Causality and Association in Epidemiology
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Questions and Answers

Which factor is NOT typically required to complete the causal circle for disease?

  • Socioeconomic state
  • Genetic predisposition (correct)
  • Person susceptibility
  • Environmental factors

In the context of multifactorial causation, which model describes factors acting independently to produce the same disease?

  • Cumulative model
  • Alternative causal factors model (correct)
  • Synergistic model
  • Independent model

Which criterion for judging causality requires that exposure to a potential causal factor must occur before the onset of the disease?

  • Temporal association (correct)
  • Consistency of the association
  • Strength of association
  • Biological plausibility

What does a larger relative risk typically indicate in terms of causal association?

<p>A greater likelihood of a causal association (B)</p> Signup and view all the answers

Which of the following diseases exemplifies multifactorial causation with several independent risk factors?

<p>Coronary heart disease (C)</p> Signup and view all the answers

What is meant by a 'biological gradient' in the context of causality?

<p>The relationship between exposure and disease incidence increases with greater exposure (A)</p> Signup and view all the answers

Which of the following statements best describes the complexity of causal association in multifactorial diseases?

<p>Numerous factors may confound the understanding of causation (B)</p> Signup and view all the answers

Which factor is considered crucial for establishing a causal relationship between a risk factor and a disease?

<p>Coherence of the association (A)</p> Signup and view all the answers

Which approach is NOT part of establishing a cause and effect relationship according to the criteria for judging causality?

<p>Statistical randomness (B)</p> Signup and view all the answers

What is the primary purpose of descriptive studies in epidemiology?

<p>To suggest an aetiological hypothesis based on disease observations (C)</p> Signup and view all the answers

Which of the following best describes the term 'association' in epidemiology?

<p>It denotes the occurrence of two events together more frequently than expected by chance. (C)</p> Signup and view all the answers

Which measure of association compares the risk of a health event between two differentiated groups?

<p>Risk ratio (relative risk) (B)</p> Signup and view all the answers

What distinguishes the odds ratio from other measures of association?

<p>It examines the probability of exposure in case-patients versus controls. (C)</p> Signup and view all the answers

Which type of association is characterized by a non-real relationship between a factor and an outcome?

<p>Spurious association (C)</p> Signup and view all the answers

What does a risk ratio compare in epidemiological studies?

<p>The rate of disease occurrence among exposed individuals to that of unexposed individuals. (C)</p> Signup and view all the answers

In the context of causal associations, what is meant by 'one-to-one causal association'?

<p>One specific factor directly leads to one specific disease. (B)</p> Signup and view all the answers

Which of the following statements about analytical and experimental studies is true?

<p>They test hypotheses derived from descriptive studies. (A)</p> Signup and view all the answers

What is the significance of examining perinatal mortality rates in the context of home vs. hospital births?

<p>It illustrates the concept of spurious association in research. (B)</p> Signup and view all the answers

What is the main reason that hospitals may have a higher perinatal mortality rate compared to home deliveries?

<p>Hospitals attract women at high risk for delivery. (B)</p> Signup and view all the answers

What is a confounding variable?

<p>A variable that may show a correlated relationship while being influenced by an external factor. (B)</p> Signup and view all the answers

In the example of high coffee drinking and ischemic heart disease, what common factor was identified?

<p>Heavy smoking. (C)</p> Signup and view all the answers

How is endemic goitre associated with altitude?

<p>Environmental deficiency of iodine at high altitude leads to goitre. (D)</p> Signup and view all the answers

What defines a one-to-one causal relationship?

<p>A change in A is always followed by a change in B. (D)</p> Signup and view all the answers

Which statement about indirect associations is true?

<p>They can be misleading due to the influence of confounding variables. (A)</p> Signup and view all the answers

What is an example of a condition that is suggested to have a one-to-one causal relationship?

<p>Measles and a specific viral infection. (A)</p> Signup and view all the answers

What complication can arise when analyzing causal relationships in health studies?

<p>Assumption of direct causality without considering other variables. (C)</p> Signup and view all the answers

What was the misinterpretation regarding home births and hospital deliveries?

<p>Higher mortality rates in hospitals might not reflect care quality. (A)</p> Signup and view all the answers

Which of the following is NOT a common confounding variable in health studies?

<p>Personal beliefs about health. (A)</p> Signup and view all the answers

What does the concept of specificity imply regarding the relationship between cause and effect?

<p>There is a 'one-to-one' relationship between a specific cause and a specific effect. (A)</p> Signup and view all the answers

Which factor is essential for establishing a consistent association in epidemiological studies?

<p>The results must replicate across multiple settings and methods. (B)</p> Signup and view all the answers

Why is biological plausibility important in assessing causal associations?

<p>It must align with established biological knowledge of health and diseases. (A)</p> Signup and view all the answers

What indicates coherence of an association between two factors according to the provided information?

<p>When the association aligns with other known and relevant historical facts. (B)</p> Signup and view all the answers

Which of the following best exemplifies a multifactorial association?

<p>The relationship between air pollution and respiratory diseases. (C)</p> Signup and view all the answers

Which scenario reflects a lack of biological plausibility?

<p>The relationship between high sugar intake and colon cancer. (D)</p> Signup and view all the answers

What does the concept of consistency of association primarily rely on?

<p>A range of studies show similar results over time. (A)</p> Signup and view all the answers

Which statement about the coherence criterion is true?

<p>Coherence must align with already known biological or historical facts. (A)</p> Signup and view all the answers

In the context of smoking and lung cancer, which variety of studies indicated a consistent association?

<p>A combination of retrospective and prospective studies across different countries. (B)</p> Signup and view all the answers

What role do risk factors play in asserting specificity?

<p>They complicate the understanding of the relationship and may not follow a singular pattern. (A)</p> Signup and view all the answers

Flashcards

Association

The concurrence of two variables more often than would be expected by chance.

Measure of Association

A measure that compares disease occurrence in one group with another group, often based on demographic factors or exposure to a risk factor.

Risk Ratio (Relative Risk)

A measure that compares the risk of a health event (disease, injury or death) in one group against another group, often based on exposure to a suspected risk factor.

Odds Ratio (OR)

A measure that quantifies the relationship between an exposure with two categories (e.g., exposed vs. not exposed) and a health outcome, using a comparison of probabilities.

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Spurious Association

A non-real relationship between a factor and an outcome, often due to confounding variables.

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Indirect Association

A relationship between two variables where the factor is not directly causing the outcome, but is influenced by a third variable.

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Direct (Causal) Association

A relationship where a factor directly causes the outcome, establishing a clear cause-and-effect connection.

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One-to-One Causal Association

A direct association where one specific factor exclusively causes the outcome.

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Multifactorial Causation

A direct association where multiple factors contribute to the outcome, often in a complex interplay.

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Confounding Variable

A factor that is common to both the characteristic of interest and the disease, leading to an apparent association.

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One-to-One Causal Relationship

A type of direct association where the presence of one variable always leads to the presence of the other.

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Complications in One-to-One Relationships

The concept of a one-to-one causal relationship can be complex due to factors that may not be apparent.

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Example: Coffee and Heart Disease

The apparent association between high coffee drinking and ischemic heart disease, later found to be due to heavy smoking as a common factor.

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Example: Altitude and Goitre

The association between altitude and endemic goitre, actually caused by iodine deficiency in high altitudes.

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Example: Home Births and Perinatal Mortality

The association between home births and lower perinatal mortality rates is not necessarily due to safer home births, but rather due to hospitals attracting higher-risk pregnancies.

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One Cause, Multiple Outcomes

One cause can lead to multiple different outcomes. For example, streptococcal bacteria can cause strep throat, scarlet fever, or erysipelas.

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Non-communicable disease Causation

In non-communicable diseases, like heart disease or cancer, the causes are always complex and involve multiple factors.

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Alternative Causal Factors

A model where different independent factors can cause the same disease. For example, lung cancer can be caused by smoking, air pollution, or asbestos exposure.

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Cumulative Causation

A model where multiple factors work together to increase the likelihood of a disease. The combined effect of these factors can be more potent than the individual effects.

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Synergistic Effect

A model where a single cause may not be sufficient to cause a disease, but it increases the chance of the disease occurring in the presence of other contributing factors.

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Temporal Association

The relationship between a cause and effect where the exposure must occur before the onset of the disease. This helps to ensure that the exposure is truly causing the disease, not just coinciding with it.

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Strength of Association

The strength of the association between a possible cause and a disease depends on the size of the relative risk and the dose-response relationship. A larger relative risk suggests a stronger association.

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Dose-Response Relationship

A causal association is stronger if there is a biological gradient, meaning that an increasing level of exposure to a risk factor leads to an increasing incidence of the disease.

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Specificity of the association

A causal association is stronger when the exposure is specifically linked to a particular disease, rather than causing a wide range of unrelated diseases.

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Specificity of Association

A causal association is said to be specific when there is a one-to-one relationship between the cause and the effect. This means that a particular cause always leads to a specific effect, and that effect is only caused by that specific cause.

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Consistency of Association

This criteria supports a causal association when the findings have been consistently replicated in various studies, using different methods and in diverse settings. It's a strong indicator that the relationship is not just by chance.

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Biological Plausibility

A causal association is more convincing if it aligns with our current understanding of biology. This means the association makes sense based on how cells, tissues, and organs respond to stimuli.

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Coherence of Association

Coherence in an association means that the observed relationship fits well with other known facts. It's consistent with what we already understand about the topic.

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Study Notes

Causality and Association

  • Descriptive studies identify disease problems in communities, relating them to host, agent, and environmental factors to propose etiological hypotheses.
  • Analytical and experimental studies test these hypotheses, confirming or disproving observed associations between suspected causes and diseases.

Association

  • Association (relationship) is the concurrence of two variables more often than expected by chance.
  • Events are considered associated if their occurrences are more frequent together than anticipated by chance.
  • Association does not imply causation.

Measures of Association

  • Measures of association compare disease occurrence in one group to another.
  • Common measures include risk ratio (relative risk), odds ratio, and proportionate mortality ratio.

Risk Ratio

  • Also known as relative risk, compares the risk of a health event (e.g., disease, injury) in one group to another.
  • Groups are typically distinguished by demographics (e.g., sex) or exposure to a suspected risk factor.
  • The risk of developing the health outcome is compared between the groups.

Odds Ratio

  • A measure of association quantifying the relationship between an exposure with two categories and a health outcome.
  • Determined by enrolling a group with the disease (case-patients) and a comparable disease-free group (controls).
  • Reflects the comparison of exposure probability between the two groups (diseased and non-diseased).

Types of Association

  • Spurious association: A non-real relationship between a factor and an outcome, often due to a third factor. Example: Home births having a lower perinatal mortality rate than hospital births, but hospitals tending to treat higher-risk patients.
  • Indirect association: A statistical association between a characteristic/variable and a disease, due to a common unknown factor (confounding variable). Example of confounding: high coffee intake might be linked to heart disease, but heavy smokers tend to drink more coffee.
  • Direct/Causal association: (i) One-to-one: A change in one variable directly causes a change in another. An example is measles. (ii) Multifactorial: Multiple factors independently contribute to the disease, or they act cumulatively. Example of lung cancer and complex factors like smoking and pollution.

Criteria for Judging Causality

  • Temporal association: Exposure must precede the disease onset
  • Strength of association: Higher relative risk suggests a stronger likelihood of causality
  • Specificity of the association: Ideal that a single cause leads to a single disease (not always the case).
  • Consistency of association: Similar associations consistently observed in several studies in different contexts.
  • Biological plausibility: The association should align with current biological understanding.
  • Coherence of the association: The association should be aligned with other known facts, like historical trends.

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Causality And Association Lecture Notes PDF

Description

This quiz covers key concepts related to causality and association in epidemiology. You will explore descriptive and analytical studies, measures of association, and the implications of risk ratios. Test your knowledge about how associations are established in the context of disease occurrence.

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