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# MEDT 401 Module 7

### Chapter 7 Epidemiology

TermDefinition
Absolute risk (AR) AKA “event rate/incidence rate” of a group. Event rate in the control group (CER) is the absolute risk of the condition for that group. Similarly, the event rate in the exposed group (EER) is the absolute risk of the condition for that group.
Absolute risk increase (ARI) When the absolute risk (AR) among the exposed group is GREATER than the AR among the control group. AKA “attributable risk”.
Absolute risk reduction (ARR) When absolute risk (AR) among the exposed group is LESS than the AR among control group. AKA “attributable risk”.
Attack rates (AR) An increased occurrence of disease among people over a short period of time.
Attributable risk (AR) A difference in absolute risk (AR) between experimental & control group. Either group can have higher attributable risk.
Attributable risk percent (AR%) Attributable risk calculated as proportion. The % of the incidence of a disease in the exposed population that is due to the exposure. AR% = [(AR)/(exposed event rate (EER))] X 100
Case definition A set of standard criteria for classifying whether a person has a particular disease, syndrome, or health condition. Basic unit of study. Provides parameters for comparing cases across time and place.
Common-source outbreak When an agent or toxin from a single source simultaneously affects exposed individuals.
Contingency table A relationship tables used for organizing data to support calculations. Most common form is a 2x2 table (4 cells for data). Used to calculate sensitivity, specificity, PPV, NPV, CER, EER, RR, RRR, AR, & OR.
Control event rate (CER) Rate of the event of interest among the control group. 2x2 table formula: a/(a+b).
Disease surveillance An epidemiological activity that involves tracking the number of people afflicted w/a particular illness.
Endemic A disease that is persistently stable in a specific locale.
Epidemic When there is an incidence of disease that exceeds what is normally expected.
Epidemiological triad A theory that explains disease outbreaks in terms of the relationships & interactions among the host, the agent, & the environment.
Epidemiology The study of the occurrence & distribution of health-related states or events in specified populations. Includes study of the determinants influencing disease states, and the application of knowledge to control health problems.
Exposed event rate (EER) AKA “Experiment event rate”. Rate of the event of interest among the exposed (or treatment) group. 2x2 table formula for EER: c/(c+d).
FDA (Food and Drug Administration) A federal agency regulating most medication, medical devices, and others (vaccines, blood, biologics, radiation products).
Incidence The number of new cases of a disease or condition during a specified time frame.
Medical geography Studies of the land, atmosphere, & inhabitants in a specific area, addressing the physical environment and the people, w/goal of understanding disease processes in order to improve health.
Modifiable risks An exposure, attribute or behavior people can change that is associated with but not the cause of a given outcome of interest.
Negative predictive value (NPV) The likelihood someone w/a negative test result will actually not have the disease. Expressed as a proportion. NPV is percentage of those w/a negative test result who actually do not have the disease. 2x2 table formula for NVP: d/(c+d).
Nonmodifiable risks An exposure, attribute or behavior people cannot change that is associated w/but not the cause of a given outcome of interest.
Odds Ratio in a group of those with an event to those without the event. 2x2 table odds for the exposed group is a/b. In 2x2 table, formula: ad/bc. Odds for control group: c/d
Odds ratio (OR) Ratio of the odds of an event occurring in one group to the odds of an event occurring in another group. In 2x2 table, formula: ad/bc. OR < 1.0 indicates protective factor. OR = 1.0 indicates nonfactor. OR > 1.0 indicates risk factor.
Pandemic When an epidemic is widespread over several countries or continents.
Period prevalent Health issue that is specific to an intermediate period of time (months or up to a few years).
Point estimate A single number such as a sample mean or incidence rate.
Point prevalent A health issue that is specific to a short period of time, such as a day or a week.
Point-source outbreak When one source of infection results in a very rapid increase in the number of cases, such as in the cholera epidemic during John Snow’s time in London.
Population attributable risk (PAR) Proportion of disease cases among the population both exposed and not exposed. The PAR is calculated by subtracting the incidence in the unexposed (CER) from the incidence in the population (exposed + unexposed groups.)
Population attributable risk percent (PAR%) % of the incidence of a disease in the population (exposed + unexposed) that is due to the exposure. Divide PAR by incidence in total population and then multiply the results by 100 to obtain the PAR%.
Positive predictive value (PPV) The likelihood someone w/a positive test result will actually have the disease. Expressed as a proportion. PPV is the percentage of those w/a positive test result who actually have the disease. 2x2 table formula for PPV: a/(a+b).
Preclinical trials Defined by the National Institutes of Health: studies that involve testing of experimental drugs in test tubes or in animals. Includes testing that occurs before human trials permitted.
Prevalence Proportion of a population w/a given disease at a single point in time.
Propagated epidemic When an infectious agent infects one person, who then transmits the disease to another person.
Protective factor Exposure or attribute that is associated w/decreased risk of disease; risk ratio < 1.0.
Relative risk (RR)/ Risk Ratio AKA “risk ratio”. The event rate among those exposed to a factor divided by the event rate among those not exposed to the same factor. Formula: ERR/CER.
Risk Probability or chance that an individual will develop a disease or condition over a specified period of time.
Screening Procedure used to identify early signs & symptoms of a disease or health problem associated with a population at risk for a specific disease or event.
Sensitivity Ability of the test to be (+) given the person tested has the diseases/problem. Expressed as proportion. The percentage of those who are known to have the disease/problem who test positive. AKA “proportion of true positives”. 2x2 table formula: a/(a+c).
Snow, John Physician from 1800’s who is credited w/one of first epidemiological studies. Identified the well in London of a specific water company (Broad Street Pump) as the source of a cholera outbreak.
Specificity Ability of test to be (-) given the person does not have the disease/problem. It is the percentage of those who are known not to have the disease/condition who test negative. AKA “proportion of true negatives”. 2x2 formula: d/(b+d).
Surveillance The ongoing, systematic collection, analysis, and interpretation of health data.
Syndemic When two or more afflictions, interacting synergistically, contribute to excess burden of disease in a population.
Tuskegee syphilis study Study performed between 1932-1972 where Public Health Service of Alabama denied treatment for syphilis to over 400 African Americans, mostly adult males. One of the reasons for human subjects’ protections in US law and regulation.
Web of causation A theory that posits that there is no singular reason for the occurrence of a disease. Rather a compendium of factors predisposes an individual to meet critical for a particular case definition.
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