Summary Class notes - HNH24806

- HNH24806
- EJM Feskens
- 2019 - 2020
- Wageningen University (Wageningen University, Wageningen)
- Voeding en Gezondheid
356 Flashcards & Notes
1 Students
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Summary - Class notes - HNH24806

  • 1567548000 E-modules on prevalence, incidence and standardisation

  • What does a/how things a clinician?
    He translates scientific knowledge and procedures to: "What is the best treatment for this specific patient?"
  • What does a/How things an epidemiologist in academic setting?
    "How can I be sure about this specific exposure-effect, independent of the context of this person or population"
  • What does an/ how tings an epidemiologist in public health setting?
    " Wat is the best prevention strategy for this specific population/risk group?"
  • Welke 5 vragen, vraagt een epidemiologie in Academic setting zich af?
  • Epidemiologist in public health setting is also about using information for prevention in populations
  • Welke 4 'tijd perken' kent de geschiedenis van Epidemiology and Public Health?
    Pre-formal (1662-1900)
    • ze gingen tellen en bijhouden
    • infectieus, diseases, nutritional deficiencies 
    • John Snow (1813-1858) cholera onderzocht kijkend naar de watervoorziening

    Early (1900-1940)
    • eerste professor in epidemiology
    • transition of acute infections to chronic disease
    • focus on non-communicable diseases, pellagra, vitamins

    Classical (1940-1980)
    • large-scale epidemiological studies started
    • new epi-methods, study designs

    Modern (1980 onwards)
    • intervention trails 
    • prevention strategies 

    infectious disease > chronic disease > any disease > all aspects of human health 
  • Er zijn twee types of epidemiology, welke 2?
    1. Descriptive epidemiology 
    2. analytical epidemiology 
  • Descriptive epidemiology =
    We are interested in the amount / frequency of disease or other conditions in a population (person, time, place)

    We ask the questions:
    • What?
    • When?
    • Who?
    • Where?

    snapshot van representative sample
  • Analytical epidemiology =
    Study of the causes of disease (exposure-disease associations)

    We ask the question:
    • Why?
  • Prevalence proportion definitie + berekening
    Measures the proportion of people in a population who have the disease at a given point in time:


    = number of people with disease at a given point in time / total number of people in the population 
  • point prevalence vs period prevalence
    Point prevalence 
    • a snapshot 
    • 1st of January 2009

    period prevalence
    • a period 
    • from January until march 2009
  • Incidence is measuring how fast people are 'catching' the disease
  • With a prevalence you are thinking about all cases/all people that have a disease, with a incidence you are thinking about all the new people how get the disease.
  • Incidence proportion: proportion of people who newly get the disease (%)

    incidence rate: rate at which new cases of a disease have occurred (500 new cases per 10.000 per year)
  • Incidence proportion (IP) = Cumulative incidence (CI) --> measures
    Measures the proportion of people who develop the disease during a specified period (new cases)
  • Wat is de formule voor het berekenen van de incidence proportion/cumulative incidence ( IP/CI)

    Number of people who develop disease in a specified period/ number of people at risk of getting the disease at the start of the period. 
  • Incidence proportion (IP) kan alleen uitgevoerd worden als er een complete follow-up is. Dus de groep moet de hele tijd gevolgd worden en niemand mag in of uit stappen

    niet helemaal zeker.....
  • Wat is de formule voor het berekenen van de incidence rate (IR)

    IR = number of people who develop disease / number of person-years when people were at risk of getting the disease 
  • Incidence rate (IR) = incidence Density 
    = (± mortality rate (sterftecijfer))

    Incidence Rate (IR): time at risk instead of people at risk!!
  • Incidence in closed population + what is a closed population
    Measure of disease occurrence:
    • incidence proportion (IP)
    • incidence rate (IR)

    closed population
    • bases ons fixed membership 
    • no one can be added 
    • but people may die, lost to follow-up etc
    • becomes smaller in time 
    • everyone is followed 
  • Incidence in open population + what is a open population
    Measure of disease occurrence:
    • incidence rate (IR)

    open cohort or dynamic population 
    • can take new members with time 
    • people move in and out of the area 
    • number remain about the same 
    • no follow-up when leaving 

  • incidence, duration, prevalence

    If incidence is low, but duration is long, prevalence will be large in relation to incidence

    if prevalence is low because of short duration, prevalence will be small in relation to incidence.
  • Relationship between incidence, prevalence and duration
    Zie de afbeelding
  • Use of incidence and prevalence

    1. used for acutely acquired diseases
    2. is more important when thinking of etiology (leer van de oorzaak) of the disorder

    1. used for more permanent states, conditions or attributes of ill-health. 
    2. is more important when thinking of societal burden (maatschappelijke last) of the disorder including the costs and resources consumed as a result of the disorder 
  • Kijk naar de tabel en naar het verschil in incidence een prevalence.
  • What is type 1 diabetes:
    Auto-immune disease. No production of insulin. Usually develops in childhood and patients require lifelong insulin injections
  • What is type 2 diabetes:
    Metabolic disorder characterized by hyperglycemia and altered lipid metabolism. Usually develops in adulthood and is associated with a unhealthy lifestyle; it is the major form of diabetes
  • What is gestational diabetes:
    State of hyperglycemia developing during pregnancy.
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To be causally associated with disease, the etiological factor should fulfill the following criteria:
  • Elimination of the factor reduces risk of the disease 
  • the exposure of this factor should precede the development of the disease 
  • the factor is more prevalent among those with the disease than among whose without the disease
Which statement is true for the cas-control study?it is a design in which 'reverse causality bias' does not occur it is a suitable design for studying rare exposuresit is important that cases and controls are sampled irrespective of their exposure status it is a suitable design for estimating the absolute risk of disease related to the exposure 
It is important that cases and controle are sampled irrespective of their exposure status
Which of the following measures provides most insight in the public health impact of a certain exposure attributable risk related to the exposure incidence proportion of the disease among the exposed prevalence of the disease among the exposed relative riks of the disease in the exposed versus non-exposed 
Attributable risk related to the exposure
Which statement is true for a randomized controlled trail?it is a suitable design for studying rare diseasesrandom sampling is applied to select the study population bias does not occur reverse causation does not occur 
Reverse causation does not occur
A prospective study reports that regular exercisers have a relative risk of 0.20 compared to sedentary people for the occurrence of strokes. The correct interpretation of this relative risk is
Regular exercisers are 80% less likely to suffer a stroke than sedentary people
What is the contribution of poor diet and lifestyle to the burden of cardiovascular disease?
More than 75%
A total of 84 countries was included in an ecological study on average household income level and yearly mortality from respiratory diseases. Which measure of association was most likely calculated in this study?
Wat is cardiovascular risk management (SCORE)
Er werd/wordt gebruik gemaakt van een score kaart
What is de prevalence of raised cholesterol

bij high-income is het veel hoger dan bij low-income 
What is de prevalence of hypertension
30-45 %

en er ziet niet tot nauwelijks verschil tussen low-income or high-income