uses of epidemiology by dr. hemant golhar moderator: dr. subodh gupta
TRANSCRIPT
USES OF EPIDEMIOLOGY
BY DR. HEMANT GOLHARMODERATOR: DR. SUBODH GUPTA
FRAME WORK• INTRODUCTION OF EPIDEMIOLOGY• DEFINITIONS• AIMS OF EPIDEMIOLOGY• USES OF EPIDEMIOLOGY
Classically speaking
• Epi = upon• Demos = people• Ology = science• Epidemiology = the science which deals with what falls upon
people…..• Bridge between biomedical, social and behavioral sciences
What is Epidemiology?
Simple Old Definitions
Oxford English Dictionary
THE BRANCH OF MEDICAL SCIENCE WHICH TREATS EPIDEMICS
Kuller LH: American J of Epidemiology 1991;134:1051
EPIDEMIOLOGY IS THE STUDY OF "EPIDEMICS" AND THEIR PREVENTION
Anderson G. In: Rothman KJ: Modern Epidemiology
THE STUDY OF THE OCCURRENCE OF ILLNESS
A Modern Definition
Study of the occurrence and distribution of health-related diseases or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problem (Porta M, Last J, Greenland S. A Dictionary of Epidemiology, 2008)
Purposes of Epidemiology
1. To investigate nature / extent of health-related phenomena in the community / identify priorities
2. To study natural history and prognosis of health-related problems
3. To identify causes and risk factors4. To recommend / assist in application of /
evaluate best interventions (preventive and therapeutic measures)
5. To provide foundation for public policy
AIM
EPIDEMIOLOGYOF
HEAL
TH
ACTION
DISEASE LOAD
EDUCATION AL & RESEARCH
CAUSE
AIM OF EPIDEMIOLOGY
FOR
TAKING
MORRIS’ SEVEN USES
1. TREND STUDY
2. COMMUNITY DIAGNOSIS
3. HEALTH SERVICES EVALUATION
4. TO KNOW THE INDIVIDUAL RISKS AND CHANCES
5. SYNDROME IDENTIFICATION
6. COMPLETING THE CLINICAL PICTURE
7. SEARCHING FOR CAUSES / RISK FACTORS FOR ESTABLISHING CAUSAL RELATIONSHIP
(1) TREND STUDY
1. Studying the past history for rise and fall
2. Studying its changing behaviour
3. Making future predictions
4. Giving early warnings or feed –back
5. Results are useful in planning for health services
and public health
SOCIAL ANATOMY
COMMUNITY DIAGNOSIS
SOCIAL PATHOLOGY
SOCIAL PHYSIOLOGY
QUANTIFICATIONQUALITATIVE ESTIMATION
(2) COMMUNITY DIAGNOSIS
COMMUNITY DIAGNOSIS
1. SOCIAL ANATOMY: Race, age and sex composition, socio economic status, population at risk, resources available.
2. SOCIAL PHYSIOLOGY: Positive &negative lifestyles, occupation, health services awareness and utilization.
3. SOCIAL PATHOLOGY: Morbidity, mortality, disability, alcoholism, smoking, crime & violence, risk prone behavior.
COMMUNITY DIAGNOSIS
• Must be dynamic
In a world of change, epidemiologist have a special duty to observe the impact “upon the people” and the way we live to diagnose where well -being is increasing and where losing out, to probe for unintended consequences , to identify trends and to think ahead.
(3) HEALTH SERVICES ASSESSMENTS, EVALUATION AND RESEARCH
• Translates knowledge of changing health scenario into needs for services.
• After that measures how they are met or unmet.• The success of met health demands are then appraised in
relation to available resources• Basically measures how well do public health services meet
the problems and needs of the population• This helps in wise allocation of resources in planning and
setting up health facilities and services
(4)ESTIMATE INDIVIDUAL RISK AND CHANCES
• Estimate individual risk of disease, accident or defect, it can be arrived using odds ratio and relative risk.
• Estimate the chances of avoiding them. It can be calculated using attributable risk.
• It is of huge public health importance.
(5) SYNDROME IDENTIFICATION
• Helps to establish and set criteria to define syndromes.
• This is done by describing the distribution and association of clinical phenomena in the population.
(6) COMPLETING THE CLINICAL PICTURE OF DISEASE • Going to the bottom, the deeper part of the iceberg to study the earlier part of disease, which is either stoppable or at least preventable by searching for
• Precursors of the disease• Dispositions due to disease• Asymptomatic disease• Subclinical cases• Latent cases• Carrier state
• Epidemiologist immensely contribute to physicians understanding of the clinical picture and natural history of disease.
• They identify gaps in natural history of the disease and take measures to fill this gap.
• Epidemiology plays an important role in outbreak investigation to establish the proper diagnosis of individual patients using case definition.
(7) EXAMINE CAUSATION
Several Causes Single Disease
Single Cause Several Diseases
Search for cause in interrelated diseases may yield clues for new causes / risk factors
SCOPE AND JURISDICTION Strictly speaking, there is no life science, where
epidemiological approach and principles cannot be applied
FROM WOMB TO TOMB EPIDEMIOLOGY IS APPLICABLE
PREVENTIVE PAEDIATRICSPREVENTIVE GERIATRICS
PREVENTIVE CARDIOLOGYCLINICAL EPIDEMIOLOGY
Reference
• 1) Basic Epidemiology by R. Beaglehole R. Bonita T. Kjellstrom
• 2) Epidemiology by Leon Gordis( Fifth Edition)
• 3) International Journal of Epidemiology 2001;30:1146-1155
• 4) Text book of Public Health and community medicine by Armed
Force Medical College
• 5)Morris J.N. uses of epidemiology third edition new York 1975
•Thank you…