Scribd
Upload
8 views

01 Measurements in Epidemiology Part II

The document provides an introduction to epidemiology focusing on incidence and its measurement, including cumulative incidence and incidence density. It discusses the relationship between incidence and prevalence, special incidence rates like attack rates and case fatality rates, and the importance of these measures in public health. Additionally, it highlights the differences between case fatality rates and mortality rates, emphasizing their significance in assessing disease severity and treatment effectiveness.

Uploaded by

shalinicd681
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
8 views

01 Measurements in Epidemiology Part II

The document provides an introduction to epidemiology focusing on incidence and its measurement, including cumulative incidence and incidence density. It discusses the relationship between incidence and prevalence, special incidence rates like attack rates and case fatality rates, and the importance of these measures in public health. Additionally, it highlights the differences between case fatality rates and mortality rates, emphasizing their significance in assessing disease severity and treatment effectiveness.

Uploaded by

shalinicd681
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 26

Introduction to

Epidemiology &
Measurements in
Epidemiology
Part II
Incidence

 No. of new cases of a disease occurring in


the
population during a specified period of time
x 10k
No. of persons at risk in developing the
disease
during that period of time
Incidence

 rate? / proportion?

numerator
 most critical element?
NEW cases

 ismeasure of events is a measure of


risk
(probability) of
getting a disease
Incidence
 denominator

only people at risk

 time period
• how long?
How do we identify new
cases?
 identify a population
 determine

who has the disease- not included

who does not but at risk- follow up
 follow up for the defined period
 determine how many have developed
disease- numerator
 no. at risk (no. followed up)
denominator
 ifall at risk were followed up for
the entire period
Cumulative incidence

units - no. of persons per time


duration
 in reality difficulties in following up all at
risk for the whole period

why?
Incidence density/ Incidence
rate
 how many have developed disease
numerator
 sum of different times that each individual
was at risk (time followed up)
denominator
 unit - person-years
Cumulative Incidence
No. of new cases of a disease occurring in the
population during a specified period of time
x 10k
No. of persons at risk in developing the disease
during that period of time

Incidence density/ incidence rate


No. of new cases of a disease occurring in the
population during a specified period of time X
10k
Total person time of observation
uses
 Incidence

rate of occurrence of a new disease during a period
of time
measure of risk
when assessing association between an
exposure and disease occurrence

 Prevalence

proportion of the population that has a disease at a
point of time
measure of burden of disease in the
community
used for planning of health services
Relationship between incidence
and prevalence
incidence

increased
prevalence
prevalence

decreased
prevalence

deaths
cures
Relationship between incidence
and prevalence

incidence

prevalence

deaths
cures
Relationship between incidence
and prevalence
 ifincidence is low but duration of
disease from onset to termination is
long

high prevalence

 ifincidence is high but duration of


disease is short (recovery/ death)

low prevalence
Relationship between incidence
and oreavalnce
 change in prevalence

change in incidence

change in duration

both

mathematical expression
P= I X D
P= prevalence , I- incidence rate, D- duration of the
disease

 valid in ‘steady state’


• incidence constant
• duration approx. same
• prevalence is low (<0.1)
Relationship between incidence
and prevalence
 change in incidence

prevention activities

improved diagnosis

 change in duration

shorten- better treatment and recovery

lengthen- treatment preventing death but do
not produce recovery

public health importance


decrease in prevalence?
increase in prevalence?
Special incidence rates

 attack rates
 case fatality rates
Attack rates

No. of people at risk in whom a certain illness


develops
Total no. of people at risk

 used in epidemic investigations


 in general, time not explicitly specified
 usually know the time period between
exposure and development of cases
 Episode of food poisoning

 No. of people who ate a certain food and


became ill
Total no. of who ate that food


to identify the exposure responsible- AR in people
who ate a certain food


useful to compare the risk of disease in groups
with different .exposures - food specific AR
Food poisoning ..
Primary and Secondary cases
 Primary case

a person who acquires the disease from
the exposure (contaminated food)

 Secondary case

a person who acquires the disease from
the primary case
Measures of morbidity..
 measure of severity of a disease

 effectiveness of treatment
Measures of mortality

 count- no indication of increasing


risk

no information on
• out of how many( size of source population)
• time period
 proportion- not indicate risk

no information on
• time period

 to assess risk - Rates


Special incidence rates

Case Fatality Rate

No. of individuals dying during a specified


period of time after disease onset or diagnosis x
100
No. of individuals with the specified disease
Differences between CFR and
mortality rates
 denominator

mortality rate
• entire population at risk of dying including
diseased/ non diseased

CFR
• those with the disease

 CFR

measure of severity

assess benefits of a new therapy
Differences between CFR and
mortality rates
 assume a population of 100,000 of whom

20 have the illness X and in one year 18 of them die


Mortality rate of disease X- 18/100,000 = 0.00018= 0.018%

CFR of disease X-18/20=0.9=90%

 mortality rate very low


 CFR very high
disease is rare (indicated by low mortality rate)
but once person has the disease chances of dying
are very high
Learning outcomes-
knowledge
 Measures - Count, Proportion, Ratio and
Rate

 Measures of morbidity

Incidence
• Different types of incidence measures
• Special incidence rates
• Uses of incidence

Prevalence
• Different types of prevalence measures
• Uses of prevalence

Relationship between incidence and prevalence
Recommended reading
 CH Hennekens, Epidemiology in
medicine
 Leon Gordis, Epidemiology

You might also like