Epidemiology For Dummies

Title Page
Copyright Page
Table of Contents
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond This Book
Where to Go from Here
Part 1 Getting Started with Epidemiology
Chapter 1 Entering the World of Epidemiology
Introducing Epidemiology
Recognizing How Numbers Can Help Study Disease
Grappling with the epidemiologic triangle
Classifying epidemiology
Understanding epidemiologic transition
Connecting demography and disease
Figuring out rates and risks
Focusing on Prevention Rather Than a Cure
Identifying prevention levels
Using vaccines
Surveilling disease
Studying an outbreak
Relying on screening
Delving into Study Finding
Figuring Out What You Know about Epidemiology: Some Q&As
Chapter 2 Epidemiology 101 — Understanding the Basics
Defining Epidemiology — What to Expect from Your Coursework and Beyond
Describing distribution
Determining determinants
Avoiding errors when conducting an epidemiological study
Realizing Why Epidemiology Is Important
Identifying and measuring health status
Focusing on disease prevention
Searching for causes
Controlling epidemics
Understanding How Epidemiology Tools Are Applied
Using epidemiologic methods to identify risks
Measuring morbidity and mortality
Describing the impact of an intervention
Preventing diseases before they hit
Investigating epidemics of unknown cause
Evaluating public health programs
Quality assurance
Quality control
Contrasting the Roles of a Physician and Epidemiologist
Eyeing the differences
Helping people
Describing diseases differently
Grasping the difference between acute and chronic disease
Seeking Medications
Eyeing over-the-counter (OTC) and prescription medication
Examining the role of traditional healers
Considering How a Disease Is Transmitted
Defining key infection terms
Spreading infection of an outbreak from person to person
Getting infection of an outbreak from a common source
Relating infections with cancers
Searching for Sources of Epidemiologic Data
From the Centers for Disease Control and Prevention (CDC)
From the National Center for Health Statistics (NCHS)
From the World Health Organization (WHO)
From census data
From the Vital Statistics System
Chapter 3 Exploring the Development of Epidemiological Thinking
Meeting Hippocrates — the First Epidemiologist
Observing “airs, waters, and places”
Relating diseases to polluted water
Tackling the Miasma Theory
Believing in bad air
Getting benefits from a misconception
Examining Contributions to Medicine and Public Health – Thomas Sydenham
Using Concepts of Environmental Epidemiology — Noah Webster
The Germ Theory — Washing Hands Is Essential
Hieronymous Fracastorius
Edward Jenner
Louis Pasteur
Robert Koch
Working on Workers’ Diseases — Bernardino Ramazzini
The Birth of Vital Statistics: No Labor Pains Involved
John Graunt
William Farr
Examining the Start of Epidemiology and Public Health in the United States
Wade Hampton Frost
Alice Hamilton
William Sedgwick
Lemuel Shattuck
Stephen Smith
Lillian Wald
Benjamin Waterhouse
Developing public health institutes
Reforming Public Health in England
Deteriorating health after the Industrial Revolution
Moving toward sanitary reforms
Looking At Modern Epidemiology
Field epidemiology
Molecular and genetic epidemiology
Chapter 4 Eyeing the Milestones in Public Health
Finding the Treatment of Scurvy — James Lind
Enquiring into the diet
Examining Lind’s experiment
Discovering Sources of Cholera in London’s Golden Square — John Snow
Questioning the miasma theory
Suspecting a hand pump
Mapping cases and deaths
Removing the handle
Uncovering Causes of Pellagra — Joseph Goldberger
Suggesting pellagra not communicable
Connecting pellagra with poverty and helping with diet
Describing the 1918 Influenza Pandemic
Gathering mortality data of the pandemic
Controlling the pandemic
Eradicating Smallpox
Finding Smoking as a Cause of Lung Cancer
Looking at early studies
Recognizing what chemicals in cigarette cause cancers
Feeling the Beat of the Framingham Heart Study
Chapter 5 Recognizing Diseases and Controlling Them
Identifying the Modes of Transmission
Eyeing the Chain of Infection: Can You Break It?
Classifying reservoirs
Discovering what carriers are
Inapparent infections
Convalescent carriers
Chronic carriers
Incubatory carriers
Recognizing a susceptible host
Focusing on the portals of exit
Examining the Natural History of Disease
Describing the nature of infectious diseases
Passing through the stages
Stage of susceptibility
Stage of subclinical disease
Stage of clinical disease
Stage of recovery, disability, or death
Listing Common Notifiable Diseases
Controlling Waterborne Diseases
Naming common waterborne diseases
Taking steps in controlling waterborne diseases
Tackling Problems of Airborne Infections
Recognizing common airborne infections
Controlling airborne infections
Curving Vector-Borne Diseases
Listing common vector-borne diseases
Finding ways to combat vector-borne diseases
Limiting Parasitic Infections
Identifying common parasitic infections
Taking steps to control parasitic infections
Controlling Sexually Transmitted Infections
Listing common STIs
Carrying out control measures for STIs
Dealing With Emerging Infectious Diseases
Finding common emerging infections
Controlling emerging infections
Identifying Diseases Caused by Heavy Metals
Part 2 Understanding Disease Causation
Chapter 6 Tackling the Epidemiologic Triangle
Scrutinizing an Acute Disease Model
Examining agent factors
Considering host factors
Looking at environment factors
Inspecting a Chronic Disease Model
Understanding How Climate Change Can Affect Health
Linking climate change with infectious diseases
Finding vector-borne diseases related to climate change
Managing malaria
Controlling and preventing malaria
West Nile disease: Not going west
Dealing with dengue
Challenging Chikungunya
Chapter 7 Inspecting Descriptive Epidemiology: Person, Place, and Time
Knowing Person Factors
Age — More than just a number
Gender — Battle of the sexes
Looking at how cultural gender differences play a role
Recognizing the differences in genders
Race/ethnicity — Inequalities exist
Occupation — A person’s job matters
Coal miners’ disease
Meniere’s disease
Carpal tunnel syndrome
Farmer’s lung
Income — Money makes the world go ’round
Education — Knowledge is power
Focusing on Place Factors
Spot mapping
Using GIS
Checking Time Factors
Defining endemic diseases
Finding sporadic diseases
Discovering epidemics
Considering pandemics
Looking at epizootic diseases
Changing patterns by seasonality
Differentiating between outbreak and cluster
Chapter 8 Viewing Disease Patterns
Defining the Epidemiologic Transition
Seeing how leading causes of death have changed
Considering causes of death in the world
Transitioning stages in some developing countries
Grasping Why Epidemiologic Transition Happens
Studying Some Chronic Health Conditions
Hypertension
Naming the four categories of hypertension
Identifying risk factors of having hypertension
Considering the causes of hypertension
Managing hypertension
Cholesterol and cardiovascular diseases
Assessing risks — American Heart Association Guideline for LSS
Controlling CVDs
Diabetes
Understanding how diabetes can lead to hypertension
Managing diabetes
Obesity
Understanding How Epidemiologic Transition Affects Healthcare
Increasing healthcare cost
Compromising quality of life
Chapter 9 Linking Demography and Disease
Defining Demography — Why It’s Important
Using Demographic Data to Identify Population at Risk
Using census data
Focusing on population density
Finding demographic data
Tackling Population Pyramids: Not the Ones in Egypt
Shaping population pyramids
Calculating the dependency ratio
Projecting Population – Simple Math
Calculating population
Working out some exercises
Exercise 1
Exercise 2
Projecting more populations
Canada
India
The United States
Chapter 10 Digging into Math: Calculating Rates and Risks
Addressing Some Basics When Calculating Descriptive Epidemiology
Recognizing the key elements of a formula
Focusing on rate, ratio, and proportion
Rate — The frequency a disease or event occurs
Ratio — The relation between two amounts
Proportion — A comparison of a part in a whole
Calculating Crude Morbidity and Crude Mortality Rates
Focusing on the terms and formulas
Mid-year population
Crude birth rate (CBR)
Crude death rate (CDR)
Doing the math
Figuring Out Commonly Used Rates
Infant mortality rate (IMR)
Maternal mortality rate (MMR)
Neonatal mortality rate (NNMR)
Post-neonatal mortality rate (PNNMR)
Perinatal mortality rate
Cause-specific mortality rate
Cancer and heart disease deaths
Homicide rates
Colorectal cancer incidence
Gender-specific rates
Prostatic cancer rates
Female breast cancer incidence and mortality
Cervical cancer incidence and mortality rates
Age-specific rates
Hospitalization rate due to rotavirus diarrhea in children
Alzheimer’s disease among seniors
Proportionate mortality rate
Case fatality rate
Measuring Incidence and Prevalence
Standardizing Rates
Using the direct method
Utilizing the indirect method
Part 3 Prevention Is Better Than a Cure
Chapter 11 Focusing on the Levels of Prevention
Identifying Primary Prevention
Combating diseases by vaccines
Giving health education
Taking prenatal care
Assuring proper nutrition
Providing safe water, sanitation, and hygiene (WASH)
Recognizing Secondary Prevention
Examining Tertiary Prevention
Limiting any disability
Providing rehabilitation
Chapter 12 Preventing Disease with Vaccine
Getting the Lowdown on Immunity
Understanding the body’s immune system
Bone marrow
Spleen
Thymus
Tonsils and lymph nodes
Mucus membranes
Skin
Comparing natural and acquired immunity
Comparing active and passive immunity
Natural passive immunity
Artificial active immunity
Natural active immunity
Artificial passive immunity
Planning Shots for Children, from Birth through Adolescence
Looking Closer at Cancer-Preventing Vaccines
Identifying cancer-causing viruses
Human papillomaviruses (HPVs)
Hepatitis B and hepatitis C viruses
Human immunodeficiency virus (HIV) and cancer risk
Epstein-Barr virus (EBV)
Human herpes virus 8 (HHV-8)
Rarer types of viruses
Cancer-causing bacteria
Cancer-causing parasites
Identifying Common Vaccine-Preventable Diseases
Measles
Mumps
Rubella
Diphtheria
Whooping cough
Tetanus
Polio
Rotavirus
Covid-19
Chickenpox
Shingles
Hib
Preventing Disease for World Travelers
Vaccinating for cholera
Protecting from malaria
Avoiding hepatitis
Knowing about the yellow fever vaccine
Chapter 13 Recognizing Methods of Disease Surveillance
Differentiating between Survey, Surveillance, and Monitoring
Survey — Making a single observation
Surveillance — Tracking continuously
Monitoring — Periodically checking
Defining the Types of Surveillance
Active surveillance
Passive surveillance
Sentinel surveillance
Conducting Surveillance: The How-to
Chapter 14 Investigating an Outbreak
Conducting an Epidemic Investigation
Classifying epidemics
Understanding the threshold level of an outbreak
Planning for field investigation
Creating a rapid response team
Having the adequate resources
Digging Out Cases by Surveillance, Step-by-Step
Establishing the existence of an outbreak
Verifying the diagnosis with data
Identifying new and ongoing cases
Intensifying the existing surveillance system
Performing descriptive epidemiology
Using analytical statistics to calculate the attack rates
Developing a hypothesis
Evaluating the hypothesis
Implementing control measures
Reporting the findings
Using Makeshift Hospitals
Walking through an Outbreak Investigation
Chapter 15 Identifying Disease by Screening
Defining Screening
Identifying the detectable preclinical phase (DPCP)
Understanding lead time
Naming Ingredients of a Good Screening Test
Focusing on disease characteristics
Noting effective test characteristics
Explaining validity and reliability
Looking Closer at Some Common Screening Programs
Mammogram
Breast self-exam
Pap smear
Colonoscopy
Prostate-specific antigen (PSA)
Tuberculin test
Fecal occult blood test
Screening newborn babies
Evaluating Screening Tests
Being familiar with key terms
Comprehending sensitivity
Looking at specificity
Predictive values
Total agreement of the test
Putting these statistics together in one example
Predicting predictive value with changes in prevalence
Explaining multiphasic screening
Differentiating between mass screening and selective screening
Selecting a cutoff point
Part 4 Examining a Study Finding
Chapter 16 Figuring Out Whether an Association Is Causal
Establishing Causality
Examining an association that may not be causal
Identifying confounders that affect a causal link
Seeing examples of a causal effect
BMI and type 2 diabetes
Cigarette smoking and lung cancer
Prostate cancer and race
Exploring a multifactorial model
Understanding Hill’s Criteria for Causality
Examining strength of association
Considering dose-response
Grasping temporality
Focusing on specificity
Striving for consistency
Explaining biological plausibility
Contemplating coherence
Conducting more experimentation
Finding analogies
Making Rothman’s Causal Pie
Knowing what a sufficient cause means
Understanding a necessary cause
Defining component causes
Getting into contributory cause
Chapter 17 Investigating the Types of Epidemiologic Studies
Looking At the Anatomy of Epidemiologic Studies
Observing observational studies
Experimenting experimental studies
Using the hierarchy of study design
Differentiating between retrospective and prospective studies
Conducting a Cross-Sectional Study
Identifying the pros and cons
Formulating a cross-sectional study
Plotting a Case-Control Study
Selecting a suitable control
Sources of cases
Sources of controls
Number of controls
Counting the pros and cons
Putting together a case-control study
Measuring association
Nesting a nested case-control study
Leading a Cohort Study
Identifying the three types of cohorts
Prospective cohort
Retrospective cohort
Mixed cohort
Recognizing the pros and cons
Devising a prospective cohort study
Figuring Out an Ecological Study
Knowing what ecological fallacy is
Focusing on the pros and cons
Looking at examples of ecological studies
Developing a Questionnaire
Creating an efficient questionnaire
Using closed and open-ended questions
Knowing what else to include
Chapter 18 Encountering Bias and Confounding
Defining Bias
Clarifying What Confounding Means
Reviewing Bias-Affecting Research Findings
Examining and avoiding selection bias
Eyeing and avoiding information bias
Recall bias
Interviewer bias
Recognizing and avoiding instrument bias
Understanding response bias
Noticing and avoiding lead time bias
Identifying and avoiding publication bias
Steering Clear of Bias in the Initial Stages of Research
Designing the study
Blinding
Controlling for Confounders
Addressing during the design phase
Assigning treatment by randomization
Utilizing restriction
Matching
Focusing on confounders during analysis
Utilizing standardization
Using stratification
Conducting multivariate analyses
Chapter 19 Focusing On Ethics in Health Research
Comprehending the Evolution of Ethical Norms in Research
Looking into cases of scientific misconduct
Examining some unethical practices in the past
The Nazi medical experiments
The Tuskegee Syphilis Study
The Willowbrook study
The Jewish Chronic Disease Hospital study
Responding to unethical studies
The Nuremberg Code of Ethics
The Declaration of Helsinki
The National Commission for the Protection for Human Subjects
The Belmont Report
Grasping the Importance of a Code of Ethics
Respecting persons
Ensuring beneficence
Providing justice
Using Informed Consent
Including this essential information
Using an expedited review
Waiving the informed consent
Part 5 The Part of Tens
Chapter 20 Ten Careers with a Degree in Epidemiology
Epidemiologist
Environmental Epidemiologist
Surveillance Data Analyst and Epidemiologist
Infection Control Officer
Research Scientist
Research Associate
Data Analyst
Program Manager
Chief Medical/Quality Officer
Data and Research Coordinator
Chapter 21 Ten Tips for Acing Your Epidemiology Classes
Ask and Answer Questions in Class
Practice, Practice, and Practice
Take Good Class Notes
Get Information Online
Apply the Knowledge
Make a Cheat Sheet
Use a Scientific Calculator
Memorize Some Definitions and Steps
Get Involved in Research
Participate in Group Work
Glossary
Index
EULA