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Lecture 2 Block 1.1 Introduction To Epidemiology

This document provides an introduction and overview of epidemiology. It defines epidemiology as the study of health problems and disease in human populations. The history of epidemiology is traced back to Hippocrates and important figures like John Snow and Doll and Hill. Epidemiology is used to assess community health, make individual decisions, and complete clinical pictures. Descriptive epidemiology examines person, time and place factors to describe disease distribution and frequency. Analytical epidemiology focuses on determining causes through study designs like cross-sectional, case-control and cohort studies. Causation is assessed using criteria like temporal sequence, strength of association and biological plausibility. The agent-host-environment model and concepts of sufficient, component and

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69 views

Lecture 2 Block 1.1 Introduction To Epidemiology

This document provides an introduction and overview of epidemiology. It defines epidemiology as the study of health problems and disease in human populations. The history of epidemiology is traced back to Hippocrates and important figures like John Snow and Doll and Hill. Epidemiology is used to assess community health, make individual decisions, and complete clinical pictures. Descriptive epidemiology examines person, time and place factors to describe disease distribution and frequency. Analytical epidemiology focuses on determining causes through study designs like cross-sectional, case-control and cohort studies. Causation is assessed using criteria like temporal sequence, strength of association and biological plausibility. The agent-host-environment model and concepts of sufficient, component and

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Introduction to Epidemiology

Nazmus Saquib Ph.D.


Head of Research
Sulaiman Al-Rajhi Colleges, KSA
Lecture Outline

 Definition

 History

 Uses and functions

 Descriptive Epidemiology

 Analytical Epidemiology

 Concept of disease occurrence

 Natural history of disease


Definition

“the study of the distribution, frequency


and determinants of health problems
and disease in human populations”

The unit of interest


is the population.
History

 400 BC -- Hippocrates

 1662 -- John Graunt analyzes mortality data

 1800 – William Farr: father of modern vital statistics

 1854 – John Snow: father of field epidemiology

 1960 – Doll and Hill: cancer and smoking

 1980 – injury and violence

 1990 – molecular and genetic


Uses of Epidemiology

 Assessing community health


 WHAT is the problem and its frequency?
 WHO is affected?
 WHERE and WHEN does it occur?

 Making individual decision


 Diet, exercise, smoking, salt, etc.

 Completing clinical picture


 MERS, AIDS, etc.

 Searching for causes


 Cancer, Diabetes, Heart disease
Descriptive Epidemiology

 Person: Variations in health by age, sex, ethnicity,


occupation, leisure interests...
 Time: Trends, seasonal variations, cohort
effects…
 Place: Variations between geographical areas –
local, national, international…
Person
Time
Place
What is prevalence?
Prevalence is the total number of cases of
disease in a population at one point in time,
taken as a proportion of the total number of
persons in that population.

Also referred to as “point prevalence”


What is incidence?

The incidence is the number of NEW CASES of


disease that develop in a population during a
specified time period

Usually expressed as the number of new cases


per 100,000 population per year.
Relation between Incidence and Prevalence

Type 2 DM
P=IxD Gall Bladder Cancer
Analytical epidemiology

Descriptive epidemiology
+
Focus on cause and effect
=
“analytical epidemiology”
Study Design in Analytical Epi

 Cross-sectional

 Case-control

 Prospective Cohort
Cross-sectional Studies

 Describes associations between exposures and


outcomes
 Useful for estimating prevalence
 Data collection
 Natural observation, archival or survey

“Snapshot”
Cross-Sectional Study

Study population

Collect data on exposure & outcome


simultaneously

Exposed Exposed Not Exposed Not Exposed


Have the disease Do not have the Have the disease Do not have the
disease disease
Case-Control Studies

 Start with people who have a particular


disease
 Match them with controls that do not have
that disease
 Look back and assess exposures
Case-Control Study

CASES CONTROLS

Have the disease Do not have the disease

Exposed Not Exposed Exposed Not Exposed


Cohort Studies
 Begin with disease-free patients
 Classify patients as exposed or unexposed
 Record outcomes in both groups
 Compare outcomes using relative risk
Prospective Cohort Study
Prospective
Study population

2011

Not randomly assigned, follow over time

2021
Not Exposed
Exposed

2031
Have the Do not have Have the Do not have
disease the disease disease the disease
DISEASE CAUSATION
Association vs. Causation

E O vs. E O

 Is the association true?


 Consider 3 alternate explanations
 If true, assess causal criteria
Cause and Effect: Criteria

1. Temporal sequence
Does exposure precede the outcome?
2. Strength of the association
How strong is it?
3. Dose-response relationship/gradient
Is risk of disease related to amount of exposure
4. Biologic credibility
Is association plausible ?
5. Consistency of findings
Has association persisted in other studies?
Traditional vs. Contemporary Model

AGENT

HOST ENVIRONMENT

AGENT – tubercle bacillus

HOST – characteristics of a person


(ex: immunity status)

ENVIRONMENT – things that affect the agent-host


interaction (ex: temperature, humidity, etc.)
Traditional vs. Contemporary Model

Q R Q R U R

S T T

 Sufficient Cause
 Many ways to acquire a disease
 Component Cause
 Each sufficient cause has many components
 Necessary Cause
 Common component in all sufficient cause
Natural History of Disease
THANK YOU

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