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EPIDEMIOLOGY.
MPH
BY: RAJAPAKAIR SANTOSH
KUMAR
Epidemiologic methods can
be used for a number of
distinct purposes:
DISEASE SURVEILLANCE.
Perhaps the most basic question that
can be asked about a disease is
What is the frequency with which
the disease occurs ?. To answer this
question , it is necessary to know the
number of persons who acquire the
disease (cases) over a specified
period of time , and the size of the
unaffected population.
SURVEILLANCE DATA.
There are many potential benefits from the
collection of surveillance data.
This type of information (1) can help to identify
the new outbreak of an illness , such as AIDS, (2)
can provide clues , by considering the population
groups that are most affected by the illness, to
possible causes of the condition ,(3) can be used
to suggest strategies to control or prevent the
spread of disease ,(4) can be used to measure the
impact of disease prevention and control efforts ,
and finally , (5) can provide information on the
burden of illness , data that are necessary for
determining health and medical service needs.
1.
2.
3.
4.
INCIDENCE RATE.
For surveillance purposes , the size of the source population
from which cases usually is estimated from census data .
The frequency of a disease occurrence is then expressed as
the number of new cases developing within a specified time
among a standard number of unaffected individuals. For
example , during 2002 over 42,000 cases of AIDS were
reported in the United States , the US populations in 2002
was about 288,000,000 .Dividing the number of reported
cases by the size of the population yields 0,00015 cases per
person during that year. Epidemiologists typically express
such frequencies of disease occurrence for for a population
of a specified size , say 100,000 persons .By multiplying
0.00015 by 100.000 , the number 15 is obtained . That is to
say , within a standard population of 100.000 persons 15
would have been reported as developing AIDS during 2002.
This measure of the rapidity of disease occurrence is
referred to as an
.
incidence rate
case-control study.
DIAGNOSTIC TESTING.
The purpose is to obtain objective
evidence of the presence or absence of
particular condition. This evidence can be
obtained to detect disease at its earliest
stages among asymptomatic persons in
general population, process referred to as
screening .In other circumstances,
diagnostic tests are used to confirm a
diagnosis among persons with existing
signs or symptoms of illness .
NATURAL HISTORY.
After being informed of a new diagnosis , patients most
frequently ask What will happen to me ? This question can
not be answered with absolute certainty because of variations
in outcome across individual patients .Consider for example a
patient newly diagnosed as being HIV positive . In this instance,
with the advent new treatment it is reasonable to question
whether the full syndrome of AIDS will develop , and if it does
how long it will take to occur.
indicate the typical course of an illness , regardless of whether
it can be treated effectively .there are several ways to
characterize the natural history of an illness .One
straightforward measure is the case fatality, which represents
the percentage of patients with a disease who die within a
specified observation period. For example , among the 11,740
reported adolescent and adult patients diagnosed with AIDS in
1985 in the United States , 10,946 are known to have died
before 1998 . In other words , the case fatality was 10,946
Natural history
prognostic factors.
STUDY QUESTION.
Incidence rate ?
Risk factors?
Case control study ?
Cohort study?
False positive?
False negative?
Natural history?
Median survival?
Prognostic factors?
Randomized controlled clicinal trial?
Uses of epidemiology
Community diagnosis
Epidemiology provides the facts about
community health; it describes the
nature and relative size of the problems
to be dealt with, and maps are
produced of such scales as are required
or possible. Results are sometimes
surprisingat any rate in contrast with
the type of problem of which there is
general awareness and concern in the
public health movement
Identification of syndromes
This use again relates directly to clinical
medicine. Broad descriptive clinical and
pathological categories often include
very different elements. Their different
statistical distribution, and their different
behaviour among the population, may
make it possible to distinguish such
elements from each other, and thus help
to identify characteristic syndromes.
Clues to causes
The main function of epidemiology is
to discover groups in the population
with high rates of disease, and with
low, so that causes of disease and of
freedom from disease can be
postulated.
Conclusion
Epidemiology is today the Cinderella
of the medical sciences. The
proposition might, however, be
advanced that public health needs
more epidemiology, and so does
medicine as a whole, and, it may be
said, society at large.