describe how epidemiological data influences changes in health practices

Enables generation of testable hypotheses regarding the etiology, exposure mode, control measure effectiveness, and other aspects of the health problem. Sensitivity of questions. WebDescribe how epidemiological data influences changes in health practices. This count of incident cases over time in a population is called incidence. WebHLT- 362 Topic 5 DQ 1 Describe how epidemiological data influences changes in health practices. Length and complexity of the survey. In this chapter, additional guidelines for preparing these data displays will appear where the specific data display type is first applied. Legal counsel can help address these concerns. In this example, nearly every peak of rainfall precedes a peak in leptospirosis, supporting the hypothesis regarding the importance of water and mud in transmission. During the 2016 epidemic of Zika virus infection, understanding the ecologic niche for the Aedes mosquito vector was important when investigating an increase in febrile rash illnesses (Box 4.2) (12). A more precise approach involves computing the average and dispersion of the individual measurements. 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. Ensures that you are fully versed in the basic dimensions of a health problem. Share sensitive information only on official, secure websites. For most conditions, when the rates vary over one or two orders of magnitude, an arithmetic scale is recommended. Lack of generalizability because of selection bias, variable participation rates. Take-Home Points: Internet-based surveys permit efficient data collection but should be designed to maximize complete responses. 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. Below are three key terms taken from the definition of epidemiology, followed by a list of activities that an epidemiologist might perform. A trend line of best fit underlying the data markers. This tends to prolong waves of vectorborne outbreaks. As a field epidemiologist, you will collect and assess data from field investigations, surveillance systems, vital statistics, or other sources. Epidemiologists working in applied public health have myriad potential data sources available to them. Mailed and Internet surveys traditionally yield lower response rates than phone surveys; however, response rate for phone surveys also has declined during the past decade (. Consider instead. 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. Plot the percentage of the total for the year represented by each interval; however, take care when interpreting the total percentage. 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. 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). 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). As an alternative to plotting onset by calendar time, plotting the time between suspected exposures and onset can help you understand the epidemiologic situation. For incident cases, specify the period during which the cases occurred. They help us to know which pages are the most and least popular and see how visitors move around the site. They indicate the association between two numerically scaled variables (Figure 6.15) (16). They can have various response categories (e.g., nominal, numeric, Likert scales). Age-adjusted rates can be used for comparing populations from different areas, from the same area at different times, and among other characteristics (e.g., ethnicity or socioeconomic status). Good sample selection can help improve generalizability of results and ensure sufficient numbers of study participants. All information these cookies collect is aggregated and therefore anonymous. Compare the association of cases during these pre-and post-epidemic periods with the main outbreak. Ensure that scaling applies accurately to all features in the map area, especially indicators of location of disease and potential exposures. More than that becomes confusing clutter. The word epidemiology comes from the Greek words epi, meaning on or upon, demos, meaning people, and logos, meaning the study of. Make sure overlapping plotting symbols are distinguishable. This Cases of jaundice, by week of onset: Jafr, Maan Governorate, Jordan,June October 1999. Age represents three different categories of determinants of disease risk (Box 6.11). Data from laboratories are critical for investigating infectious disease outbreaks. 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. 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. Provide an As a convention in plotting epidemiologic or geographic association, the explanatory variable (exposure, environmental, or geographic) is plotted on the x-axis, and the outcome (rate or individual health measurement [e.g., BMI]) is plotted on the y-axis. Accessing or collecting clean, valid, reliable, and timely data challenges most field epidemiologic investigations. 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. Organizations can develop interventions and therapies that are suited to the needs of the public by gathering and analyzing data to These are widely dispersed, indicating that they did not acquire their infection from their local environs. Describe how epidemiological data influences changes in health practices. 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). Ajloun Non-Communicable Disease Project, Jordan, Unpublished data, 2017. The underlying epidemiologic process might produce disease distributions within and among social groupings that range from strong aggregation to randomness or uniformity. Although epidemiologists and direct health-care providers (clinicians) are both concerned with occurrence and control of disease, they differ greatly in how they view the patient. The clinician is concerned about the health of an individual; the epidemiologist is concerned about the collective health of the people in a community or population. 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. Indicate underpopulated or depopulated areas. Significant spacetime clustering (assessed by the Knox test) of dengue cases in the city of Cairns, Australia, during JanuaryAugust 2003. Source: Adapted from Ajloun Non-Communicable Disease Project, Jordan, unpublished data, 2017. The ability to conduct an epidemiologic field investigation efficiently and effectively depends on understanding the interconnectedness of its parts. mosquitoes was identified in northeastern Brazil. Use other intervals (e.g., weeks or days) accordingly. The importance of developing a protocol, identifying roles and responsibilities of team members, and documenting all activities and processes should not be underestimated. Conversely, many new sources of data are opportunities made possible by the expanded use of computer technology by individuals, businesses, and health systems. Ensure that potential exposures are easily discerned and labeled. The line-listing in Table 6.1 has been sorted by days between vaccination and onset to reveal the pattern of this important timeevent association. A more precise approach to estimating how much for measurements on a continuous scale, discussed earlier in this chapter, might be to compute the average and dispersion of the individual BMI measurements, as shown on a box-and-whisker plot (Figure 6.1). Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. This is important so that we have a background, and average on these ailments that we may see within the healthcare practice. 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). The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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). On maps representing land areas, indicate longitude and latitude and orientation (i.e., by using a northward-pointing arrow). In other words, the clinicians patient is the individual; the epidemiologists patient is the community. 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 alternatives to joining data points with a line. NRS-440V Week 5 Assignment Combining Nurse Leader With Advocacy. Instructions related to protection of participants (e.g., maintaining confidentiality, data security). Similarly, prevalent case counts divided by the population from which they arose produce a proportion (termed prevalence). The last three questions are assessed as patterns of these data in terms of time, place, and person. We take your privacy seriously. Thus, incidence divided by an appropriate estimation of the population yields several versions of incidence rates. When the row or column headings are numeric (e.g., age groups), they should govern the order of the data. To assess adverse effects from a vaccine or pharmaceutical, consider using total doses distributed as the denominator. Provides timely information for decision-makers, the media, the public, and others about ongoing investigations. Sources of data and approaches to data collection vary by topic. Relating disease with these events in time can support calculation of key characteristics of the disease or health event. Therefore, writing a protocol before embarking on any data collection is paramount. For certain conditions, a description by season, month, day of the week, or even time of day can be revealing. Let the difference in shading of map areas define and replace detailed internal boundary lines. Text that highlights the main patterns of the data (this text might appear within the table or graphic or in the body of the report). 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. Mean daily temperatures of less than 68F (<20C) typically arrest multiplication of infectious agents in the arthropod. Cookies used to make website functionality more relevant to you. Recognizing disease patterns by personal attributes (e.g., age, sex, education, income, or immunization status) constitutes the fifth element in descriptive epidemiology. Epidemiological research 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), Helps validate the eventual incrimination of causes or risk factors. WebHealthcare data improves communication between patients and healthcare providers and provides doctors with an in-depth understanding of specific health conditions. < Previous Chapter 3: Conducting a Field Investigation, Next Chapter 5: Using Technologies for Data Collection and Management >. Rates, Ratios, and Alternative Denominators. 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. The application period for EIS Class of 2024 is now open through June 5, 2023. For example, a maternal mortality ratio and infant mortality rate use births in a calendar year as a denominator for deaths in the same calendar year, yet the deaths might be related to births in the previous calendar year. 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. 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. Generally, government public health agencies have the authority to access healthcare system data (with justification). Response rate. Never mix incident with prevalent cases in epidemiologic analyses. When comparing two graphs of the same dependent variable, use scaling that improves comparison and resolution. Furthermore, EHRs contain potentially useful data on healthcare use, treatment, and outcomes of a diseaseelements not typically assessed by more traditional public health data sources. To indicate nominative (non-numeric) qualities, use different hues or fill patterns. Now, with the recent explosion in molecular methods, epidemiologists can make important strides in examining genetic markers of disease risk. Stratifying seasonal curves can further expose key differences by place, person, or other features (Figure 6.12) (12). The field epidemiologist must understand the characteristics of the study population and their ability and willingness to respond to various survey methods (e.g., access computers and Internet-based surveys). Provides a systematic approach for dissecting a health problem into its component parts. Seasonal distribution of malaria cases, by month of detection by voluntary collaborators in four villages: El Salvador, 19701977. Use time intervals of half an incubation or latency period or less. Thank you for taking the time to confirm your preferences. The choice between tables and charts depends on the purpose, the audience, and the complexity of the data. A data space where the data are organized and displayed to indicate patterns. The outbreak grew to involve 714 case-patients in 46 states; 166 (23%) were hospitalized and 9 (1%) died. 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. Use graphic designs that reveal the data from the broad overview to the fine detail. These might include detailed administrative boundaries or a longitude-latitude grid. 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). To indicate no data, use a different hue or fill pattern. 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. 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). Is the objective to identify factors in the environment that might be causing disease (e.g., elevated lead levels in drinking water)? Provide an example and explain what data would be necessary to make a change in practice. 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]). These distance associations of cases or rates are best understood on maps. Logistics, including budget, personnel, and timeline. 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. Mark on a map the residences of all children born with birth defects within 2 miles of a hazardous waste site, ____ 4. Information bias, such as measurement error, self-report bias, and interviewer bias. Pay special attention to ensuring that survey instruments can be used across multiple sites in the event that the outbreak involves multiple jurisdictions. The feasibility of reaching participants through different modes. The disease or health condition onset time is the preferred statistic for studying time patterns. what is a groomspiel new zealand,

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