Therefore, the clinician and the epidemiologist have different responsibilities when faced with a person with illness. Although it is logical to believe that a field investigation of an urgent public health problem should roll out sequentiallyfirst identification of study objectives, followed by questionnaire development; data collection, analysis, and interpretation; and implementation of control measuresin reality many of these activities must be conducted in parallel, with information gathered from one part of the investigation informing the approach to another part. Moreover, most, if not all, field investigations will be done by a larger team. In Figure 6.15, a distinctive pattern of rapidly increasing cholera death rates is apparent as the altitude approaches the level of the River Thames. 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. Provide an example and explain what data would be necessary to make a change in practice. Arthropod populations can grow explosively and can decline even more rapidly. BMI, Body mass index; F, female; M, male; SD, standard deviation. Similarly, prevalent case counts divided by the population from which they arose produce a proportion (termed prevalence). For certain conditions, a description by season, month, day of the week, or even time of day can be revealing. 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). 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). Clustered distributions might result from common exposures of group members, an agent that is transmissible through personal contact, an environmental exposure in the living or meeting areas, or localization of houses near or within an environmental area of high risk. Among 9,422 blood lead tests conducted during April 2013March 2016, 284 (3.0%) BLLs were 5 g/dL or higher; the probability of having BLLs of 5 g/dL or greater was 46% higher during the period after the switch from Detroit Water Authority to FWS than before the switch to FWS. 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. WebEpidemiology is concerned with the frequency and pattern of health events in a population. Norovirus (GII) infection was confirmed as the causative agent. As a field epidemiologist, you will collect and assess data from field investigations, surveillance systems, vital statistics, or other sources. The underlying epidemiologic process might produce disease distributions within and among social groupings that range from strong aggregation to randomness or uniformity. Response rate. Although field epidemiologic investigations of an urgent public health problem are legally considered to be public health practice and not research (. Avoid using area maps to display case counts. Cervical cancer (invasive) Surveillance Epidemiology, and End Results Program incidence and death rate: United States, 19992013. Public Health Problem: In November 2008, CDCs PulseNet staff noted a multistate cluster of Salmonella enterididis serotype Typhimurium isolates with an unusual DNA fingerprint (pulsed-field gel electrophoresis [PFGE] pattern). When using transformed data (e.g., logarithmic, normalized, or ranked), represent equal units of the transformed data with equal distances on the axis. Multiple factors must be considered when identifying relevant data sources for conducting a field investigation. Many an epidemiologist has bemoaned a misinterpreted question, confusing survey formatting, or a missing confounding variable resulting in study questions without meaningful results. Rates correct counts for differences among population sizes or study periods. Epidemiological data play an important role in healthcare In fact, epidemiology is often described as the basic science of public health, and for good reason. Each person providing such an answer may interpret trouble hearing differently. The line indicates the rapid decrease in Aedes-infested houses (house index). Significant spacetime clustering (assessed by the Knox test) of dengue cases in the city of Cairns, Australia, during JanuaryAugust 2003. Cases of salmonellosis among passengers on a flight from London to the United States, by time of onset, March 13 14, 1984. More than that becomes confusing clutter. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. In addition, maps display a wealth of underlying detail to compare against disease distributions. These include investigation objectives and scope, whether requisite data exist and can be accessed, to what extent data from different sources can be practically combined, methods for and feasibility of primary data collection, and resources (e.g., staff, funding) available. This will be reflected by an instability of the epidemic curve. The 5 Ws are the essential components of a news story because if any of the five are missing, the story is incomplete. Outbreaks that arise from environmental sources usually encompass multiple generations or incubation periods for the agent. Thank you for taking the time to confirm your preferences. An outbreak of dengue arising from a single imported case in a South China town reveals several of these features (Figure 6.6) (8). Match the term to the activity that best describes it. CDC twenty four seven. Time has special importance in interpreting epidemiologic data in that the initial exposure to a causative agent must precede disease. WebDescribe how epidemiological data influences changes in health practices. An important initial step in collecting data as part of a field investigation is determining the mode of data collection (e.g., self-administered, mailed, phone or in-person interview, online survey) (29). Thank you for taking the time to confirm your preferences. 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. Basic epidemiologic methods tend to rely on careful observation and use of valid comparison groups to assess whether what was observed, such as the number of cases of disease in a particular area during a particular time period or the frequency of an exposure among persons with disease, differs from what might be expected. WebDescribe how epidemiological data influences changes in health practices. A first and simple step in determining how much is to count the cases in the population of interest. Cases of Salmonella enterica serovar Heidelberg infection, by illness onset date: Colorado, July 10 August 17, 1976. : Adapted from Ajloun Non-Communicable Disease Project, Jordan, unpublished data, 2017. Collecting mortality statistics and classifying the causes of death dates to the 1500s in London, when the Bill of Mortality was periodically published (2). Good sample selection can help improve generalizability of results and ensure sufficient numbers of study participants. These might include detailed administrative boundaries or a longitude-latitude grid. The story of removing the pump handle is the quintessential public health intervention based on scientific data. Participants were less likely to complete the Internet surveys. Epidemiology 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 meningitis or diabetes in a population, but also to the relationship of that number to the size of the population. This protocol can include the following: Train staff collecting data on the protocol, reviewing instructions carefully and modifying as needed. Consider instead. Date of onset of 185 cases of dengue in a fishing port: Guangdong Province, China, 2007. 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). Arthropod vectors, after becoming infected, remain so until they perish. Question: Describe how epidemiological data Rates, Ratios, and Alternative Denominators. Distribution of the mosquito vector throughout the Americas led to recognition of the potential further spread of the virus. If this means that you must exclude the zero level, exclude it, but note for the reader that this has been done. Many definitions have been proposed, but the following definition captures the underlying principles and public health spirit of epidemiology: Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems (1). These secondary cases might appear as a prominent wave after a point source by one incubation period, as observed after a point source hepatitis E outbreak that resulted from repairs on a broken water main (Figure 6.4) (7). This data looks at the when, where, why, and how of diseases, injuries, and environmental hazards (CDC, 2018). 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. Characterizing health events by time, place, and person are activities of descriptive epidemiology, discussed in more detail later in this lesson. 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). 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), TTY: (800) 241-1055nidcdinfo@nidcd.nih.gov, Types of Research Training Funding Opportunities, Research Training in NIDCD Laboratories (Intramural), Congressional Testimony and the NIDCD Budget, U.S. Department of Health & Human Services, Discovery revives old theory of the origins of hearing loss, Low birth weight linked to communication problems in children, Research finds low hearing aid use by Hispanic/Latino older adults, U.S. Department of Health and Human Services. Extreme aspect ratios distort data. Stacking different strata atop one another (as in Figure 6.7, which is not recommended) defeats attempts to compare the time patterns by group. WebEpidemiological data influences changes in health practices in the following ways: These data can be used for the understanding of population-level disease progression. Use columns for most crucial data comparisons. 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. Is the objective to identify a point source (e.g., a contaminated food item) of an outbreak to recall the product? Topic 5 DQ 1 DQ-1 Describe how epidemiological data 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. Recommend that close contacts of a child recently reported with meningococcal meningitis receive Rifampin, ____ 6. Contact diagrams are versatile tools for revealing relationships between individual cases in time. 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. 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. Mean, median, range, and interquartile range of body mass index measurements of 1,800 residents, by education level: Ajloun and Jerash Governorates, Jordan, 2012. Similarly, times of suspected exposures vary in their precision. Personal characteristics include demographic factors which may be related to risk of illness, injury, or disability such as age, sex, marital status, and socioeconomic status, as well as behaviors and environmental exposures. Your analytic findings must explain the observed patterns by time, place, and person. For incident cases, specify the period during which the cases occurred. 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. Epidemiology Now, with the recent explosion in molecular methods, epidemiologists can make important strides in examining genetic markers of disease risk. 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. In the healthcare field we use epidemiological data when doing a Cluster bar charts with more than two bars per cluster (e.g., Figure 6.16, panel B) are not recommended. The important attributes of a public health surveillance system can and should be applied to data collected in response to an urgent event (see Introduction). Source: Adapted from: Ajloun Non-Communicable Disease Project, Jordan, unpublished data, 2017. See Answer. Whether the tables or graphs help the investigator understand the data or explain the data in a report or to an audience, their organization should quickly reveal the principal patterns and the exceptions to those patterns. Certain sensitive topics (e.g., sexual behaviors) might be better for a self-administered survey than a phone survey. Length and complexity of the survey. Use redundant beginning and end points (see Figures 6.9 through 6.14) to visualize the trend between the last and first months of the cycle. Describe how epidemiological data influences changes in health practices. The Internet survey took more up-front time and resources to prepare but less staff time for data collection and data entry. Epidemiological data play an important role in healthcare Decrease the time interval size as case numbers increase. Supports decisions for initiating or modifying control and prevention measures. Information and variables to include in a survey instrument are. Analysis by other personal attributes in descriptive epidemiology involves comparing rates or other numeric data by different classes of the attribute. For example, for a long survey or one with complex skip patterns, an interviewer-administered survey might be better than a self-administered one. 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. Epidemiologists would do well to remember GIGO (garbage in, garbage out) when delineating their data collection plans. With diseases of shorter incubation and lower rates of secondary spread, the secondary wave might appear only as a more prolonged downslope. 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. Tables are commonly used for characterizing disease cases or other health events and are ideal for displaying numeric values. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Answered: Describe how epidemiological data | bartleby Use alternatives to joining data points with a line. Information about place of affected persons might include residence, workplace, school, recreation site, other relevant locales, or movement between fixed geographic points. Indeed, the term health-related states or events may be seen as anything that affects the well-being of a population. Voice: (800) 241-1044 Considering all the different elements of an investigation from the beginning will minimize error that potentially can lead to inconclusive results. Epidemiological data of clinical epidemiology in medical practice Upright bars in each interval represent the case counts during that interval. Indicate the data range in the legend; do not leave it open-ended. Major sources of error that need to be considered during data collection include the following: Keeping in mind the investigation objectives, the epidemiologist should evaluate whether existing data sources (e.g., vital statistics, notifiable disease registries, population surveys, healthcare records, environmental data) are useful for addressing the investigation objectives, whether these data are accurate and readily accessible for analysis, whether existing data systems are interoperable, and what additional data, if any, need to be collected de novo. All information these cookies collect is aggregated and therefore anonymous. T5DQ1 Describe how epidemiological data influences changes in health practices. 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. Cookies used to make website functionality more relevant to you. 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. If the survey is interviewer-administered, it should include fields for interviewer name and interview date. To calculate incidence, special care therefore is needed to avoid counting the same person every time a fluctuation occurs above or below the cutoff point. Control measures targeting the larva and adults of the mosquito vectors Aedes aegypti and A. albopictus began late in the first generation. Provide marginal averages, rates, totals, or other summary statistics for rows and columns whenever possible. 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). Determinant: any factor, whether event, characteristic, or other definable entity, that brings about a change in a health condition or other defined characteristic. Use visually prominent symbols to plot and emphasize the data. Describe how epidemiological data influences changes in health practices. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. May 18, 2022 Epidemiology data influence in health practices Describe how epidemiological data influences changes in health practices. Like the practice of medicine, the practice of epidemiology is both a science and an art. Contact between severe acute respiratory syndrome (SARS) cases among a group of relatives and health care workers: Beijing, China, 2003. 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. How epidemiological data influences The feasibility of reaching participants through different modes. 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). Saving Lives, Protecting People, https://www.cdc.gov/nchs/data/dvs/edrs-online-reference-manual.pdf, https://aspe.hhs.gov/system/files/pdf/255531/Decliningresponserates.pdf, http://www.hhs.gov/ohrp/regulations-and-policy/guidance/checklists/, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, U.S. Department of Health & Human Services. Consequently, they also accelerate and amplify epidemic development. You can review and change the way we collect information below. Content experts should review the draft questionnaire. Seasonal patterns might be summarized in a seasonal curve (Box 6.8). Plot the percentage of the total for the year represented by each interval; however, take care when interpreting the total percentage. In contact diagrams (Figure 6.2, panel A) (5), which are commonly used for visualizing person-to-person transmission, different markers are used to indicate the different groups exposed or at risk. 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. For probability sampling procedures other than a simple random sample (e.g., stratified or cluster sampling), consult with a survey sampling expert. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. NRS-440V Week 5 Assignment Combining Nurse Leader With Advocacy. JULY.docx - Describe how epidemiological data influences 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. Each spot in the plotting area represents the joint magnitude of the two variables. The x-axis represents a period of interest. 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). Scatter plots are versatile instruments for exploring and communicating data. Identifies populations at increased risk for the health problem under investigation. The word epidemiology comes from the Greek words epi, meaning on or upon, demos, meaning people, and logos, meaning the study of. aRotaShield, Wyeth-Lederle, Collegeville, Pennsylvania If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. This task, called descriptive epidemiology, answers the following questions about disease, injury, or environmental hazard occurrence: The first question is answered with a description of the disease or health condition. Probability sampling is a better choice for statistical tests and statistical inferences. A well-structured analytical table that is organized to focus on comparisons will help you understand the data and explain the data to others. For example, elevated childhood blood lead levels are a reportable condition, prompting investigation into possible environmental sources of lead. Saving Lives, Protecting People. Sources of data and approaches to data collection vary by topic. 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. Cates W. Epidemiology: Applying principles to clinical practice. Describing Epidemiologic Data | Epidemic Intelligence Service | CDC However, it is important to consider conducting some preliminary data analysis even before data collection is complete. Logistics, including budget, personnel, and timeline. Tabulate the frequency of clinical signs, symptoms, and laboratory findings among children with chickenpox in Cincinnati, Ohio. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. This type of curve can be made for any time cycle (e.g., time of day, day of week, or week of influenza season). Use the smallest possible administrative area that the numerator and denominator will allow. 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. For foodborne outbreaks, most states and local jurisdictions publish data at least annually; however, for chronic diseases (e.g., cancer) or birth outcomes (e.g., microcephaly), expected baseline rates might have to be extrapolated by applying previously published rates to the population of concern. Cases of leptospirosis by week of hospitalization and rainfall in Salvador, Brazil, March 10November 2, 1996. Often, this will follow a biologically determined interval. Provide an example and explain what data would be necessary to make a change in practice. For rates that vary more widely, a logarithmic scale for the y-axis is recommended for epidemiologic purposes (Figure 6.10) (10). A rapid decrease in dengue cases follows this decrease in vector density. 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. When two or more data sets are plotted in the same data space, Design point markers and lines for visual discrimination; and. Last JM, editor. Keep keys, legends, markers, and other annotations out of the data space. 4th ed. WebWith that being said, epidemiological data can have an impact on changes in health practices. Often, a periodicity equivalent to the generation period for the agent might be obvious during the initial stages of the outbreak. If the denominator of the population unit is known, spots of different size or shading (Box 6.10) can represent rates or ratios. Ensures that you are fully versed in the basic dimensions of a health problem. To determine the most efficient means of collecting data, epidemiologists administered a questionnaire using Internet-and telephone-based interview methods to directly compare data regarding response rates, attack rates, and risk factors for illness. To support person-to-person transmission, you should also see that the timing between onsets of cases approximates the known incubation periods for the disease (Figure 6.8) (5). In surveillance systems, you might have only the report date or another onset surrogate. These can then be compared among groups, against expected values, or against target values. For questions about the EIS program, please contact us directly at EISApplication@cdc.gov. Another example is injuries from snowmobile use, which have been calculated both as ratios per registered vehicle and as per crash incident (4). Statistics/Nursing - Describe how epidemiological data Information was drawn in part from the Surveys and Sampling chapter in the earlier edition of this book (27) and from Designing Clinical Research (28). This is important so that we have a background, and average on these ailments that we may see within the healthcare practice. However, epidemiology is not just a research activity but an integral component of public health, providing the foundation for directing practical and appropriate public health action based on this science and causal reasoning.(2). WebDescribe how epidemiological data influences changes in health practices. describe how epidemiological data influences changes in health 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.
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