#4 PH 150A Jan27 Overview Study Design

#4 PH 150A Jan27 Overview Study Design - Overview of Study...

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1 Overview of Study Designs PH 150A: Introduction to Epidemiology Lecture 4 Spring 2010 2 Objectives Disease of the day Introduction to study designs http://theinfantcare.com/ 3 Why Quantify Occurrence of Disease or Health Outcome? Identify high risk groups in population for public health interventions Identify risk factors in etiological studies Compare disease occurrence between populations 4 Basic Measures of Disease Counts - absolute number of occurrences Useful for public health efforts, burden of disease Example: 12 individuals with colds in class on Wednesday Proportions - what fraction of population affected? Numerator is included in the denominator Example: 12% of class of 100 students with a cold If class size is 50, 12 individuals with colds would be 24% 5 Neural Tube Defect (NTD) Malformation of neural tube 17-30 days after conception causing serious birth defects of the spine and brain Leading cause of infantile paralysis in U.S http://cdc.gov/ 6 Major Types of NTD
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7 Human Embryo Day 22 The neural tube begins to close like a zipper from the middle toward the end. Closure will normally be complete within a week. 8 Human Embryo Day 23 The back portion is rolled into a tube called the neural tube. The lower end becomes the spine and the upper end, the brain. 9 Spina Bifida 10 Encephalocele Anencephaly 11 12 Quantifying Neural Tube Defects US (2006) 30 per 100,000 births* 18 per 100,000 Spina Bifida 11 per 100, 000 anencephaly Highest frequency worldwide**: Shanxi province, northern China 1388/100,000 * http://www.cdc.gov/nchs/data/hestat/spine_anen.htm; http://www.cdc.gov/ncbddd/folicacid/data.html **Birth defects research. Clinical and molecular teratology 2006 76:237.
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13 Risk Factors Family History Hispanics and whites of European origin; less frequent in Ashkenazi Jews, most Asian ethnic groups and African-Americans Maternal obesity Diabetes Certain medications Elevated body temperature Low maternal folate status at the time the neural tube closes 14 Vitamin Folic Acid (Folate) Dietary sources Best sources liver super-fortified cereals dried beans asparagus spinach broccoli avocados Top US sources
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