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Questions and Answers
What theory replaced the concept of miasma in the late 19th century?
What theory replaced the concept of miasma in the late 19th century?
- Evolutionary theory
- Germ theory (correct)
- Cell theory
- Quantum theory
Who proposed the basic forms of the germ theory of disease in 1546?
Who proposed the basic forms of the germ theory of disease in 1546?
- Girolamo Fracastoro (correct)
- Hugh Leavell
- Clark
- Marcus von Plenciz
Which small organisms are known as pathogens or 'germs' according to the germ theory of disease?
Which small organisms are known as pathogens or 'germs' according to the germ theory of disease?
- Fungi
- Viruses
- Bacteria (correct)
- Protozoa
Who were the first to document the terms primary, secondary, and tertiary prevention in relation to disease prevention?
Who were the first to document the terms primary, secondary, and tertiary prevention in relation to disease prevention?
What specific organism is mentioned in the text that can cause diseases like cholera?
What specific organism is mentioned in the text that can cause diseases like cholera?
What is the main focus of the lecture on the concept of causation?
What is the main focus of the lecture on the concept of causation?
In epidemiology, what is a cause most closely associated with?
In epidemiology, what is a cause most closely associated with?
What is disease characterized by?
What is disease characterized by?
What is the primary aim of establishing causality in epidemiology?
What is the primary aim of establishing causality in epidemiology?
Which theory of causation mentioned in the text involves supernatural punishment?
Which theory of causation mentioned in the text involves supernatural punishment?
What distinguishes a cause in epidemiology from a direct result of physical injury?
What distinguishes a cause in epidemiology from a direct result of physical injury?
What theory detailing the supposed makeup and workings of the human body was adopted by Ancient Greek and Roman physicians and philosophers?
What theory detailing the supposed makeup and workings of the human body was adopted by Ancient Greek and Roman physicians and philosophers?
What was a key factor in the downfall of Humorism in the 1850s?
What was a key factor in the downfall of Humorism in the 1850s?
According to Humorism, what were the four supposed humors that made up the human body?
According to Humorism, what were the four supposed humors that made up the human body?
Which theory proposed that diseases were caused by a noxious form of 'bad air' known as miasma?
Which theory proposed that diseases were caused by a noxious form of 'bad air' known as miasma?
What was believed to be protective against diseases according to the miasma theory?
What was believed to be protective against diseases according to the miasma theory?
According to Hill's criteria, which is NOT a requirement for establishing causation?
According to Hill's criteria, which is NOT a requirement for establishing causation?
What do critics of using analogy in epidemiology argue?
What do critics of using analogy in epidemiology argue?
What does Hill suggest should happen if an intervention modifies exposure in an experiment testing causation?
What does Hill suggest should happen if an intervention modifies exposure in an experiment testing causation?
In terms of cancer deaths and smoking, what could prevent the observation of a biological gradient even if there is a causal effect?
In terms of cancer deaths and smoking, what could prevent the observation of a biological gradient even if there is a causal effect?
What does Hill consider essential for 'Coherence' in terms of causation?
What does Hill consider essential for 'Coherence' in terms of causation?
Which statement accurately reflects Hill's suggestion for establishing causation through analogy?
Which statement accurately reflects Hill's suggestion for establishing causation through analogy?
Which model introduced in 1976 is also known as the Causal Pies model?
Which model introduced in 1976 is also known as the Causal Pies model?
What is the term used to describe a component that appears in every pie or pathway and is essential for disease occurrence?
What is the term used to describe a component that appears in every pie or pathway and is essential for disease occurrence?
According to Sir Austin Bradford Hill's criteria, which attribute describes the concept that true causes must exhibit strong associations?
According to Sir Austin Bradford Hill's criteria, which attribute describes the concept that true causes must exhibit strong associations?
In the context of epidemiology, which factor refers to extrinsic factors that affect the agent and the opportunity for exposure?
In the context of epidemiology, which factor refers to extrinsic factors that affect the agent and the opportunity for exposure?
What model explores multiple causative factors, giving equal prominence to Agent, Host, and Environment in identifying determinants and relevant interventions?
What model explores multiple causative factors, giving equal prominence to Agent, Host, and Environment in identifying determinants and relevant interventions?
Which criterion for assessing causality asserts that associations are more likely to be causal if they are observed repeatedly by different individuals in different circumstances?
Which criterion for assessing causality asserts that associations are more likely to be causal if they are observed repeatedly by different individuals in different circumstances?
What refers to a variety of intrinsic factors in a host that may influence exposure, susceptibility, or response to a causative agent?
What refers to a variety of intrinsic factors in a host that may influence exposure, susceptibility, or response to a causative agent?
'An association is more likely to be causal if its strength increases as the exposure level increases' - which criterion does this statement refer to?
'An association is more likely to be causal if its strength increases as the exposure level increases' - which criterion does this statement refer to?
'An individual factor that contributes to causing disease shown as a piece of a pie' - this concept is associated with which model?
'An individual factor that contributes to causing disease shown as a piece of a pie' - this concept is associated with which model?
In epidemiology, what is broadened to include chemical and physical causes of disease or injury besides infectious microorganisms?
In epidemiology, what is broadened to include chemical and physical causes of disease or injury besides infectious microorganisms?
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Study Notes
Disease Causation
- Many cultures have a story about a deity exacting punishment upon previous inhabitants of their land, causing their doom (e.g. great flood, Tower of Babel, Sodom and Gomorrah)
Humorism
- A system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers
- The system began to fall out of favor in the 1850s with the advent of germ theory
- It proposed that the human body consisted of four humors: phlegm, blood, yellow bile, and black bile
Miasma Theory
- An obsolete medical theory that diseases were caused by a noxious form of "bad air" or a miasma
- The theory was advanced by Hippocrates in the fourth century B.C. and accepted in ancient times in Europe and China
- It was eventually abandoned by scientists and physicians after 1880, replaced by the germ theory of disease
Germ Theory
- The currently accepted scientific theory for many diseases, stating that microorganisms (pathogens or "germs") can lead to disease
- These small organisms, too small to see without magnification, invade humans, other animals, and other living hosts
- Basic forms of germ theory were proposed by Girolamo Fracastoro in 1546 and expanded upon by Marcus von Plenciz in 1762
Web of Causation
- The epidemiologic triad or triangle model of causation, consisting of an external agent, a susceptible host, and an environment that brings the host and agent together
- Disease results from the interaction between the agent and the susceptible host in an environment that supports transmission of the agent
- The triad model is the traditional model for infectious disease, but has proven inadequate for diseases like cardiovascular disease and cancer that have multiple contributing causes
Epidemiologic Triad
- Agent: an external agent or infectious microorganism, which must be present for disease to occur
- Host: a human who can get the disease, influenced by factors such as genetic composition, nutritional and immunologic status, and psychological makeup
- Environment: extrinsic factors that affect the agent and the opportunity for exposure, including physical, biologic, and socioeconomic factors
Sufficient-Component Cause Model
- A model introduced by Rothman in 1976, where an individual factor that contributes to cause disease is shown as a piece of a pie
- The complete pie, or a sufficient cause, is composed of several component causes that may or may not overlap
- A necessary cause is a component that appears in every pie or pathway
Guidelines for Assessing Causality
- Criteria for assessing causation proposed by Sir Austin Bradford Hill in 1965:
- Strength of association
- Consistency
- Specificity
- Temporality
- Biological gradient
- Biological plausibility
- Coherence
- Experimental evidence
- Analogy
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