describe how epidemiological data influences changes in health practices describe how epidemiological data influences changes in health practices

This can be as simple as finding that a health event is affecting only a limited age group or as complicated as comparing age-specific rates among multiple groups. Epidemiological research helps us to understand how many people have a disease or disorder, if those numbers are changing, and how the disorder affects our society and our economy. Factors to consider when deciding on data collection methods include the following: Before developing a survey instrument, review the investigation objectives (i.e., study questions) to identify the specific variables that need to be collected to answer the questions. Such changes range from laboratories moving to nonculture diagnostic methods for isolating infectious pathogens, which decreases the epidemiologists ability to link cases spread out in space and time, to increasing use of social media to communicate, which limits response rates from time-honored methods of data collection, such as landline telephones. Recognizing disease patterns by personal attributes (e.g., age, sex, education, income, or immunization status) constitutes the fifth element in descriptive epidemiology. Good sample selection can help improve generalizability of results and ensure sufficient numbers of study participants. Take-Home Point: Increase in an unusual syndrome (microcephaly) prompted government health agencies to coordinate efforts to collect systematic case data, develop a standard case definition to use across jurisdictions, and conduct uniform laboratory testing for possible etiologic agents. Use separate, equally scaled epidemic curves to indicate different groups. Supports decisions for initiating or modifying control and prevention measures. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. For probability sampling procedures other than a simple random sample (e.g., stratified or cluster sampling), consult with a survey sampling expert. Rate yourself using One such tool, Epi Info, was developed by the Centers for Disease Control and Prevention (CDC) and is a public domain suite of interoperable software tools designed for public health practitioners (available at https://www.cdc.gov/epiinfo/index.html) (see Chapter 5). Second, epidemiology is a method of causal reasoning based on developing and testing hypotheses grounded in such scientific fields as biology, behavioral sciences, physics, and ergonomics to explain health-related behaviors, states, and events. After the epidemiologist has confirmed the existence of an urgent public health problem, the next important task in a field investigation is to define the specific objectives and determine what data are necessary and sufficient to justify the control measures. Provide an example and explain what data would be necessary to make a change in Dot plots, box plots, and bar charts are easier to understand and read if aligned horizontally (with the numeric axis horizontal). Greenwood M.Epidemics and crowd-diseases: an introduction to the study of epidemiology, Oxford University Press; 1935. Organizing descriptive data into tables, graphs, diagrams, maps, or charts provides a rapid, objective, and coherent grasp of the data. Epidemiology is the study of the distribution and determinants of health 2. Use alternatives to joining data points with a line. However, sometimes the population is unknown, costly to determine, or even inappropriate. In compiling questions, consider the flow, needed skip patterns, and order (e.g., placing more sensitive questions toward the end). They help us to know which pages are the most and least popular and see how visitors move around the site. Discussing up front the purpose of the investigation and the data collection processes will prove invaluable in the long run when collaborators are needed during case finding, data collection, implementation of control measures, and communication with affected populations and the public. Describe how epidemiological data influences changes in health practices. Graphs are most frequently used for displaying time associations and patterns in epidemiologic data. Cases can be plotted on a base map (Figure 6.13 [14]), a satellite view of the area, a floor plan, or other accurately scaled diagram to create a spot map. Share sensitive information only on official, secure websites. Provide marginal averages, rates, totals, or other summary statistics for rows and columns whenever possible. Students of journalism are taught that a good news story, whether it be about a bank robbery, dramatic rescue, or presidential candidates speech, must include the 5 Ws: what, who, where, when and why (sometimes cited as why/how). Clustered distributions might result from common exposures of group members, an agent that is transmissible through personal contact, an environmental exposure in the living or meeting areas, or localization of houses near or within an environmental area of high risk. The counts of incident or prevalent cases can be compared with their historical norm or another expected or target value. Use columns for most crucial data comparisons. Cates W. Epidemiology: Applying principles to clinical practice. May 18, 2022 Epidemiology data influence in health practices Describe how epidemiological data influences changes in health practices. < Previous Chapter 5: Using Technologies for Data Collection and Management, Next Chapter 7: Designing and Conducting Analytic Studies in the Field>. Cookies used to make website functionality more relevant to you. Age represents three different categories of determinants of disease risk (Box 6.11). WebDescribe how epidemiological data influences changes in health practices. The last two factors listed in the box will lead to irregular peaks during the progression of the outbreak and precipitous decreases. Collecting mortality statistics and classifying the causes of death dates to the 1500s in London, when the Bill of Mortality was periodically published (2). WebThey concluded that epidemiological data helps to plan and strategizes in the prevention and management of epidemic diseases or illnesses. Ajloun Non-Communicable Disease Project, Jordan, Unpublished data, 2017. Although public health departments have access to notifiable disease case data (primarily for communicable diseases) through mandatory reporting by providers and laboratories, data on chronic diseases and injuries might be available only through secondary sources, such as hospital discharge summaries. WebDescribe how epidemiological data influences changes in health practices. Much of the data that epidemiologists collect comes from self-reportfrom answers provided by people participating in a study. WebEpidemiology is concerned with the frequency and pattern of health events in a population. Ongoing population surveys are important for understanding the prevalence of health risk behaviors in the general population. Cases of Salmonella enterica serovar Heidelberg infection, by illness onset date: Colorado, July 10 August 17, 1976. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. WebDQ9 : Describe how epidemiological data influences changes in health practices. Of note, administration of antimicrobials, immunoglobulins, antitoxins, or other quickly acting drugs can lead to a shorter than expected outbreak with a curtailed downslope. Epidemiologists working in applied public health have myriad potential data sources available to them. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. A propagated pattern arises with agents that are communicable between persons, usually directly but sometimes through an intermediate vehicle. Another example is injuries from snowmobile use, which have been calculated both as ratios per registered vehicle and as per crash incident (4). They are often different and have distinct epidemiologic implications. Moreover, most, if not all, field investigations will be done by a larger team. Conversely, many new sources of data are opportunities made possible by the expanded use of computer technology by individuals, businesses, and health systems. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. You can review and change the way we collect information below. The word epidemiology comes from the Greek words epi, meaning on or upon, demos, meaning people, and logos, meaning the study of. Now, with the recent explosion in molecular methods, epidemiologists can make important strides in examining genetic markers of disease risk. The choice between tables and charts depends on the purpose, the audience, and the complexity of the data. Last JM, editor. Even scientists working in the same field at the same time may not agree on the best way to measure or define a particular disorder. Examples of data sources for assessing possible exposures include sales receipts (e.g., meals ordered online or food items purchased from a particular store) (20) and law enforcement data (e.g., drug seizures involving illicit fentanyl in conjunction with opioid overdose deaths due to fentanyl) (21). The importance of developing a protocol, identifying roles and responsibilities of team members, and documenting all activities and processes should not be underestimated. Ensure that scaling applies accurately to all features in the map area, especially indicators of location of disease and potential exposures. The field epidemiologist may find it useful to consult his or her agencys attorney for legal counsel regarding data collection during a specific public health event. Use the table layout to guide the eye. Public Health Problem: In November 2008, CDCs PulseNet staff noted a multistate cluster of Salmonella enterididis serotype Typhimurium isolates with an unusual DNA fingerprint (pulsed-field gel electrophoresis [PFGE] pattern). Plot the percentage of the total for the year represented by each interval; however, take care when interpreting the total percentage. They help us to know which pages are the most and least popular and see how visitors move around the site. Is the objective to identify factors in the environment that might be causing disease (e.g., elevated lead levels in drinking water)? Similarly, when the incubation period is known, you can estimate a time window of exposure and identify exposures to potential causative agents during that window. After the data are organized and displayed, descriptive epidemiology then involves interpreting these patterns, often through comparison with expected (e.g., historical counts, increased surveillance, or output from prevention and control programs) patterns or norms. Graph the number of cases of congenital syphilis by year for the country, ____ 5. These cookies may also be used for advertising purposes by these third parties. Provide an example and explain what data would be necessary to make a change in practice. An important initial step in collecting data as part of a field investigation is determining the mode of data collection (e.g., self-administered, mailed, phone or in-person interview, online survey) (29). The line indicates the rapid decrease in Aedes-infested houses (house index). Reduce embellishments that obstruct a clear vision of disease and potential exposures. The resulting rate allows epidemiologists to compare disease occurrence across different populations. Coordination of epidemiologic studies (e.g., common methods, questionnaires), having a national database of PFGE patterns to identify outbreak-associated isolates, and an FDA product trace-back were key to identifying the cause, which resulted in a widespread product recall (and eventual criminal liability of the peanut butter producer). Instructions for recruiting and enrolling participants in the survey, including obtaining consent for participation. WebIn general, epidemiological data is a crucial instrument for influencing changes in medical procedures. Centers for Disease Control and Prevention. Let the difference in shading of map areas define and replace detailed internal boundary lines. For example, when a patient with diarrheal disease presents, both are interested in establishing the correct diagnosis. An outbreak of dengue arising from a single imported case in a South China town reveals several of these features (Figure 6.6) (8). Changes in the shape of primary care, and the range of symptoms and illnesses managed by different members of the primary health care team, can influence understanding of: the epidemiology of disease in the community; the need for different health care services; and how primary care epidemiology is done. But in the 1960's a possible role for epidemiology in the study of clinical practice emerged. You can review and change the way we collect information below. This task, called descriptive epidemiology, answers the following questions about disease, injury, or environmental hazard occurrence: The first question is answered with a description of the disease or health condition. Participants were less likely to complete the Internet surveys. It is incumbent upon field epidemiologists to adapt to these changes to be able to investigate and control urgent public health threats. This type of curve can be made for any time cycle (e.g., time of day, day of week, or week of influenza season). Aspect ratios (data space width to height) of approximately 2:1 work well. Reported incidence rate of spotted fever rickettsiosis by county: United States, 20002013. First, determining rates is more often necessary than for time and place. Instructions related to protection of participants (e.g., maintaining confidentiality, data security). They assess whether groups with different rates of disease differ in their demographic characteristics, genetic or immunologic make-up, behaviors, environmental exposures, or other so-called potential risk factors. Is the objective to identify specific behaviors that put people at increased risk (e.g., cross-contamination during food handling)? Cookies used to make website functionality more relevant to you. In addition, most states require laboratories to send cultures to the public health laboratory in their jurisdiction for confirmation, subtyping, and cataloging results in state and national databases. Having a written data collection section as part of the overall study protocol is essential. Public Health Response: The broad scope of the outbreak and severity of illness required coordination of data collection across jurisdictions and use of multiple data sources to identify a common source. Cases of jaundice, by week of onset: Jafr, Maan Governorate, Jordan,June October 1999. This means that the results of such a study may be quite different from a study in which actual hearing (audiometric) tests are administered to each person in a household. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Summarize with average rates, average counts, or totals for all the Januarys, Februarys, and so on for each of the 12 months. Determining whether an urgent public health problem exists (i.e., an excess of observed cases of illness above what is expected) depends on knowing the expected background rate of endemic disease. Secure .gov websites use HTTPS When starting data entry, check several records against the completed survey instrument for accuracy and consider double data entry of a sample of surveys to check for errors. Local, national, and global health threats are monitored by agencies such as the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), All information these cookies collect is aggregated and therefore anonymous. Plot the rate, average, or total for each interval on a histogram or line graph. View the Upright bars in each interval represent the case counts during that interval. Decrease the time interval size as case numbers increase. Wednesday 10 Question: Describe how epidemiological data Information specialists can answer your questions in English or Spanish. Numbers are more easily compared down a column than across a row. Indicate underpopulated or depopulated areas. To indicate divergence from an average range, use white for the center range and deepening intensities of two different hues for divergent strata on opposite extremes. Epidemic curves for large geographic areas might not reveal the early periodicity or the characteristic increase and decrease of a propagated outbreak. The x-axis represents a period of interest. In contact diagrams (Figure 6.2, panel A) (5), which are commonly used for visualizing person-to-person transmission, different markers are used to indicate the different groups exposed or at risk. Sorting nominative categories by the magnitude of the numeric value helps the readers understanding. Compare frequency of brain cancer among anatomists with frequency in general population, ____ 3. For example, to detect a difference in proportions between two groups using a chi-square test, consider how much of a difference needs to be detected to be meaningful. Adapting preexisting protocols and questionnaires will facilitate a timely response and consistency across jurisdictions. Accordingly, less efficient and inaccurate displays, although common, were avoided or noted as not recommended. This will be modified by the variability of contact between humans and the reservoir animal and, for vectorborne zoonoses, contact with the arthropod vector. For most conditions, when the rates vary over one or two orders of magnitude, an arithmetic scale is recommended. These distance associations of cases or rates are best understood on maps. Compute and plot rates for the smallest area possible. Use an overlaid line graph, labels, markers, and reference lines to indicate suspected exposures, interventions, special cases, or other key features. For example, the consistent time interval between rotavirus vaccination and onset of intussusception (Table 6.1) helped build the hypothesis that the vaccine precipitated the disease (1). Frequency refers not only to the number of health events such as the number of cases of When comparing two graphs of the same dependent variable, use scaling that improves comparison and resolution. For self-administered surveys, the format needs to be friendly, well-spaced, and easy to follow, with clear instructions and definitions. Consider including dont know and refused response categories. BMI, Body mass index; F, female; M, male; SD, standard deviation. Write questions that are clear and use vocabulary understandable to the study population and that contain only one concept. WebEpidemiology is concerned with the frequency and pattern of health events in a population: Frequency refers not only to the number of health events such as the number of cases of Certain sensitive topics (e.g., sexual behaviors) might be better for a self-administered survey than a phone survey. This protocol can include the following: Train staff collecting data on the protocol, reviewing instructions carefully and modifying as needed. These include investigation objectives and scope, whether requisite data exist and can be accessed, to what extent data from different sources can be practically combined, methods for and feasibility of primary data collection, and resources (e.g., staff, funding) available. Significant spacetime clustering (assessed by the Knox test) of dengue cases in the city of Cairns, Australia, during JanuaryAugust 2003. Time has special importance in interpreting epidemiologic data in that the initial exposure to a causative agent must precede disease. You should include on the epidemic curve a representation of the suspected environmental factor (e.g., rainfall connected with leptospirosis in Figure 6.7 [9]). You will be subject to the destination website's privacy policy when you follow the link. Interviewer-administered surveys provide more control by the interviewer than self-administered ones. Use graphic designs that reveal the data from the broad overview to the fine detail. New health policies in 1970 and 1995 that broadened coverage of Papanicolaou smear screenings for women were initially followed by steeper decreases and subsequent leveling off of the downward trend. Similarly, prevalent case counts divided by the population from which they arose produce a proportion (termed prevalence). Distribution of the mosquito vector throughout the Americas led to recognition of the potential further spread of the virus. In the healthcare field we use epidemiological data when doing a The downslope can be precipitous if the common source is removed or gradual if it exhausts itself. 4th ed. For instance, an epidemiological study may collect data on the number of people who answer, Yes when asked if someone in their household has trouble hearing. Recommend that close contacts of a child recently reported with meningococcal meningitis receive Rifampin, ____ 6. A cover sheet with attempts to contact, code status of interview (e.g., completed), and notes can be helpful. If the classification variable is numeric (e.g., age group), sort by the numeric category. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. WebHLT- 362 Topic 5 DQ 1 Describe how epidemiological data influences changes in health practices. Thank you for taking the time to confirm your preferences. The map is divided into population enumeration areas for which rates or ratios can be computed. For example, a plot of the days between contact with a SARS patient and onset of SARS in the person having contact indicates an approximation of the incubation period (Figure 6.8) (5). On maps representing land areas, indicate longitude and latitude and orientation (i.e., by using a northward-pointing arrow). Data presentation is interchangeable with tables. Ensure that overlapping spots are distinguishable. Epidemiologists work with other scientists to find who is infected, why they were infected, For incident cases, specify the period during which the cases occurred. Pay special attention to ensuring that survey instruments can be used across multiple sites in the event that the outbreak involves multiple jurisdictions. Cluster bar charts with more than two bars per cluster (e.g., Figure 6.16, panel B) are not recommended. Enables generation of testable hypotheses regarding the etiology, exposure mode, control measure effectiveness, and other aspects of the health problem. Always check whether data sources are providing incident (new events among the population) or prevalent (an existing event at a specific point in time) cases. You can review and change the way we collect information below. Cases of salmonellosis among passengers on a flight from London to the United States, by time of onset, March 13 14, 1984. Use six or fewer tick mark labels on the axes. As an alternative to plotting onset by calendar time, plotting the time between suspected exposures and onset can help you understand the epidemiologic situation. You should match only one term per activity. Study design (e.g., cohort study, casecontrol study). They indicate the association between two numerically scaled variables (Figure 6.15) (16). Minimize frames, gridlines, and tick marks (610/axis is sufficient) to avoid interference with the data. For example, available resources will influence how complex data collection efforts can be; the timeline for an investigation of an infectious disease outbreak needing urgent control measures might require a quick-and-dirty data collection process, whereas an investigation of a cancer cluster that has unfolded over several years may permit more in-depth data collection and analysis. Match the term to the activity that best describes it. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Contact diagrams are versatile tools for revealing relationships between individual cases in time. On the opposite end of the scale, injuries and acute poisonings have instantaneous and obvious onsets. How large a sample to select depends on resources, study timeline (generally the larger the sample, the more expensive and time-consuming), the analyses to be conducted, and the effect size you want to detect. Nonetheless, accessing data sources that are not specifically collected and maintained by public health authorities can be challenging. Tables, graphs, maps, and charts all have four elements in common: a title, data, footnotes, and text (Box 6.2). The epidemiology of human communication is a rewarding and challenging field.