SlideShare a Scribd company logo
Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.
CHAPTER 5
Epidemiologic
Principles and
Methods
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Definition of Epidemiology
 Epidemiology is defined as “the study of the distribution and determinants of
disease frequency in human populations.”
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Step 1: Define the Disease
 Death is easy to determine.
– A death certificate states cause of death.
 A blood test or stool culture is needed to verify a diagnosis of certain diseases.
 Some diseases are hard to define.
– EMS and SARS
 Sometimes a definition changes as more is learned.
– AIDS
 Other health outcomes include injuries and risk factors.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Disease Frequency
 Count the number of people with a disease and relate that to the population at
risk (PAR).
 PAR (denominator) may be the total population or exposed population, or one
gender or age group.
– PAR often comes from a census.
 Two ways to measure frequency are:
– Incidence, the number of new cases
– Prevalence, the number of existing cases
 Incidence is used for studying causes of disease.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Disease Frequency (cont.)
 Prevalence depends on incidence and prognosis.
– If causes or risk factors increase, incidence and prevalence increase.
– If ability to diagnose increases, incidence and prevalence appear to increase.
 Prevalence rates are most useful in assessing the societal impact of a disease
and planning for healthcare services.
 Mortality rates are used to measure frequency for diseases that are often fatal.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Distribution of Disease
 Who:
– Sex, age, occupation, race, and economic status
 When:
– Looks for disease frequency over time: Season, year (long-term trends), elapsed
time since an exposure (epidemic curve)
– Is crucial in tracking an outbreak of infectious diseases such as hepatitis and
legionellosis
 Where:
– Neighborhood (e.g., clusters), latitude (climate), urban vs. rural, national variations
– Looks at comparisons of disease frequency in different countries, states, counties,
or other geographical divisions
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Determinants of Disease
 Why is distribution as it is?
 We can make inferences from distribution.
 Epidemiologists usually speak of risk factors not causes.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Human Population
 Epidemiology studies human population, usually using observational rather
than experimental methods.
 Biomedical approach uses animal models to investigate the causes of disease.
 Experiments conducted on animals can yield clear answers as to cause and
effect.
 For ethical reasons, experiments cannot usually be done on humans.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Kinds of Epidemiologic Studies
 Goal is to determine an association between an exposure and a disease or
other health outcome.
 Studies may be prospective or retrospective.
 Intervention study
 Cohort study
 Case-control study
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Intervention Study
 Epidemiologists do not perform the experiments.
– Closest thing to an experiment.
 Start with two groups:
– Experimental group (gets the intervention or exposure)
– Control group
 Watch them over time and compare outcomes.
 Experimenter chooses who is in which group.
 Two groups should be as similar as possible so that intervention is the only
difference.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Intervention Study (cont.)
 Randomized, double-blind, placebo control is ideal.
 Pharmaceutical companies conduct many clinical trials for new drugs.
 Physicians’ Health Study was a prevention study:
– Aspirin to prevent heart disease
– Beta carotene to prevent cancer
 Field trial of polio vaccine in 1954 was randomized and double-blind.
 Kingston–Newburgh study of fluoridation to prevent tooth decay was a
community trial.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Cohort Study
 Are for situations when doing an intervention study would be unethical or too
difficult.
– Considered the next most accurate
 Choose a large number of healthy people, collect data on their exposures, and
track outcomes over time.
 The only difference from intervention is that people choose their own
exposures.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Cohort Study: Examples
 Framingham Heart Study
 Nurses’ Health Study
 British study of physicians on smoking and lung cancer
 Hammond–Horn study on smoking and lung cancer in the U.S.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Case-Control Study
 Faster and cheaper are the advantages.
 This is the least accurate approach.
 It is commonly done to follow up on a hypothesis generated by shoeleather
epidemiology.
 Choose people who already have disease.
 Choose a healthy control group of individuals, as similar as possible to cases.
 Interview them all and ask for their previous exposures.
 Estimate the strength of the association between exposure and disease by
calculating an odds ratio.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 1
 What is the difference between incidence and prevalence?
 Why is incidence more useful in identifying the cause of a disease?
 When is it most useful to use prevalence?
 Give examples for each.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 2
 Explain the interaction between incidence, prevalence, and prognosis.
 Give examples.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 3
 Why are the who, when, and where questions useful in determining the causes
of disease?
 Give examples.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 4
 Explain the three major types of epidemiologic studies.
 Which is most likely to yield a valid result? Why?
 Which is likely to yield an answer in the shortest period of time? Why?
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 5
 Visit the National Institutes of Health website on clinical trials,
www.clinicaltrials.gov.
– Browse by condition.
 How many clinical trials are going on right now?
 Choose a condition and investigate what treatments are being tested for that
condition.
Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 6
 Visit the website of the Nurses’ Health Study, www.channing.harvard.edu/nhs.
 Read the most recent annual newsletter.
 What are the most recent findings of this cohort study?

More Related Content

PPTX
SAC360 Chapter 8 role of data in public health
PPTX
SAC360 Chapter 3 powers and responsibilities of government
PPTX
SAC360 Chapter 12 genetic diseases and other inborn errors
PPTX
SAC360 Chapter 2 why is public health controversial
PPTX
SAC360 Chapter 16 public health enemy number two and growing
PPTX
Diagnosis of COVID-19
PPSX
Covid 19
PPTX
Investigative options covid 19
SAC360 Chapter 8 role of data in public health
SAC360 Chapter 3 powers and responsibilities of government
SAC360 Chapter 12 genetic diseases and other inborn errors
SAC360 Chapter 2 why is public health controversial
SAC360 Chapter 16 public health enemy number two and growing
Diagnosis of COVID-19
Covid 19
Investigative options covid 19

What's hot (20)

PPTX
Corona Virus Basic Introduction
PPTX
COVID-19 Vaccination Strategies for Youth
PDF
Descriptive epidemiology
PPT
Cholera
PDF
Diagnosis and treatment recommendations for 2019 novel coronavirus - Dr Vigya...
PPTX
Covid 19
PPT
Management of opportunistic infections (o is)
PPTX
COVID-19
PDF
Introduction to epidemiology
PPT
Epidemiology.ppt
PDF
Hepatitis C
PPTX
Social determinant of health
PPTX
R0 Value & Herd Immunity
PPT
Ebola virus disease
PPTX
Epidemiology of communicable diseases
PDF
International health regulations
PDF
Silver blaze bias....................pdf
PPTX
Lesson five - Models of health
PPTX
Cholera
PPTX
Public Health Competencies
Corona Virus Basic Introduction
COVID-19 Vaccination Strategies for Youth
Descriptive epidemiology
Cholera
Diagnosis and treatment recommendations for 2019 novel coronavirus - Dr Vigya...
Covid 19
Management of opportunistic infections (o is)
COVID-19
Introduction to epidemiology
Epidemiology.ppt
Hepatitis C
Social determinant of health
R0 Value & Herd Immunity
Ebola virus disease
Epidemiology of communicable diseases
International health regulations
Silver blaze bias....................pdf
Lesson five - Models of health
Cholera
Public Health Competencies
Ad

Similar to SAC360 Chapter 5 epidemiologic principles and methods (20)

DOCX
CHAPTER 5Epidemiologic Principles and MethodsCopyrig
PPTX
SAC360 Chapter 4 epidemiology
PDF
semo2037
PPTX
SAC360 Chapter 7 statistics
PDF
Introduction to Epidemiology
PPTX
The Centers for Disease Control and Prevention
PPT
epidemiology and Diseases cause agents.ppt
DOCX
Chapter 3Public Health Data and Communications.docx
PPTX
3 forfar-full classproject
PPTX
Lecture of epidemiology
PPTX
Epidemiology Concepts
PPTX
Epidemiology of periodontal diseases By Dr. Abhishek Gaur (8741095005)
PDF
Health Inequalities Among Australians
PPTX
Lec 2 Disease Burden & Epidemiology.pptx
PPTX
Study designs
PPTX
Epidemiological study designs for paramedics.pptx
PPTX
XNN001 Introductory epidemiological concepts - Study design
PPTX
SAC360 Chapter 1 public health
PPTX
SAC366 Chapter 1 public health
PPT
EPIDEMIOLOGY POWERPOINT power point pptd
CHAPTER 5Epidemiologic Principles and MethodsCopyrig
SAC360 Chapter 4 epidemiology
semo2037
SAC360 Chapter 7 statistics
Introduction to Epidemiology
The Centers for Disease Control and Prevention
epidemiology and Diseases cause agents.ppt
Chapter 3Public Health Data and Communications.docx
3 forfar-full classproject
Lecture of epidemiology
Epidemiology Concepts
Epidemiology of periodontal diseases By Dr. Abhishek Gaur (8741095005)
Health Inequalities Among Australians
Lec 2 Disease Burden & Epidemiology.pptx
Study designs
Epidemiological study designs for paramedics.pptx
XNN001 Introductory epidemiological concepts - Study design
SAC360 Chapter 1 public health
SAC366 Chapter 1 public health
EPIDEMIOLOGY POWERPOINT power point pptd
Ad

More from BealCollegeOnline (20)

PPT
BA650 Week 3 Chapter 3 "Why Change? contemporary drivers and pressures
PPTX
BIO420 Chapter 25
PPTX
BIO420 Chapter 24
PPTX
BIO420 Chapter 23
PPTX
BIO420 Chapter 20
PPTX
BIO420 Chapter 18
PPTX
BIO420 Chapter 17
PPTX
BIO420 Chapter 16
PPTX
BIO420 Chapter 13
PPTX
BIO420 Chapter 12
PPTX
BIO420 Chapter 09
PPTX
BIO420 Chapter 08
PPTX
BIO420 Chapter 06
PPTX
BIO420 Chapter 05
PPTX
BIO420 Chapter 04
PPTX
BIO420 Chapter 03
PPTX
BIO420 Chapter 01
PPTX
BA350 Katz esb 6e_chap018_ppt
PPTX
BA350 Katz esb 6e_chap017_ppt
PPTX
BA350 Katz esb 6e_chap016_ppt
BA650 Week 3 Chapter 3 "Why Change? contemporary drivers and pressures
BIO420 Chapter 25
BIO420 Chapter 24
BIO420 Chapter 23
BIO420 Chapter 20
BIO420 Chapter 18
BIO420 Chapter 17
BIO420 Chapter 16
BIO420 Chapter 13
BIO420 Chapter 12
BIO420 Chapter 09
BIO420 Chapter 08
BIO420 Chapter 06
BIO420 Chapter 05
BIO420 Chapter 04
BIO420 Chapter 03
BIO420 Chapter 01
BA350 Katz esb 6e_chap018_ppt
BA350 Katz esb 6e_chap017_ppt
BA350 Katz esb 6e_chap016_ppt

Recently uploaded (20)

PDF
Paper A Mock Exam 9_ Attempt review.pdf.
PDF
A GUIDE TO GENETICS FOR UNDERGRADUATE MEDICAL STUDENTS
PDF
احياء السادس العلمي - الفصل الثالث (التكاثر) منهج متميزين/كلية بغداد/موهوبين
PDF
Black Hat USA 2025 - Micro ICS Summit - ICS/OT Threat Landscape
PDF
Chinmaya Tiranga quiz Grand Finale.pdf
PDF
advance database management system book.pdf
PDF
SOIL: Factor, Horizon, Process, Classification, Degradation, Conservation
PPTX
A powerpoint presentation on the Revised K-10 Science Shaping Paper
PPTX
202450812 BayCHI UCSC-SV 20250812 v17.pptx
PDF
Practical Manual AGRO-233 Principles and Practices of Natural Farming
PDF
RTP_AR_KS1_Tutor's Guide_English [FOR REPRODUCTION].pdf
PPTX
Chinmaya Tiranga Azadi Quiz (Class 7-8 )
PPTX
UNIT III MENTAL HEALTH NURSING ASSESSMENT
PDF
Weekly quiz Compilation Jan -July 25.pdf
PPTX
Tissue processing ( HISTOPATHOLOGICAL TECHNIQUE
PDF
GENETICS IN BIOLOGY IN SECONDARY LEVEL FORM 3
PPTX
Orientation - ARALprogram of Deped to the Parents.pptx
PPTX
Digestion and Absorption of Carbohydrates, Proteina and Fats
PDF
OBE - B.A.(HON'S) IN INTERIOR ARCHITECTURE -Ar.MOHIUDDIN.pdf
PDF
Supply Chain Operations Speaking Notes -ICLT Program
Paper A Mock Exam 9_ Attempt review.pdf.
A GUIDE TO GENETICS FOR UNDERGRADUATE MEDICAL STUDENTS
احياء السادس العلمي - الفصل الثالث (التكاثر) منهج متميزين/كلية بغداد/موهوبين
Black Hat USA 2025 - Micro ICS Summit - ICS/OT Threat Landscape
Chinmaya Tiranga quiz Grand Finale.pdf
advance database management system book.pdf
SOIL: Factor, Horizon, Process, Classification, Degradation, Conservation
A powerpoint presentation on the Revised K-10 Science Shaping Paper
202450812 BayCHI UCSC-SV 20250812 v17.pptx
Practical Manual AGRO-233 Principles and Practices of Natural Farming
RTP_AR_KS1_Tutor's Guide_English [FOR REPRODUCTION].pdf
Chinmaya Tiranga Azadi Quiz (Class 7-8 )
UNIT III MENTAL HEALTH NURSING ASSESSMENT
Weekly quiz Compilation Jan -July 25.pdf
Tissue processing ( HISTOPATHOLOGICAL TECHNIQUE
GENETICS IN BIOLOGY IN SECONDARY LEVEL FORM 3
Orientation - ARALprogram of Deped to the Parents.pptx
Digestion and Absorption of Carbohydrates, Proteina and Fats
OBE - B.A.(HON'S) IN INTERIOR ARCHITECTURE -Ar.MOHIUDDIN.pdf
Supply Chain Operations Speaking Notes -ICLT Program

SAC360 Chapter 5 epidemiologic principles and methods