describe how epidemiological data influences changes in health practices

Information about determining whom to select is covered in study design discussions in Chapter 7, but sample size is worth briefly mentioning here. Contact between severe acute respiratory syndrome (SARS) cases among a group of relatives and health care workers: Beijing, China, 2003. To indicate no data, use a different hue or fill pattern. Your analytic findings must explain the observed patterns by time, place, and person. These cookies may also be used for advertising purposes by these third parties. 4th ed. Determinant: any factor, whether event, characteristic, or other definable entity, that brings about a change in a health condition or other defined characteristic. Numbers are more easily compared down a column than across a row. With the advent of personal computers in most households and smartphones in many pockets (23), epidemiologists are evaluating the utility of the Internet and social media as data sources for identifying outbreaks or case finding during outbreak investigations. Describe how epidemiological data WebAn example of how epidemiological data influences changes in health practices is with the pandemic we are currently experiencing (Covid-19). Match the term to the activity that best describes it. You can review and change the way we collect information below. Provide an example and explain what data would be necessary to make a change in practice. Place patterns include geographic variation, urban/rural differences, and location of work sites or schools. Small sample size, resulting in inadequate power to detect differences between groups. Use the table layout to guide the eye. 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. Take-Home Points: Internet-based surveys permit efficient data collection but should be designed to maximize complete responses. Although not specific, data from syndromic surveillance systems (e.g., from emergency departments) can be useful in determining background rates of prediagnostic signs or symptoms, such as fever, respiratory illness, or diarrhea. Participants were less likely to complete the Internet surveys. First, determining rates is more often necessary than for time and place. Source: Adapted from Reference 2. aDefined as a symptom that improved while away from the facility, either on days off or on vacation. WebDescribe how epidemiological data influences changes in health practices. The goal of this symposium was to take When two or more data sets are plotted in the same data space, Design point markers and lines for visual discrimination; and. Outbreaks can arise from common sources that continue over time. Much of the data that epidemiologists collect comes from self-reportfrom answers provided by people participating in a study. Plot the rate, average, or total for each interval on a histogram or line graph. 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). bDuring the previous 12 months. 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. Indicate an interval of 12 incubation periods before the outbreak increases from the background and after it returns to background levels. They indicate the association between two numerically scaled variables (Figure 6.15) (16). They are often different and have distinct epidemiologic implications. Generally, government public health agencies have the authority to access healthcare system data (with justification). Public Health Problem: To support a rapid response, field epidemiologists need to determine the most efficient, timely, and cost-effective method for data collection during an outbreak. Last JM, editor. Cases not included in clusters are marked with smaller dots. Let the difference in shading of map areas define and replace detailed internal boundary lines. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Aspect ratios (data space width to height) of approximately 2:1 work well. The choice between tables and charts depends on the purpose, the audience, and the complexity of the data. Cates W. Epidemiology: Applying principles to clinical practice. Use alternatives to joining data points with a line. Interviewer-administered surveys provide more control by the interviewer than self-administered ones. Use alternating light shading of rows to assist readers in following data across a table. These data are invaluable for determining whether an apparent cluster of cases might be linked and require further investigation or caused by a random clustering of events. In field investigations, tradeoffs exist between these attributes; for example, a more timely collection of data might lead to lower quality data, fewer resources might mean less complete data, and retrospective analysis of preexisting data might be more cost-effective, although prospective data collection from case-patients might enable more targeted questions about specific exposures. Possible confounders and effect modifiers. Cases of typhoid fever by date of onset: Tabuk, Saudi Arabia, AprilJune 1992. Since this outbreak was recognized, the epidemic has spread through the mosquito vector as well as through sexual and perinatal transmission to multiple countries and continents around the world. This will be modified by the variability of contact between humans and the reservoir animal and, for vectorborne zoonoses, contact with the arthropod vector. You'll get a detailed solution from a subject matter expert that helps you learn core concepts. Do participants have access to phones, mailing addresses, or computers? Seasonal patterns might be summarized in a seasonal curve (Box 6.8). Have a plan for quality checks during questionnaire administration (if the survey is not computer-based). Temporal disease rates are usually illustrated by using a line graph (Box 6.4). Home > Homework Answsers > Nursing homework help. In September 2009, the Oregon Public Health Division investigated an outbreak of gastroenteritis that occurred among more than 2,000 participants of a week-long, 475-mile bicycle ride. In this chapter, additional guidelines for preparing these data displays will appear where the specific data display type is first applied. If the classification variable is numeric (e.g., age group), sort by the numeric category. An outbreak of dengue arising from a single imported case in a South China town reveals several of these features (Figure 6.6) (8). This will save time in the long run; many epidemiologists have learned the hard way that a survey question was not clear or was asking about more than one concept, or that the menu of answers was missing a key response category. The range of public health control measures is broad (see Chapter 11). Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Often, a periodicity equivalent to the generation period for the agent might be obvious during the initial stages of the outbreak. This reveals that factor and that an environmental exposure also related to low altitude (e.g., poor drainage of sewage) might have contributed to cholera incidence. Therefore, it is incumbent on the epidemiologists to determine up front which decisions need to be made and what information is needed to support these decisions. With acute infections, poisonings, and injuries, you will often have precise exposure times to different suspected agents. Of note, administration of antimicrobials, immunoglobulins, antitoxins, or other quickly acting drugs can lead to a shorter than expected outbreak with a curtailed downslope. But in the 1960's a possible role for epidemiology in the study of clinical practice emerged. Dot chart (A) and bar chart (B) comparison of mean body mass index among adults, by age group and sex: Ajloun and Jerash Governorates, Jordan, 2012. In most epidemiologic studies the activities are not done linearly and sequentially; rather, the steps frequently are conducted in parallel and are iterative, with results informing edits or amendments. 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. Distinguish between place of onset, place of known or suspected exposure, and place of case identification. Arthropod vectors, after becoming infected, remain so until they perish. mosquitoes was identified in northeastern Brazil. Sorting nominative categories by the magnitude of the numeric value helps the readers understanding. Length and complexity of the survey. Responding to urgent public health issues expeditiously requires balancing the speed of response with the need for accurate data and information to support the implementation of control measures. An official website of the United States government. For example, initial respiratory symptoms might indicate exposure through the upper airways, as in Table 6.2. On an arithmetic scale, represent equal numerical units with equal distances on an axis. If using color, use increasing intensities of the same hue. Rates correct counts for differences among population sizes or study periods. Logistics, including budget, personnel, and timeline. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (31) has specific language allowing for the use of personal health information by government agencies to perform public health activities. Use the smallest possible administrative area that the numerator and denominator will allow. Cases of Salmonella enterica serovar Heidelberg infection, by illness onset date: Colorado, July 10 August 17, 1976. The probability of having an elevated BLL when the FWS was the source of water remained after controlling for covariates (e.g., age, race, season). DQ1 Describe how epidemiological data influences changes in health practices. For diseases or behaviors spread through personal contact or association, contact diagrams reveal the pattern of spread plus such key details as index cases and outliers. They help us to know which pages are the most and least popular and see how visitors move around the site. Similarly, times of suspected exposures vary in their precision. 6).docx - Describe how epidemiological data The epidemiologist must keep in mind that the primary purpose of a field investigation into an urgent public health problem is to control the problem and prevent further illness. For example, understanding the distribution of vectors for each infection and patterns of the diseases in animals is paramount. The media can play important and sometimes conflicting roles during an outbreak. The best charts for quick and accurate understanding are dot plots, box-and-whisker plots, and simple bar charts. or https:// means you've safely connected to the .gov website. For questions about the EIS program, please contact us directly at EISApplication@cdc.gov. 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. Epidemic curves often have patterns that reveal likely transmission modes. Examples of clinical data sources include medical record abstraction, hospital discharge data (e.g., for cases of hemolytic uremic syndrome) (15), syndromic surveillance systems (16) (e.g., for bloody diarrhea during an Shiga toxinproducing Escherichia coli outbreak) (17), poison control center calls (e.g., exposure to white powder during anthrax-related events) (18), and school and work absenteeism records (e.g., New York City school absenteeism in students traveling to Mexico at the beginning of the influenza A[H1N1] pandemic) (19). 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). They begin with a single or limited number of cases and increase with a gradually increasing upslope. Is the objective to identify factors in the environment that might be causing disease (e.g., elevated lead levels in drinking water)? Certain sensitive topics (e.g., sexual behaviors) might be better for a self-administered survey than a phone survey. After evaluating whether existing data can address the study objectives, the field epidemiologist must determine whether additional data need to be collected and, if so, what and how (Box 4.4). Rates, Ratios, and Alternative Denominators. 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. An epidemic curve with a tight clustering of cases in time (1.5 times the range of the incubation period, if the agent is known) and with a sharp upslope and a trailing downslope is consistent with a point source (Figure 6.3) (6). Several states conduct population-based food preference surveys; such surveys are valuable in assessing the background rate of consumption of various food items and can help the field epidemiologist determine whether a foodborne outbreak in which many case-patients report eating a particular food item needs to be investigated further. Mean daily temperatures of less than 68F (<20C) typically arrest multiplication of infectious agents in the arthropod. Determine Decisions Regarding Control Measure Implementation, Define The Investigations Objectives And Determine Data Needed, Multistate Outbreak Of Salmonella Typhimurium Infections Associated With Peanut Butter Containing Products, 2008 2009, Zika Virus Infection: An Emerging Vectorborne Disease, Environmental: Childhood Lead Poisoning And Drinking Water, Comparison Of Survey Methods In Norovirus Outbreak Investigation, Develop the Questionnaire or Survey Instrument, Calculate the Sample Size and Select the Sample, Review Legal Authority, Rules, and Policies Governing Data Collection, Issues and Challenges with Data Collection, Centers for Disease Control and Prevention. A lock (LockA locked padlock) These might include detailed administrative boundaries or a longitude-latitude grid. Cookies used to make website functionality more relevant to you. Nonetheless, many epidemiologists still use the term disease as shorthand for the wide range of health-related states and events that are studied. Then epidemiologists began to look at behaviors related to health and well-being, such as amount of exercise and seat belt use. If the denominator of the population unit is known, spots of different size or shading (Box 6.10) can represent rates or ratios. WebEpidemiological data influences changes in health practices because it estimates the individual chances and risks of disease, and if an individual has a high risk of contracting a certain disease he or she may be forced to change some health practices. The definition of a disorder also tends to change over time, however, making estimates more difficult. Dictionary of epidemiology. Because population estimates or censuses follow standard geographic areas (e.g., city, census tract, county, state, or country), determination of rates is also restricted to these same areas. Spot maps that plot cases have a general weakness. In the example diagram, closeness and quality of relationships, timing between onsets, and places of contact are all displayed through different symbols and shading (Figure 6.2) (5). The map is divided into population enumeration areas for which rates or ratios can be computed. Consequently, they also accelerate and amplify epidemic development. Let's take This count of incident cases over time in a population is called incidence. All information these cookies collect is aggregated and therefore anonymous. Seasonal distribution of malaria cases, by month of detection by voluntary collaborators in four villages: El Salvador, 19701977. WebWith that being said, epidemiological data can have an impact on changes in health practices. Public Health Problem: During April 2014October 2015, residents of Flint, Michigan, were exposed to elevated lead levels in drinking water after the water source was switched from the Detroit Water Authority from Lake Huron to the Flint Water System (FWS) from the Flint River. See answer Advertisement ah6129783 Data influences changes in health practices provide a Advertisement Advertisement By the middle of the 20th Century, additional epidemiologic methods had been developed and applied to chronic diseases, injuries, birth defects, maternal-child health, occupational health, and environmental health. WebExpert Answer. 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). However, it is important to consider conducting some preliminary data analysis even before data collection is complete. 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. of clinical epidemiology in medical practice 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. Make sure overlapping plotting symbols are distinguishable. The background rate generally is determined by accessing existing data sources, such as reportable disease registries or vital statistics. Pay special attention to ensuring that survey instruments can be used across multiple sites in the event that the outbreak involves multiple jurisdictions. WebDescribe how epidemiological data influences changes in health practices. Saving Lives, Protecting People. Information bias, such as measurement error, self-report bias, and interviewer bias. Genotyping data on specific infectious agents (e.g., Salmonella strains) produced by state public health laboratories are loaded to CDCs PulseNet database to enable identification of cases across jurisdictions that might have a common source (Box 4.1) (9). As a field epidemiologist, you will collect and assess data from field investigations, surveillance systems, vital statistics, or other sources. 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. 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. 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. Epidemiologists working in applied public health have myriad potential data sources available to them. Cookies used to make website functionality more relevant to you. Many investigation activities must be conducted in parallel and are interdependent and iterative, with results informing edits or amendments. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. HLT-362V DQ 5 12 .docx - Describe how epidemiological data During the 1800s, Dr. William Farr developed a disease classification system that ushered in the era of modern vital statistics (3). 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. 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. Secular trends of invasive cervical cancer (Figure 6.11) reveal steady decreases over 37 years (11). Epidemiology is not just the study of health in a population; it also involves applying the knowledge gained by the studies to community-based practice. Uncontrolled confounding or bias introduced in the association between exposure and outcome because of third variable. 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. Using three or more significant figures interferes with comparison and comprehension. All information these cookies collect is aggregated and therefore anonymous. Indicate underpopulated or depopulated areas. The y-axis represents the rate of the health event. National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, U.S. Department of Health & Human Services. In other words, the word epidemiology has its roots in the study of what befalls a population. As an alternative to using tables, charts (Box 6.12) (e.g., dot charts) (Figure 6.16, panel A) or horizontal cluster bar charts (Figure 6.16, panel B) improve perception of the patterns in the data, compared with a table. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Similarly, prevalent case counts divided by the population from which they arose produce a proportion (termed prevalence). Characterizing health events by time, place, and person are activities of descriptive epidemiology, discussed in more detail later in this lesson. In the United States, the legal framework for reporting infectious diseases to public health authorities for investigation and control dates to 1878, when Congress authorized the Public Health Service to collect reports of cholera, smallpox, plague, and yellow fever from consuls overseas to implement quarantine measures to prevent introduction into the United States (6). Also, many epidemiological estimates try to determine how the number of people affected by a disorder changes over time. Ensure that potential exposures are easily discerned and labeled. Relating disease with these events in time can support calculation of key characteristics of the disease or health event. The outbreak grew to involve 714 case-patients in 46 states; 166 (23%) were hospitalized and 9 (1%) died. This expected or target case count is now corrected for the population and can be compared with the actual observed case counts. It is incumbent upon field epidemiologists to adapt to these changes to be able to investigate and control urgent public health threats. Avoid pie charts, cluster bar charts, stacked bar charts, and other types not presented in this chapter. Align columns of numbers on the decimal point (or ones column). It reveals the location of the first case in the business district and the large initial cluster surrounding it (Figure 6.13) (14). An analysis of BMI by age from Ajloun and Jerash Governorates, Jordan, draws attention to increasing BMI and accumulating overweight prevalence for persons aged 1875 years (Table 6.3) (Ajloun Non-Communicable Disease Project, Jordan, unpublished data, 2017). Provide an example and explain what data would be necessary to make a change in practice. All information these cookies collect is aggregated and therefore anonymous. Age represents three different categories of determinants of disease risk (Box 6.11). Compare the association of cases during these pre-and post-epidemic periods with the main outbreak. T5DQ1 Describe how epidemiological data influences changes in health practices. Describe how epidemiological data influences changes in health See Answer. More precision is usually not needed for epidemiologic purposes. Legal considerations, including statutes, rules, and regulations. Compute and plot rates for the smallest area possible. By September, an increased number of infants with microcephaly was reported from Zika virusaffected areas. The last three questions are assessed as patterns of these data in terms of time, place, and person. 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. Solved Describe how epidemiological data influences changes You can review and change the way we collect information below. Participants came from throughout Oregon and other states, and were of higher socioeconomic status and technology-savvy. For probability sampling procedures other than a simple random sample (e.g., stratified or cluster sampling), consult with a survey sampling expert. The epidemic curve for a zoonotic disease among humans typically mirrors the variations in prevalence among the reservoir animal population. This Topic 5 DQ 1 A statistical data display should include, at a minimum, F, female; M, male. The mode in part dictates the format, length, and style of the survey or questionnaire. cDefined as current use of asthma medicine or one or more of the following symptoms during the previous 12 months: wheezing or whistling in the chest, awakening with a feeling of chest tightness, or attack of asthma. Time has special importance in interpreting epidemiologic data in that the initial exposure to a causative agent must precede disease. The difference is that epidemiologists tend to use synonyms for the 5 Ws: diagnosis or health event (what), person (who), place (where), time (when), and causes, risk factors, and modes of transmission (why/how). As with survey development, borrowing from previous data collection protocols can be helpful. Use other intervals (e.g., weeks or days) accordingly. Thank you for taking the time to confirm your preferences. Provide an example and explain what data would be necessary to make a change in practice. Lack of generalizability because of selection bias, variable participation rates. Nowhere are data more Describe how epidemiological data influences changes in health practices. Information specialists can answer your questions in English or Spanish. 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. This will be reflected by an instability of the epidemic curve. Compare frequency of brain cancer among anatomists with frequency in general population, ____ 3. Wednesday 10 In contrast, if the public believes an outbreak resulted from eating a specific food item or eating at a specific restaurant, that belief can preclude the field epidemiologists ability to obtain accurate data after a press release has been issued because it might cause self-report bias among study participants. These factors have potential impact on population health states similar to that of risk factors on disease occurrence. For incident cases, specify the period during which the cases occurred. Cholera deaths per 10,000 inhabitants and altitude above the average high-tide level, by district in London, England, 1849. Question: Describe how epidemiological data Considering all the different elements of an investigation from the beginning will minimize error that potentially can lead to inconclusive results. The urgency of most field investigations requires that the epidemiologist act quickly but thoughtfully. 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. On the opposite end of the scale, injuries and acute poisonings have instantaneous and obvious onsets. Additional existing data sources can help identify cases, determine background rates of human illness, or assess exposures to disease-causing agents (e.g., pathogenic bacteria, vectors, environmental toxins) in a field investigation. Commonly in descriptive epidemiology, you organize cases by frequency of clinical findings (Table 6.2) (3). These cookies may also be used for advertising purposes by these third parties. Use the most important epidemiologic features on which to sort the data. 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).

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