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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?Who?
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
- eerste professor in epidemiology
- transition of acute infections to chronic disease
- focus on non-communicable diseases, pellagra, vitamins
- 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?
- Descriptive epidemiology
- analytical epidemiology
- Descriptive 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:
snapshot van representative sample
Analytical epidemiology =Study of the causes of disease (exposure-disease associations)
We ask the question:
Prevalence proportion definitie + berekeningMeasures 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 prevalencePoint prevalence
- a snapshot
- 1st of January 2009
- 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) --> measuresMeasures 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 populationMeasure of disease occurrence:
- incidence proportion (IP)
- incidence rate (IR)
- 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 populationMeasure 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
incidenceis low, but durationis long, prevalencewill be large in relation to incidence
prevalenceis low because of short duration, prevalence will be small in relation to incidence.
Relationship between incidence, prevalence and durationZie de afbeelding
Use of incidence and prevalenceIncidence
- used for acutely acquired diseases
- is more important when thinking of etiology (leer van de oorzaak) of the disorder
- used for more permanent states, conditions or attributes of ill-health.
- 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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