Essentials of Epidemiology in Public Health

Cover......Page 1
Essentials of Epidemiology in Public Health......Page 2
Copyright......Page 3
Contents......Page 4
Preface......Page 8
Acknowledgments......Page 12
Introduction......Page 14
Definition and Goals of Public Health......Page 15
Sources of Scientific Knowledge in Public Health......Page 16
Definition and Objectives of Epidemiology......Page 18
Historical Development of Epidemiology......Page 21
Modern Epidemiology......Page 40
Summary......Page 42
References......Page 43
Chapter Questions......Page 44
Introduction......Page 46
Definition of a Population......Page 47
Definitions of Health and Disease......Page 49
Changes in Disease Definitions......Page 50
Measuring Disease Occurrence......Page 52
Types of Calculations: Ratios, Proportions, and Rates......Page 53
Measures of Disease Frequency......Page 54
Commonly Used Measures of Disease Frequency in Public Health......Page 64
Summary......Page 65
References......Page 66
Chapter Questions......Page 67
Introduction......Page 70
Data Organization......Page 71
Measures of Comparison......Page 74
Direct Standardization......Page 82
Summary......Page 85
Chapter Questions......Page 86
Introduction......Page 90
Census of the U.S. Population......Page 91
Vital Statistics......Page 92
National Health Interview Survey......Page 97
Behavioral Risk Factor Surveillance System......Page 98
National Health Care Surveys......Page 99
Surveillance of HIV Infection......Page 100
Reproductive Health Statistics......Page 101
Survey of Occupational Injuries and Illnesses......Page 102
Air Quality System......Page 103
Birth Defects Surveillance and Research Programs......Page 104
World Health Statistics......Page 105
Other Resources......Page 106
Summary......Page 107
References......Page 109
Chapter Questions......Page 110
Introduction......Page 112
Person......Page 113
Place......Page 115
Time......Page 117
Disease Clusters and Epidemics......Page 118
Ebola Outbreak and Its Investigation......Page 123
Generating Hypotheses About Causal Relationships......Page 129
Public Health Planning and Evaluation......Page 130
Example: Patterns of Mortality in the United States According to Age......Page 131
Overall Pattern of Mortality......Page 134
Examples: Three Important Causes of Morbidity in the United States......Page 142
Summary......Page 157
References......Page 158
Chapter Questions......Page 163
Introduction......Page 166
Overview of Experimental Studies......Page 169
Overview of Cohort Studies......Page 172
Overview of Case–Control Studies......Page 176
When Is It Desirable to Use a Particular Study Design?......Page 181
Other Types of Studies......Page 183
Summary......Page 190
References......Page 191
Chapter Questions......Page 192
Introduction......Page 194
Overview of Experimental Studies......Page 195
Types of Experimental Studies......Page 198
Study Population......Page 203
Sample Size......Page 204
Treatment Assignment......Page 205
Use of the Placebo and Masking......Page 209
Maintenance and Assessment of Compliance......Page 210
Ascertaining the Outcomes......Page 213
Data Analysis......Page 215
Special Issues in Experimental Studies......Page 218
References......Page 220
Chapter Questions......Page 222
Introduction......Page 224
Cohort Study Definitions and Overview......Page 225
Types of Populations Studied......Page 226
Follow-Up and Outcome Assessment......Page 228
Timing of Cohort Studies......Page 229
Issues in the Selection of Cohort Study Populations......Page 231
Sources of Information......Page 237
Analysis of Cohort Studies......Page 242
Special Types of Cohort Studies......Page 244
Strengths and Limitations of Cohort Studies......Page 245
Summary......Page 246
References......Page 247
Chapter Questions......Page 248
Introduction......Page 250
The Changing View of Case–Control Studies......Page 251
When Is It Desirable to Use the Case–Control Method?......Page 255
Selection of Cases......Page 257
Selection of Controls......Page 260
Sources of Exposure Information......Page 265
Analysis of Case–Control Studies......Page 268
The Case–Crossover Study: A New Type of Case–Control Study......Page 271
Applications of Case–Control Studies......Page 273
Strengths and Limitations of Case–Control Studies......Page 274
Summary......Page 275
References......Page 276
Chapter Questions......Page 278
Introduction......Page 280
Overview of Bias......Page 281
Selection Bias......Page 283
Information Bias......Page 291
Summary......Page 304
Chapter Questions......Page 305
Definition and Examples of Confounding......Page 308
Confounding by Indication and Severity......Page 314
Controlling for Confounding in the Design......Page 315
Controlling for Confounding in the Analysis......Page 318
Residual Confounding......Page 322
Assessment of Mediation......Page 323
Summary......Page 324
References......Page 325
Chapter Questions......Page 326
Introduction......Page 328
History of Biostatistics in Public Health......Page 329
Precision......Page 330
Sampling......Page 332
Hypothesis Testing and P Values......Page 333
Confidence Interval Estimation......Page 339
P-Value Function......Page 342
Probability Distributions......Page 343
Hypothesis-Testing Statistics......Page 349
Confidence Intervals for Measures of Disease Frequency and Association......Page 352
Sample Size and Power Calculations......Page 358
Summary......Page 359
References......Page 361
Chapter Questions......Page 362
Introduction......Page 364
Definitions and Terms for Effect Measure Modification......Page 365
Effect Measure Modification Versus Confounding......Page 366
Evaluation of Effect Measure Modification......Page 367
Synergy and Antagonism......Page 372
Choice of Measure......Page 373
Evaluating Effect Measure Modification and Confounding in Stratified Analyses......Page 374
Summary......Page 375
Chapter Questions......Page 376
Introduction......Page 380
Guide to Answering the Critique Questions......Page 382
Sample Critiques of Epidemiological Studies......Page 391
References......Page 404
Introduction......Page 406
Definitions of a Cause......Page 408
Characteristics of a Cause......Page 410
Risk Factors Versus Causes......Page 411
Historical Development of Disease Causation Theories......Page 412
Hill’s Guidelines for Assessing Causation......Page 415
Use of Hill’s Guidelines by Epidemiologists......Page 420
Sufficient-Component Cause Model......Page 421
Why Mainstream Scientists Believe That HIV Is the Cause of HIV/AIDS......Page 424
Summary......Page 427
References......Page 428
Chapter Questions......Page 429
Introduction......Page 432
Natural History of Disease......Page 433
Definition of Primary, Secondary, and Tertiary Prevention......Page 434
Appropriate Diseases for Screening......Page 436
Characteristics of a Screening Test......Page 439
Lead Time......Page 443
Predictive Value: A Measure of Screening Program Feasibility......Page 444
Bias......Page 447
Selecting an Outcome......Page 450
Study Designs to Evaluate Screening Programs......Page 451
Examples of the Effect of Screening on Public Health......Page 453
Summary......Page 455
References......Page 457
Chapter Questions......Page 458
Introduction......Page 462
Historical Perspective......Page 463
International Ethical and Research Practice Guidelines......Page 470
The U.S. Regulatory Framework for Human Subjects Research......Page 471
Contemporary Examples......Page 473
The Informed Consent Process......Page 474
References......Page 479
Chapter Questions......Page 480
Chapter 18 Answers to Chapter Questions (Chapters 1–17)......Page 482
Glossary......Page 506
Index......Page 516