IIHE Education, Epidemiology I Notes
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Introduction to Epidemiologic Concepts and Measures

Objectives of Session

1. Residents will become familiar with definition and purpose of epidemiology.
2. Residents will learn about disease pattern trends and subpopulations at increased risk.
3. Residents will learn about measures of association used in epidemiology.

Outline

1. Introduction
   • Epidemiology defined
     • Assumptions
     • Components
     • Epidemiologic reasoning
   • Historical perspective
   • Changing patterns of morbidity and mortality
   • Urban health
2. Epidemiologic Measures
   • Proportions, ratios and rates
   • Measures of disease frequency
     • Prevalence
     • Incidence
   • Measures of association
     • 2 x 2 tables
     • Relative risk
     • Odds ratios
     • Attributable risk/Population attributable risk

Study Questions

1. 1. The study of epidemiology is focused on the distribution and determinants of diseases in the human population.
   1. True 
   2. False
2. 2. The basic assumptions of the study of epidemiology are that:
   1. Diseases are contagious 
   2. Diseases occur randomly
   3. have both causal and preventive factors
   4. Both a and b
3. Infectious diseases as major causes of death have been eliminated because of all of the following except:
   1. Improvements in sanitation and water supply
   2. Availability of effective vaccines
   3. Improvements in diagnostic radiology
   4. Availability of antibiotics
4. The increase in life expectancy experienced in the U.S. over the last century is largely due to improvement in diagnostic technologies.
   1. True
   2. False
5. Describe how changing patterns of morbidity and mortality have impacted the field of epidemiology. Have these trends impacted primary care medicine? If yes, briefly describe.
    
    
    
    
    
   
6. If the population receiving care at an urban clinic consisted of 1,200 patients of whom 450 were pediatric, what proportion of the population is pediatric?
   1. Not enough information to calculate
   2. 42.5%
   3. 37.5%
   4. 62.5%
7. 7. If there were 21,533 deaths in 1997 in a population of 1,800,000 what would the overall mortality rate be?
   1. Not enough information to calculate
   2. 1196 per 100,000
   3. 120 per 100,000
   4. 119 per 1,000
8. If 780 persons within a clinic practice population of 6,000 total patients have a history of depression, the lifetime prevalence of depression in that population would be:
   1. 13 per 1,000
   2. 13 %
   3. 7.7 %
   4. Not enough information to calculate
9. Prevalence is affected by:
   1. Recovery
   2. Death
   3. Migration
   4. All of the above
10. Prevalence may be biased and appear to be on the increase if advancements in treatment improve survival.
    1. True
    2. False
11. If 330 new cases of prostate cancer are diagnosed in 1998 in a population of 60,000 men, the cumulative incidence rate of prostate cancer in this population is:
    1. 5.5 cases per 100
    2. 5.5 cases per 1,000
    3. .0055 per 1,000
    4. Not enough information to calculate
12. Incidence density allows for varying periods of observation because the denominator is based on the sum of person-time of a study population.
    1. True
    2. False
13. If there were 43 new cases of TB diagnosed in a total of 1,000,000 person-years at risk, the incidence density of TB in this population would be:
    1. 4.3 cases / 1,000,000
    2. 43 cases / 100,000
    3. 4.3 %
    4. 4.3 cases / 100,000
14. A measure of overall risk of dying is the:
    1. Incidence rate
    2. Prevalence rate
    3. Mortality rate
    4. Morbidity
15. 15. If 65 people die of lung cancer in 1998 from a population of 120 persons diagnosed with lung cancer, the case-fatality rate would be:
    1. 54.2%
    2. 5.4
    3. 65 %
    4. Not enough information to calculate
16. If 60 people attending a meeting at a local hotel become ill with diarrhea and vomiting following the meeting out of a total of 95 attendees, the attack rate of diarrhea and vomiting would be:
    1. 67 %
    2. 75 / 100 attendees
    3. 63.2 %
    4. Not enough information to calculate
17. Considering your practice population, describe a prevalent condition that you would like to target for risk reduction. Describe the measures you would use to reduce the risk of disease or improve the outcome.
      
     
     
     
     

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