describe how epidemiological data influences changes in health practices

When creating graphics and interpreting distributions of disease by place, keep in mind Waldo Toblers first law of geography: Everything is related to everything else, but near things are more related than distant things (13). Generation periods between waves of an outbreak are usually longer than with simple person-to-person transmission because two sequential incubation periods, extrinsic in the vector and intrinsic in the human, are involved. Graphs are most frequently used for displaying time associations and patterns in epidemiologic data. However, it is important to consider conducting some preliminary data analysis even before data collection is complete. This count of incident cases over time in a population is called incidence. Equal rates of change in time (e.g., a 10% decrease/year) will yield misleading, divergent lines on an arithmetic plot; a logarithmic scale will yield parallel lines. WebDescribe how epidemiological data influences changes in health practices. It is incumbent upon field epidemiologists to adapt to these changes to be able to investigate and control urgent public health threats. 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. Source: Adapted from Reference 2. aDefined as a symptom that improved while away from the facility, either on days off or on vacation. Much has changed in the past 100 years, including tools to describe, analyze, and address determinants of health and disease. This propagated pattern has four principal characteristics (Box 6.6). CDC twenty four seven. Although field epidemiologic investigations of an urgent public health problem are legally considered to be public health practice and not research (. The predominant survey conducted in all states is the Behavioral Risk Factor Surveillance System, a random-digit dialed household survey of noninstitutionalized US adults. Time has special importance in interpreting epidemiologic data in that the initial exposure to a causative agent must precede disease. Review the first several completed surveys to check completeness of fields, inconsistencies in responses, and how well skip patterns work. The ability to conduct an epidemiologic field investigation efficiently and effectively depends on understanding the interconnectedness of its parts. 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. Never mix incident with prevalent cases in epidemiologic analyses. Summarize with average rates, average counts, or totals for all the Januarys, Februarys, and so on for each of the 12 months. In addition, maps display a wealth of underlying detail to compare against disease distributions. Therefore, writing a protocol before embarking on any data collection is paramount. When using transformed data (e.g., logarithmic, normalized, or ranked), represent equal units of the transformed data with equal distances on the axis. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Rate yourself using If the classification variable is numeric (e.g., age group), sort by the numeric category. To search for these determinants, epidemiologists use analytic epidemiology or epidemiologic studies to provide the Why and How of such events. Advancing the science of communication to improve lives. During 20142015, a sharp increase in the percentage of children with elevated blood lead levels in Flint, Michigan, resulted from exposure to drinking water after the city introduced a more corrosive water source containing higher levels of lead (Box 4.3) (14). Use alternating light shading of rows to assist readers in following data across a table. Provide an example and explain what data would be necessary to make a change in practice. Certain behaviors (e.g., drug addiction or mass sociogenic illness) might propagate from person to person, but the epidemic curve will not necessarily reflect generation times. But in the 1960's a possible role for epidemiology in the study of clinical practice emerged. 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 Your analytic findings must explain the observed patterns by time, place, and person. You can review and change the way we collect information below. In other words, the clinicians patient is the individual; the epidemiologists patient is the community. Avoid using dividing lines, grids, and other embellishments within the data space. 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. Examples of these data sources include Google hits for antidiarrheal or antipyretic medications to detect outbreaks of gastrointestinal illness or influenza (24) and social media (e.g., Facebook, Twitter, blogs) to identify contacts of patients with sexually transmitted infections, restaurants where case-patients ate or products they ate before becoming sick, or levels of disease activity during influenza season (25). First, epidemiology is a quantitative discipline that relies on a working knowledge of probability, statistics, and sound research methods. Point source outbreaks result in infected persons who might have transmitted the agent directly or through a vehicle to others. Days (2-day intervals) between onset of a case of severe acute respiratory syndrome and onset of the corresponding source case: Beijing, China, MarchApril 2003. Centers for Disease Control and Prevention. 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. Through this process of organization, inspection, and interpretation of data, descriptive epidemiology serves multiple purposes (Box 6.1). The following sections describe certain kinds of epidemic situations that can be diagnosed by plotting cases on epidemic curves. A mixed mode of survey administration (e.g., mailed survey with phone follow-up) might be less expensive to conduct than a phone-only survey, but it also increases study complexity. Saving Lives, Protecting People. Use an overlaid line graph, labels, markers, and reference lines to indicate suspected exposures, interventions, special cases, or other key features. Scatter plots are versatile instruments for exploring and communicating data. Cervical cancer (invasive) Surveillance Epidemiology, and End Results Program incidence and death rate: United States, 19992013. Because age is a pervasive determinant of disease and because population groups often differ in their age structures, age adjustment (standardization) is a useful tool for comparing rates between population groups (17). Sensitivity of questions. Accessing or collecting clean, valid, reliable, and timely data challenges most field epidemiologic investigations. On the opposite end of the scale, injuries and acute poisonings have instantaneous and obvious onsets. CDC twenty four seven. Although engaging stakeholders, such as other public health agencies, community partners, industry leaders, affected businesses, healthcare practitioners, customers, and regulatory agencies, early in an investigation is time-consuming, including them is essential. 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. The map is divided into population enumeration areas for which rates or ratios can be computed. Generally, government public health agencies have the authority to access healthcare system data (with justification). Information bias, such as measurement error, self-report bias, and interviewer bias. Information specialists can answer your questions in English or Spanish. Recognizing disease patterns by personal attributes (e.g., age, sex, education, income, or immunization status) constitutes the fifth element in descriptive epidemiology. Use separate, equally scaled epidemic curves to indicate different groups. You can review and change the way we collect information below. The 5 Ws are the essential components of a news story because if any of the five are missing, the story is incomplete. All information these cookies collect is aggregated and therefore anonymous. 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. epidemiology Dictionary of epidemiology. A data space where the data are organized and displayed to indicate patterns. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Nonetheless, accessing data sources that are not specifically collected and maintained by public health authorities can be challenging. The last three questions are assessed as patterns of these data in terms of time, place, and person. Pattern refers to the occurrence of health-related events by time, place, and person. What type of contact information is available? To reveal distinctive internal patterns (e.g., by exposure, method of case detection, place, or personal characteristics) in time distributions, epidemic curves should be stratified (Figure 6.9). To approximate the time of exposure, count backward to the average incubation period before the peak, the minimum incubation period from the initial cases, and the maximum incubation period from the last cases. The analyses and results are only as good as the quality of the data collected (remember GIGO!). Use spot maps to reveal spatial associations between cases and between cases and geographic features. 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). It reveals the location of the first case in the business district and the large initial cluster surrounding it (Figure 6.13) (14). Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. If the denominator of the population unit is known, spots of different size or shading (Box 6.10) can represent rates or ratios. Dots, onset times, case identification numbers for indexing with a line listing, or other symbols might represent disease cases (Box 6.10). Numbers are more easily compared down a column than across a row. Cases of salmonellosis among passengers on a flight from London to the United States, by time of onset, March 13 14, 1984. These cookies may also be used for advertising purposes by these third parties. The tables, graphs, and charts presented in this chapter have been determined experimentally to perform best in conveying information and data patterns to you and others. Ajloun Non-Communicable Disease Project, Jordan, Unpublished data, 2017. A propagated pattern arises with agents that are communicable between persons, usually directly but sometimes through an intermediate vehicle. Epidemiology is also used to search for determinants, which are the causes and other factors that influence the occurrence of disease and other health-related events. This demonstrates how review of secular trends can bring attention to key events, improvements in control, changes in policy, sociologic phenomena, or other factors that have modified the epidemiology of a disease. The media can play important and sometimes conflicting roles during an outbreak. Align columns of numbers on the decimal point (or ones column). 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. Mean, median, range, and interquartile range of body mass index measurements of 1,800 residents, by education level: Ajloun and Jerash Governorates, Jordan, 2012. They can have various response categories (e.g., nominal, numeric, Likert scales). This tends to prolong waves of vectorborne outbreaks. Thank you for taking the time to confirm your preferences. Using three or more significant figures interferes with comparison and comprehension. Other relevant events supplementing a chronologic framework of a health problem include underlying environmental conditions, changes in health policy, and application of control and prevention measures. Cookies used to make website functionality more relevant to you. Epidemiology is the study (scientific, systematic, data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (patient is community, individuals viewed collectively), and the application of (since epidemiology is a discipline within public health) this study to the control of health problems. Adhere to mathematical principles in plotting data and scaling axes. 100% (3 ratings) Ans) Epidemiology is the study of the health status of human populations. Time patterns may be annual, seasonal, weekly, daily, hourly, weekday versus weekend, or any other breakdown of time that may influence disease or injury occurrence. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Outbreaks can arise from common sources that continue over time. 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). Much of the data that epidemiologists collect comes from self-reportfrom answers provided by people participating in a study. Two important qualifications apply to person data assessments. You should match only one term per activity. Doing so facilitates data exchange with other systems if the outbreak extends to other jurisdictions. WebDQ9 : Describe how epidemiological data influences changes in health practices. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Epidemiology data influence in health practices Collecting mortality statistics and classifying the causes of death dates to the 1500s in London, when the Bill of Mortality was periodically published (2). Provides timely information for decision-makers, the media, the public, and others about ongoing investigations. Disease or unhealthy conditions also can be measured on a continuous scale rather than counted directly (e.g., body mass index [BMI], blood lead level, blood hemoglobin, blood sugar, or blood pressure). Cases of jaundice, by week of onset: Jafr, Maan Governorate, Jordan,June October 1999. Epidemiological data Study design (e.g., cohort study, casecontrol study). For example, overweight prevalence in the Ajloun data can be compared by using different education levels. Describe how epidemiological data influences changes The story of removing the pump handle is the quintessential public health intervention based on scientific data. An official website of the United States government. The rapid increase, plateau, and precipitous downslope all appeared with a salmonellosis outbreak from cheese distributed to multiple restaurants and then recalled (Figure 6.5). Stacking different strata atop one another (as in Figure 6.7, which is not recommended) defeats attempts to compare the time patterns by group. In arranging analytical tables, you should begin with the arrangement of the data space by following a simple set of guidelines (Box 6.3) (1). Other ongoing surveys include the Youth Risk Behavior Survey, Pregnancy Risk Assessment Monitoring System, and National Health and Nutrition Examination Survey. Another example is injuries from snowmobile use, which have been calculated both as ratios per registered vehicle and as per crash incident (4). Upright bars in each interval represent the case counts during that interval. This is important so that we have a background, and average on these ailments that we may see within the healthcare practice. The averages and dispersions can be displayed in a table or visualized in a box-and-whisker plot that indicates the median, mean, interquartile range, and outliers (Figure 6.1) (5). Many an epidemiologist has bemoaned a misinterpreted question, confusing survey formatting, or a missing confounding variable resulting in study questions without meaningful results. Electronic health records (EHRs) appear to be a promising newer source of data for public health surveillance and for assessing the prevalence of disease or behavioral risk factors in the population seeking healthcare (22). Rates, Ratios, and Alternative Denominators. Considering all the different elements of an investigation from the beginning will minimize error that potentially can lead to inconclusive results. Compare food histories between persons with, ____ 2. The resulting rate allows epidemiologists to compare disease occurrence across different populations. Describe how epidemiological data Take-Home Point: This outbreak involved many jurisdictions and evolved over a several months. Each spot in the plotting area represents the joint magnitude of the two variables. Cookies used to make website functionality more relevant to you. Instead, put them just outside the data region.
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