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Epidemiological Methods
The science of epidemiology has matured significantly from the times of Hippocrates, Semmelweis and John Snow. The techniques for gathering and analyzing epidemiological data vary depending on the type of disease being monitored but each study will have overarching similarities. Outline of the process of an epidemiological study # Establish that a problem exists #* Full epidemiological studies are expensive and laborious undertakings. Before any study is started, a case must be made for the importance of the research. # Confirm the homogeneity of the events #* Any conclusions drawn from inhomogeneous cases will be suspicious. All events or occurrences of the disease must be true cases of the disease. # Collect all the events #* It is important to collect as much information as possible about each event in order to inspect a large number of possible risk factors. The events may be collected from varied methods of epidemiological study or from censuses or hospital records. #* The e ...
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Hippocrates
Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, or the formulation of humoral theory. The Hippocratic school of medicine revolutionized ancient Greek medicine, establishing it as a discipline distinct from other fields with which it had traditionally been associated (theurgy and philosophy), thus establishing medicine as a profession. However, the achievements of the writers of the Hippocratic Corpus, the practitioners of Hippocratic medicine, and the actions of Hippocrates himself were often conflated; thus very little is known about what Hippocrates actually t ...
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Point Prevalence
In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number of people found to have the condition with the total number of people studied and is usually expressed as a fraction, a percentage, or the number of cases per 10,000 or 100,000 people. Prevalence is most often used in questionnaire studies. Difference between prevalence and incidence Prevalence is the number of disease cases ''present ''in a particular population at a given time, whereas incidence is the number of new cases that ''develop '' during a specified time period. Prevalence answers "How many people have this disease right now?" or "How many people have had this disease during this time period?". Incidence answers "How many people acquired the disease uring a specified time period". However, mathematically, prevalence is propor ...
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Mortality Rate
Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of deaths per 1,000 individuals per year; thus, a mortality rate of 9.5 (out of 1,000) in a population of 1,000 would mean 9.5 deaths per year in that entire population, or 0.95% out of the total. It is distinct from "morbidity", which is either the prevalence or incidence of a disease, and also from the incidence rate (the number of newly appearing cases of the disease per unit of time). An important specific mortality rate measure is the crude death rate, which looks at mortality from all causes in a given time interval for a given population. , for instance, the CIA estimates that the crude death rate globally will be 7.7 deaths per 1,000 people in a population per year. In a generic form, mortality rates can be seen as calculated using (d/ ...
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Infectivity
In epidemiology, infectivity is the ability of a pathogen to establish an infection. More specifically, infectivity is a pathogen's capacity for horizontal transmission — that is, how frequently it spreads among hosts that are not in a parent–child relationship. The measure of infectivity in a population is called incidence. Infectivity has been shown to positively correlate with virulence, in plants. This means that as a pathogen's ability to infect a greater number of hosts increases, so does the level of harm it brings to the host. A pathogen's infectivity is subtly but importantly different from its transmissibility, which refers to a pathogen's capacity to pass from one organism to another. See also * Basic reproduction number In epidemiology, the basic reproduction number, or basic reproductive number (sometimes called basic reproduction ratio or basic reproductive rate), denoted R_0 (pronounced ''R nought'' or ''R zero''), of an infection is the expected numb ...
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Virulence
Virulence is a pathogen's or microorganism's ability to cause damage to a host. In most, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host. The pathogenicity of an organism—its ability to cause disease—is determined by its virulence factors. In the specific context of gene for gene systems, often in plants, virulence refers to a pathogen's ability to infect a resistant host. The noun ''virulence'' derives from the adjective ''virulent'', meaning disease severity. The word ''virulent'' derives from the Latin word ''virulentus'', meaning "a poisoned wound" or "full of poison." From an ecological standpoint, virulence is the loss of fitness induced by a parasite upon its host. Virulence can be understood in terms of proximate causes—those specific traits of the pathogen that help make the host ill—and ultimate causes—the evolutionary pressures that lead to virulent traits occurring in a pathogen strain. Virulent ba ...
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Percent Attributable Risk
In epidemiology, attributable fraction among the exposed (AFe) is the proportion of incidents in the exposed group that are attributable to the risk factor. The term attributable risk percent among the exposed is used if the fraction is expressed as a percentage. It is calculated as AF_e = (I_e - I_u)/I_e = (RR - 1) / RR, where I_e is the incidence in the exposed group, I_u is the incidence in the unexposed group, and RR is the relative risk. It is used when an exposure increases the risk, as opposed to reducing it, in which case its symmetrical notion is preventable fraction among the unexposed. Synonyms Multiple synonyms of AFe are in use: attributable fraction, relative attributable risk, attributable proportion among the exposed, and attributable risk among the exposed. Similarly, attributable risk percent (ARP) is used as a synonym for the attributable risk percent among the exposed. In climatology, fraction of attributable risk (FAR) is used to denote a proportion of adv ...
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Attributable Risk
In epidemiology, attributable risk or excess risk is a term synonymous to risk difference, that has also been used to denote attributable fraction among the exposed and attributable fraction for the population. See also * Population Impact Measures Population impact measures (PIMs) are biostatistical measures of risk and benefit used in epidemiological and public health research. They are used to describe the impact of health risks and benefits in a population, to inform health policy. Fre ... References {{Medical research studies Epidemiology ...
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Absolute Risk Reduction
The risk difference (RD), excess risk, or attributable risk is the difference between the risk of an outcome in the exposed group and the unexposed group. It is computed as I_e - I_u, where I_eis the incidence in the exposed group, and I_u is the incidence in the unexposed group. If the risk of an outcome is increased by the exposure, the term absolute risk increase (ARI) is used, and computed as I_e - I_u. Equivalently, if the risk of an outcome is decreased by the exposure, the term absolute risk reduction (ARR) is used, and computed as I_u - I_e. The inverse of the absolute risk reduction is the number needed to treat, and the inverse of the absolute risk increase is the number needed to harm. Usage in reporting It is recommended to use absolute measurements, such as risk difference, alongside the relative measurements, when presenting the results of randomized controlled trials. Their utility can be illustrated by the following example of a hypothetical drug which reduces the ...
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Hazard Ratio
In survival analysis, the hazard ratio (HR) is the ratio of the hazard rates corresponding to the conditions characterised by two distinct levels of a treatment variable of interest. For example, in a clinical study of a drug, the treated population may die at twice the rate per unit time of the control population. The hazard ratio would be 2, indicating higher hazard of death from the treatment. A scientific paper might utilise a Hazard Ratio (HR) to state something as follows. "Adequate COVID-19 vaccination status was associated with significantly decreased risk for the composite of severe COVID-19 or mortality with a HR of 0.20 (95% CI, 0.17-0.22)." In layman's English, this means: People in the study who were vaccinated were 20% as likely to get severe Covid-19 or to die, compared to people who weren't vaccinated in the same study. So, for a hazardous outcome (e.g. death), a Hazard Ratio below 1 indicates that the treatment (e.g. vaccination) might be favorable (less hazardous ...
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Odds Ratio
An odds ratio (OR) is a statistic that quantifies the strength of the association between two events, A and B. The odds ratio is defined as the ratio of the odds of A in the presence of B and the odds of A in the absence of B, or equivalently (due to symmetry), the ratio of the odds of B in the presence of A and the odds of B in the absence of A. Two events are independent if and only if the OR equals 1, i.e., the odds of one event are the same in either the presence or absence of the other event. If the OR is greater than 1, then A and B are associated (correlated) in the sense that, compared to the absence of B, the presence of B raises the odds of A, and symmetrically the presence of A raises the odds of B. Conversely, if the OR is less than 1, then A and B are negatively correlated, and the presence of one event reduces the odds of the other event. Note that the odds ratio is symmetric in the two events, and there is no causal direction implied (correlation does not imply causat ...
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