Epi Exam 1 Study guide - Lecture 1 Scope and History of...

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Lecture 1: Scope and History of Epidemiology Epidemiology: study of disease patterns and distribution at a population level Two main goals: Improve our understanding of casual factors Once understood, intervention Development of Epidemiology Recognition of a biologic basis of disease Systematic methods for describing and summarizing disease Quantitative assessment of disease Hippocrates Father of Medicine & 1 st Epidemiologist Described diseases from a rational rather than supernatural basis John Graunt One of the founding members of Royal Society of London First to employ statistics in the study of disease Created mortality tables William Farr Developed modern vital statistics system Developed method for coding medical conditions, served as foundation for today’s International Classification Disease system John Snow Conducts first modern outbreak investigation (Cholera in London) Snow disagreed with common view that disease transmitted through bad air or ‘vapors’ called miasmata Snow’s investigation included: door-to-door interviews, created maps to describe death patterns, revolved Broad street pump handle Turned out that Southwark & Vauxhall’s water supply was contaminated & caused the cholera outbreak Snow wasn’t believed for many years Significance of Snow’s work o Charted frequency & distribution of the cholera outbreak o Used systematic methods to determine a cause of cholera o Laid ground work for descriptive and analytic epidemiology Infectious diseases were the focus of the bacteriological revolution U.S. National Cancer Institute founded in 1937 Framingham Study (MA, 1948-present) Cohort study to evaluate risk factors for coronary heart disease Started with a defined population of exposed & unexposed people, and watch for the development of disease or other outcomes over time Gave us much of what we know today about heart disease
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Doll & Hill Study Case-control design used to study lung cancer & cigarette smoking in British physicians o Compared 1465 cases with 1465 controls Main findings: smokers had increased lung cancer death rates compared to non-smokers Lecture 2-Basic Outcome measures Rate: type of ratio which consists of a numerator & a denominator calculated in units of time Risk vs. Rate Risk describes the chance of having an event (probability) Rate describes the number of events that occurs per unit of time (velocity) o
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