for conducting the study, which allows the investigator to translate the conceptual hypothesis into an operational one.
Application of a test or a procedure to large number of population who have no symptoms of a particular disease for the purpose of determining their likelihood of having the disease.
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
Screening for diseases from community medicine. It explains the definition of screening, lead time, uses of screening, differences between screening and diagnostic test, criteria for a disease to be screened and criteria for a screening test, cut-off points, etc
Epidemiology is the study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations. It is the cornerstone of public health, and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare. Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies, and, to a lesser extent, basic research in the biological sciences
Study designs, Epidemiological study design, Types of studiesDr Lipilekha Patnaik
Study design, Epidemiological study designA study design is a specific plan or protocol
for conducting the study, which allows the investigator to translate the conceptual hypothesis into an operational one.
Application of a test or a procedure to large number of population who have no symptoms of a particular disease for the purpose of determining their likelihood of having the disease.
Epidemiological Exercise for Undergraduate Medical Students. The exercise is based on Cohort Study, Case control study, Horrock's apparatus, Vital Indices.
It is an acute viral infection caused by an RNA virus belonging to Picornaviridae family under enterovirus genera.
It primarily infects human alimentary tract but may infect the CNS resulting in varying degrees of paralysis & possibly death.
It is discussed in the following headings:
1. Epidemiology of Poliomyelitis in children
2. Clinical spectrum of poliomyelitis
3. Clinical features/presentation of poliomyelitis in children
4. Treatment of Poliomyelitis in children
5. Prevention of Poliomyelitis in children
6. Eradication strategy of Poliomyelitis in children
A study design is a specific plan or protocol for conducting the study, which allows the investigator to translate the conceptual hypothesis into an operational one
Obesity is defined as an abnormal growth of the adipose tissue and or enlargement of fat cell size (hypertrophic obesity) or increase in fat cell number (hyperplastic obesity).
Obesity is often expressed in terms of body mass index (BMI)
Dengue is a self limited acute febrile condition and sometimes
haemorrhagic, primarily transmitted to the humans from
infected Aedes species ( Ae. aegypti or Ae. albopictus ).
Dengue Syndrome will be discussed in following headings
1.Epidemiology
2. Manifestation
3. Clinical presentation,
4. Diagnosis
5. Treatment
6. Prevention & Control
Infection caused by three closely related nematodes (W. bancrofti, B. malayi & B. timori) & transmitted to man by bite of infective mosquitos & clinically characterized by-
Lymphangitis, lymphadenitis, elephantiasis of genitals, legs & arms or
Pulmonary esonophilia or Filaria arthritis
CLINIC PRESENTATION
MANAGEMENT
PREVENTIVE MEASURES
FILARIALSURVEY
Malaria epidemiology, clinical features & treatmentDr. Animesh Gupta
Malaria is a protozoal disease caused by infection with
parasites of the genus Plasmodium and transmitted by
certain species of infected female Anopheles mosquito.
Experimental Epidemiology
1st Clinical trial
Basic steps in RCT
Randomization & its method
Manipulation/ Intervention
Types of RCT
Phases in Clinical trial
Hierarchy of epidemiological study
Concept of Association, Causation and Correlation
Association - Spurious, Indirect & Direct
Multi-factorial causation
Guidelines for Judging causality
Additional Criteria for Judging causality
What is Cohort?
Indication and Elements of Cohort Study.
What is Relative risk and Attributable risk, and its interpretation?
Advantages & disadvantages of Cohort study.
Difference between Case control & Cohort study.
Different types of epidemiological methods
Salient features of case control study
Steps for conducting case control study
Matching
Odds ratio
Bias in case control study
Advantages & disadvantages in case control study
Epidemiology - Definition, History, Aims, Approach, Uses/Purpose.
"The study of the distribution and determinants of
health related states in specified populations , and
the application of this study to control of health
problems."
Screening is defined as the search for unrecognized disease or defect by means of rapidly applied tests , examinations or other procedures in apparently healthy individuals
Rheumatic Heart Disease (RHD) is one of the major causes of cardiovascular disease, accounting for nearly 25-45% of the acquired heart disease.
Rheumatic Fever (RF) is a febrile disease affecting connective tissue (heart) & joints. It is caused due to infection of the throat by group-A beta hemolytic streptococci.
It is NOT a communicable disease but results from communicable disease(streptococcal pharyngitis).
RF is the common cause of acquired heart disease in childhood and adolescence.
IMNCI (Integrated Management of Neonatal and Childhood illness) is an integrated approach to child health that focuses on the well-being of the whole child.
IMNCI strategy is one of the main interventions under RCH-II/NRHM, that focuses on Preventive, Promotive and Curative aspects of program.
NACP (National AIDS Control Programme) launched on February 12 ,2014. The Objectives was:
- Reduce new infections by 50% (2007 Baseline of NACP III)
- Comprehensive care, support and treatment to all persons living with HIV/AIDS
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. Measurement of
▪ Mortality
▪ Morbidity
▪ Disability
▪ Presence or absence or distribution of characteristic or
attributes of disease
▪ Health care or health utilization
▪ Demographic variables
4/25/2020Epidemiology - Dr. Animesh Gupta 2
3. 4/25/2020Epidemiology - Dr. Animesh Gupta 3
▪ Incidence – the no. of NEW cases
occurring in a defined population
during a specified period of time".
▪ Prevalence – all current cases (old
and new) existing at a given point in
time, or over a period of time in a
given population.
▪ Prevalence = Incidence * Duration of
illness
5. ▪Rate
▪ It measures the occurrence of particular event in a population
during given time period.
▪ A rate comprises the following elements - numerator, denominator,
time specification and multiplier.
▪ Example:
Death rate = No. of death in a year/ Mid year population * 1000
4/25/2020Epidemiology - Dr. Animesh Gupta 5
6. ▪Ratio
▪ It expresses a relation in size between two random quantities.
▪ The numerator is not a component of the denominator.
▪Proportion
▪ It is a ratio which indicates the relation in magnitude of a part of the
whole.
▪ The numerator is always included in the denominator.
▪ It is usually expressed as a percentage.
4/25/2020Epidemiology - Dr. Animesh Gupta 6
7. ▪Descriptive
▪Analytic
▪Experimental
▪Study of the occurrence and
distribution of disease
▪Further studies to determine the
validity of a hypothesis concerning
the occurrence of disease.
▪Deliberate manipulation of the cause
is predictably followed by an
alteration in the effect not due to
chance
74/25/2020Epidemiology - Dr. Animesh Gupta
8. OBSERVATIONAL STUDIES
DESCRIPTIVE STUDY ANALYTICAL STUDIES
✓ TIME
✓ PLACE
✓ PERSON
➢ ECOLOGICAL STUDY
➢ CROSS SECTIONAL STUDY
➢ CASE-CONTROL STUDY
➢ COHORT STUDY
EXPEREMENTAL STUDIES
➢ RANDOMIZED CONTROLLED TRIAL (RCT)
➢FIELD TRIAL
➢COMMUNITY TRIAL 4/25/2020 8Epidemiology - Dr. Animesh Gupta
9. ▪1st phase of an epidemiological investigation
▪Descriptive analysis is limited to a description of the
occurrence of a disease in a population & identifying the
characteristics associated with it
▪Relatively inexpensive and less time-consuming than
analytic studies.
4/25/2020Epidemiology - Dr. Animesh Gupta 9
10. ▪Patterns of disease occurrence, in terms of,
▪When is the disease occurring – time distribution
▪Where is it occurring – place distribution
▪Who is getting a disease – person distribution
4/25/2020Epidemiology - Dr. Animesh Gupta 10
11. ▪ Defining the population to be studied
▪ Defining the disease under study
▪ Describing the disease by
✓ Time
✓ Place
✓ Person
▪ Measurement of disease
▪ Comparing with known indices
▪ Formulation of etiological hypothesis
4/25/2020Epidemiology - Dr. Animesh Gupta 11
12. ▪Define the population in
relation to:
1. Number
2. Age
3. Gender
4. Occupation
5. Cultural and other
characteristics
▪The defined population
can be:
1. Whole population
2. Sample
3. Specially selected
groups
4/25/2020Epidemiology - Dr. Animesh Gupta 12
13. ▪Large enough
▪Stable (no migration)
▪Clear on who belongs to the population
▪Community participation
4/25/2020Epidemiology - Dr. Animesh Gupta 13
14. ▪The epidemiologist defines the disease which can be
measured and identified in the defined population with a
degree of accuracy (operational definition).
▪This is different from the clinician’s definition of a disease.
▪Example - tonsillitis might be defined clinically as an
inflammation of the tonsils caused by infection, usually with
streptococcus pyogenes.
▪OD - presence of enlarged, red tonsils with white exudate,
which on throat swab culture grow predominantly S.
pyogenes.
4/25/2020Epidemiology - Dr. Animesh Gupta 14
15. TIME PLACE PERSON
Climatic zones Age Birth order
Year, season
Month, week
Country,
region
Gender
Marital state
Family size
Height, weight
Day, hour
Duration
Urban/rural
Towns, cities,
institutions
Occupation
Social status
Education
BP.
Cholesterol,
habits
Objective of descriptive epidemiology?
This involves systemic collection and analysis of data.
4/25/2020Epidemiology - Dr. Animesh Gupta 15
17. ▪An epidemic is the best known short term fluctuation.
▪It is defined as “ The occurrence in a community or region
of cases of an illness or other health related events clearly
in excess of normal expectancy”
4/25/2020Epidemiology - Dr. Animesh Gupta 17
18. ▪ A graph of time distribution ofepidemic cases is called epidemic curve.
4/25/2020Epidemiology - Dr. Animesh Gupta
19. 13
▪ Common source epidemics-
a) Single/Point exposure
b)Continuous/Multiple exposure
▪ Propagated epidemics
a) person to person
b)arthropod vector
c) animal reservoir
▪ Slow(modern) epidemics
4/25/2020Epidemiology - Dr. Animesh Gupta 19
20. ▪ Single exposure
It can occur due to an infectious agent or as a result of
contamination of the environment and develops within one
incubation period. Eg: Bhopal gas tragedy, Minamata
disease
The epidemic curve rises and falls rapidly, usually has one
peak
It tends to be explosive (i.e. clustering of cases within a short
time) 14
4/25/2020Epidemiology - Dr. Animesh Gupta 20
22. ▪ Continuous exposure
It is when the exposure from the same source is prolonged
and the epidemic continues over more than one incubation
period.
The epidemic reaches a sharp peak, but tails off gradually
over a longer period of time.
Eg: A well of contaminated water or nationally distributed
vaccine(polio vaccine) or food; water borne cholera.
4/25/2020Epidemiology - Dr. Animesh Gupta
24. ▪The epidemic shows gradual rise and tails off over a much
longer period of time
▪It is more likely to occur where there is
▪large number of susceptible are aggregated
▪regular supply of new susceptible individuals (Births,
Immigrants)
18
4/25/2020Epidemiology - Dr. Animesh Gupta 24
26. COURSE OF A TYPICAL PROPAGATED EPIDEMIC
4/25/2020Epidemiology - Dr. Animesh Gupta
27. ▪Seasonal trend-
▪Seasonal variation is characteristic of many
communicable diseases.
▪Eg: Measles, upper respiratory tract infections(seasonal
rise during winter), Malaria, etc.
▪Non-infectious diseases and conditions may sometimes
exhibit seasonal variation.
▪Example - Sunstroke, hay fever
21
4/25/2020Epidemiology - Dr. Animesh Gupta 27
29. ▪Some diseases occur in cycles spread over short periods
of time (days, weeks, months or years) .
▪Eg: Influenza pandemics are known to occur at intervals
of 7-10yrs due to antigenic variations.
▪Non-infectious conditions may also occur in this trend.
▪Eg: Automobile accidents are more frequent on
weekends.
294/25/2020Epidemiology - Dr. Animesh Gupta
30. ▪It refers to changes in the occurrence of disease over a
long period of time.
▪Eg: Coronary disease, diabetes showing consistent
upward trend,
▪decline in TB, polio in developed countries during the
past 50 yrs.
4/25/2020Epidemiology - Dr. Animesh Gupta 30
32. InternationalVariation
▪Descriptive studies have
shown that the pattern
of a disease is not the
same everywhere
▪Eg: Cancer of the
stomach is very
common in Japan, but
unusual in the US.
NationalVariation
▪There are variations in
disease occurrence
within countries.
▪Example:
▪Endemic goitre,
▪Fluorosis
▪Malaria
▪Nutritional deficiencies
4/25/2020Epidemiology - Dr. Animesh Gupta 32
33. ▪Due to differences in population density, levels of
sanitation, deficiencies of medical care, education and
environment factors, there exists a rural-urban variation
▪Chronic bronchitis, cardiovascular diseases, accidents are
more frequent in urban than rural areas.
▪Skin and zoonotic diseases and soil transmitted helminths
may be more frequent in rural than urban areas
4/25/2020Epidemiology - Dr. Animesh Gupta 33
34. ▪These variations can be
studied with the help of “spot
or shaded” maps.
▪If the map showed clustering,
it may suggest a common
source of infection.
▪Eg: Study of Cholera epidemic
by John Snow in 1854
4/25/2020Epidemiology - Dr. Animesh Gupta 34
35. ▪Way of distinguishing genetic and environmental factors.
▪Study of genetically similar groups but living under
different environmental conditions.
▪ Eg: Twins
▪Study of genetically different groups living in a
similar environment.
▪ Eg: Men of Japanese origin living in USA have higher rate of
coronary heart disease than the Japanese in Japan
4/25/2020Epidemiology - Dr. Animesh Gupta 35
37. ▪Cross sectional study – Prevalence
▪It is based on a single examination of a cross section of
population at one point in time.
▪More useful for chronic diseases
▪Longitudinal Study – Incidence
▪The observations are repeated in the same population
over a prolonged period of time by means of follow up
examination.
▪Longitudinal is more useful, but it is time consuming.
▪Mortality, Morbidity & Disability
4/25/2020Epidemiology - Dr. Animesh Gupta 37
38. ▪Making comparison
▪Asking question
▪It helps to
▪Arrive at clues to the disease’s etiology
▪Identify groups at increased risk
4/25/2020Epidemiology - Dr. Animesh Gupta 38
39. ▪It is a supposition, arrived at from observation or
reflection
▪It should specify following:
▪ Population
▪ Specific cause being considered
▪ Expected outcome – the disease
▪ Dose-response relationship
▪ Time-response relationship
4/25/2020Epidemiology - Dr. Animesh Gupta 39
40. ▪Contributes to research by describing variations in
disease occurrence by time, place and person
▪Clues to disease epidemiology – aetiological
hypothesis
▪Data regarding magnitude of disease load and types of
disease problems in community in terms of morbidity
and mortality
▪Background data for planning, organizing and
evaluating preventive and curative services
4/25/2020Epidemiology - Dr. Animesh Gupta 40
41. ▪Epidemiological methods (Classification)
▪Descriptive epidemiology
▪Defining the population
▪Defining the disease under study
▪Describing the disease
▪Measurement of disease
▪Comparing with known indices
▪Formulation of etiological hypothesis
▪Uses
4/25/2020Epidemiology - Dr. Animesh Gupta 41
Steps