分享一本书Basic epidemiology
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目录:
Preface ix
Introduction xi
Chapter 1 What is epidemiology? 1
Key messages 1
The historical context 1
Origins 1
Recent developments in epidemiology 1
Definition, scope, and uses of epidemiology 2
Definition 2
Scope 3
Epidemiology and public health 4
Causation of disease 4
Natural history of disease 4
Health status of populations 5
Evaluating interventions 5
Achievements in epidemiology 6
Smallpox 6
Methyl mercury poisoning 7
Rheumatic fever and rheumatic heart disease 7
Iodine deficiency diseases 8
Tobacco use, asbestos and lung cancer 9
Hip fractures 9
HIV/AIDS 10
SARS 10
Study questions 11
References 12
Chapter 2 Measuring health and disease 15
Key messages 15
Defining health and disease 15
Definitions 15
Diagnostic criteria 16
Measuring disease frequency 17
Population at risk 17
Incidence and prevalence 18
Case fatality 22
Interrelationships of the different measures 22
Using available information to measure health and disease 23
Mortality 23
Limitations of death certificates 23
Limitations of vital registration systems 24
Towards comparable estimates 24
Death rates 25
Infant mortality 26
Child mortality rate 26
Contents iii
Maternal mortality rate 27
Adult mortality rate 28
Life expectancy 28
Age-standardized rates 29
Morbidity 30
Disability 31
Health determinants, indicators, and risk factors 32
Other summary measures of population health 32
Comparing disease occurrence 34
Absolute comparisons 34
Relative comparisons 35
Study questions 36
References 36
Chapter 3 Types of studies 39
Key messages 39
Observations and experiments 39
Observational studies 39
Experimental studies 39
Observational epidemiology 40
Descriptive studies 40
Ecological studies 41
Ecological fallacy 43
Cross-sectional studies 44
Case-control studies 44
Cohort studies 46
Summary of epidemiological studies 49
Experimental epidemiology 49
Randomized controlled trials 50
Field trials 50
Community trials 51
Potential errors in epidemiological studies 51
Random error 52
Sample size 52
Systematic error 53
Selection bias 53
Measurement bias 54
Confounding 55
The control of confounding 56
Validity 57
Ethical issues 58
Study questions 60
References 60
Chapter 4 Basic biostatistics: concepts and tools 63
Key messages 63
Summarizing data 63
Tables and graphs 64
Pie charts and component band charts 64
Spot maps and rate maps 65
Bar charts 65
iv Contents
Line graphs 66
Frequency distributions and histograms 66
Normal distributions 67
Summary numbers 67
Means, medians and mode 67
Variances, standard deviations and standard errors 68
Basic concepts of statistical inference 69
Using samples to understand populations 69
Confidence intervals 70
Hypothesis tests, p-values, statistical power 71
The p-value 71
Statistical power 71
Basic methods 73
t-tests 73
Chi-squared tests for cross tabulations 74
Correlation 75
Regression 75
Linear regression 76
Logistic regression 78
Survival analyses and Cox proportional hazards models 79
Kaplan-Meier survival curves 79
Sample size issues 80
Meta-analysis 81
Study questions 82
References 82
Chapter 5 Causation in epidemiology 83
Key messages 83
The concept of cause 83
Sufficient or necessary 83
Sufficient and necessary 84
A causal pathway 85
Single and multiple causes 86
Factors in causation 87
Interaction 88
A hierarchy of causes 88
Establishing the cause of a disease 89
Considering causation 89
Temporal relationship 89
Plausibility 91
Consistency 91
Strength 93
Dose–response relationship 93
Reversibility 95
Study design 95
Judging the evidence 96
Study questions 96
References 97
Contents v
Chapter 6 Epidemiology and prevention: chronic noncommunicable
diseases
Key messages 99
The scope of prevention 99
Recent trends in death rates 99
Preventive potential 99
Causation framework 101
Levels of prevention 102
Primordial prevention 103
Primary prevention 103
Population strategy 105
High-risk individual strategy 105
Secondary prevention 107
Tertiary prevention 108
Screening 109
Definition 110
Types of screening 110
Criteria for screening 110
Study questions 110
References 114
Chapter 7 Communicable diseases: epidemiology surveillance and 114
response 117
Key messages 117
Introduction 117
Definitions 117
Role of epidemiology 118
The burden of communicable disease 118
Threats to human security and health systems 118
Epidemic and endemic disease 119
Epidemics 119
Endemic diseases 121
Emerging and re-emerging infections 122
Chain of infection 123
The infectious agent 123
Transmission 124
Host 125
Environment 125
Investigation and control of epidemics 126
Investigation 126
Identifying cases 126
Management and control 126
Surveillance and response 127
Study questions 130
References 131
Chapter 8 Clinical epidemiology 133
Key messages 133
Introduction 133
Definitions of normality and abnormality 133
vi Contents
Normal as common 134
Abnormality associated with disease 135
Abnormal as treatable 135
Diagnostic tests 136
Value of a test 136
Natural history and prognosis 137
Prognosis 137
Quality of life 138
Quantity of life 138
Effectiveness of treatment 139
Use of evidence-based guidelines 140
Prevention in clinical practice 140
Reducing risks 141
Reducing risks in patients with established disease 141
Study questions 142
References 143
Chapter 9 Environmental and occupational epidemiology 145
Key messages 145
Environment and health 145
Impact of exposure to environmental factors 146
Evaluation of preventive measures 147
Exposure and dose 149
General concepts 149
Biological monitoring 150
Interpreting biological data 151
Individual versus group measurements 151
Population dose 152
Dose–effect relationships 153
Dose–response relationships 154
Assessing risk 155
Risk assessment 155
Health impact assessment 155
Risk management 155
Environmental health impact assessment 155
Injury epidemiology 157
Traffic crash injuries 157
Workplace injury 157
Violence 158
Suicides 158
Special features of environmental and occupational epidemiology 159
Setting safety standards 159
Measuring past exposure 160
Healthy worker effect in occupational studies 160
Continuing challenges for epidemiologists 160
Study questions 161
References 161
Chapter 10 Epidemiology, health policy and planning 165
Key messages 165
Introduction 165
Contents vii
Health policy 165
Health planning 165
Evaluation 165
Health policy 166
The influence of epidemiology 166
Framing health policy 167
Health policy in practice 168
Health planning 169
The planning cycle 170
Assessing burden 171
Understanding causes 172
Measuring effectiveness of interventions 172
Assessing efficiency 173
Implementing interventions 174
Monitoring activities and measuring progress 175
Study questions 175
References 176
Chapter 11 First steps in practical epidemiology 177
Key messages 177
Introduction 177
Specific diseases 177
Critical reading 178
Planning a research project 181
Choosing a project 181
Writing the protocol 182
Doing the research 183
Analysing the data 183
Getting published 183
Further reading 184
Study questions 185
Abstract 186
Methods 187
Annex Answers to Study Questions 187
Index 189
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发表于 2012-9-6 21:41:38