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Questions and Answers
What is the term for the frequency of occurrences of disease, injury, or death in the study population during the time period of the study?
What is the term for the frequency of occurrences of disease, injury, or death in the study population during the time period of the study?
What is the term for the number of persons in a defined population who have a specified disease or condition at a given point in time?
What is the term for the number of persons in a defined population who have a specified disease or condition at a given point in time?
What is the term used to avoid confusion between incidence and incidence rate?
What is the term used to avoid confusion between incidence and incidence rate?
What is the term used to avoid confusion between prevalence and prevalence rate?
What is the term used to avoid confusion between prevalence and prevalence rate?
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What is the difference between point prevalence and period prevalence?
What is the difference between point prevalence and period prevalence?
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What is the term that refers to the number of persons who had a given disease at any time during the specified time interval?
What is the term that refers to the number of persons who had a given disease at any time during the specified time interval?
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What is the purpose of using different denominators in measuring disease frequency?
What is the purpose of using different denominators in measuring disease frequency?
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What is period prevalence composed of?
What is period prevalence composed of?
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What is the ideal denominator for measuring risk related to infectious disease?
What is the ideal denominator for measuring risk related to infectious disease?
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What is the case fatality ratio?
What is the case fatality ratio?
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What is the pathogenicity of an organism?
What is the pathogenicity of an organism?
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What is the limitation of the concept of risk?
What is the limitation of the concept of risk?
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What is the force of mortality?
What is the force of mortality?
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Why is the rate a more precise measure than the risk?
Why is the rate a more precise measure than the risk?
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What is the formula for prevalence that is conceptually important for understanding and predicting the burden of disease?
What is the formula for prevalence that is conceptually important for understanding and predicting the burden of disease?
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What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive before dying or recovering?
What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive before dying or recovering?
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What is the definition of risk in epidemiology?
What is the definition of risk in epidemiology?
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What is the risk of an event if it occurs in an individual?
What is the risk of an event if it occurs in an individual?
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Who is truly at risk for becoming pregnant?
Who is truly at risk for becoming pregnant?
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What is the result of the increase in the length of survival for people with AIDS due to antiviral agents and other methods of treatment and prophylaxis?
What is the result of the increase in the length of survival for people with AIDS due to antiviral agents and other methods of treatment and prophylaxis?
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What is typically used as the denominator of a rate?
What is typically used as the denominator of a rate?
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What is the general form for calculating a rate?
What is the general form for calculating a rate?
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What is an instantaneous death rate also known as?
What is an instantaneous death rate also known as?
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Why is period prevalence not recommended for scientific work?
Why is period prevalence not recommended for scientific work?
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What is the relationship between incidence and prevalence?
What is the relationship between incidence and prevalence?
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What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
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What is the implication of a person being an incident case only once?
What is the implication of a person being an incident case only once?
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What is the primary reason for distinguishing between incident cases and incidence?
What is the primary reason for distinguishing between incident cases and incidence?
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What is the main difference between point prevalence and period prevalence?
What is the main difference between point prevalence and period prevalence?
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Why is the term 'prevalent cases' often preferred to 'prevalence'?
Why is the term 'prevalent cases' often preferred to 'prevalence'?
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What is the relationship between incidence and prevalence?
What is the relationship between incidence and prevalence?
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What is the purpose of using different denominators in measuring disease frequency?
What is the purpose of using different denominators in measuring disease frequency?
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What is the implication of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
What is the implication of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
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What is the primary focus of epidemiology in relation to disease frequency?
What is the primary focus of epidemiology in relation to disease frequency?
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What is the main challenge in measuring the risk of death from an infectious disease?
What is the main challenge in measuring the risk of death from an infectious disease?
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What is the proportion of infected persons who are clinically ill?
What is the proportion of infected persons who are clinically ill?
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What is the ideal denominator when measuring the risk related to infectious disease?
What is the ideal denominator when measuring the risk related to infectious disease?
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What is the proportion of clinically ill persons who die?
What is the proportion of clinically ill persons who die?
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Why is the concept of risk limited?
Why is the concept of risk limited?
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What is the limitation of using the concept of risk to measure the frequency of occurrences of disease, injury, or death?
What is the limitation of using the concept of risk to measure the frequency of occurrences of disease, injury, or death?
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What is the proportion of exposed persons who become infected?
What is the proportion of exposed persons who become infected?
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Why is the concept of rate superior to the concept of risk in showing differences in the force of mortality?
Why is the concept of rate superior to the concept of risk in showing differences in the force of mortality?
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What is the condition for a rate to be a good approximation of risk?
What is the condition for a rate to be a good approximation of risk?
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What is the term for the number of events that occur in a defined time period, divided by the average number of people at risk for the event during the period under study?
What is the term for the number of events that occur in a defined time period, divided by the average number of people at risk for the event during the period under study?
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Why is the midperiod population often used as the denominator of a rate?
Why is the midperiod population often used as the denominator of a rate?
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What is an instantaneous death rate also known as?
What is an instantaneous death rate also known as?
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Why is the concept of rate important in epidemiology?
Why is the concept of rate important in epidemiology?
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What is the general form for calculating a rate?
What is the general form for calculating a rate?
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What is the advantage of using rates over risks in epidemiology?
What is the advantage of using rates over risks in epidemiology?
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What is the key factor in determining the correct denominator for a measure of risk?
What is the key factor in determining the correct denominator for a measure of risk?
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What is the implication of the formula Prevalence = Incidence × (average) Duration?
What is the implication of the formula Prevalence = Incidence × (average) Duration?
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What is the purpose of putting the risk of surgery in the context of the many other risks a person may take frequently?
What is the purpose of putting the risk of surgery in the context of the many other risks a person may take frequently?
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Why is the concept of prevalence important in understanding and predicting the burden of disease on a society or population?
Why is the concept of prevalence important in understanding and predicting the burden of disease on a society or population?
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Why is it important to have a consistent definition of a disease?
Why is it important to have a consistent definition of a disease?
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What is the limitation of the concept of risk?
What is the limitation of the concept of risk?
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What is the implication of the formula Prevalence = Incidence × (average) Duration on the burden of disease?
What is the implication of the formula Prevalence = Incidence × (average) Duration on the burden of disease?
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What is the importance of understanding the relationship between incidence and prevalence?
What is the importance of understanding the relationship between incidence and prevalence?
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What is the purpose of comparing observed rates to target rates?
What is the purpose of comparing observed rates to target rates?
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What are crude rates?
What are crude rates?
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What is the main concern when comparing rates between two populations?
What is the main concern when comparing rates between two populations?
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Why is it necessary to adjust for changes in the composition of a population over time?
Why is it necessary to adjust for changes in the composition of a population over time?
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What is the purpose of studying time trends?
What is the purpose of studying time trends?
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What is a limitation of comparing rates between two populations?
What is a limitation of comparing rates between two populations?
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What is the purpose of comparing rates within the same population over time?
What is the purpose of comparing rates within the same population over time?
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What type of rates are obtained when a population is divided into more homogeneous sub-groups based on a particular characteristic?
What type of rates are obtained when a population is divided into more homogeneous sub-groups based on a particular characteristic?
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Why may crude rates be misleading?
Why may crude rates be misleading?
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Why should investigators not make comparisons of the risk of death or disease between populations without controlling for age?
Why should investigators not make comparisons of the risk of death or disease between populations without controlling for age?
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What is the formula for calculating the age-specific death rate?
What is the formula for calculating the age-specific death rate?
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What is the result of a difference in the relative weights of the old and young populations in two age-specific populations?
What is the result of a difference in the relative weights of the old and young populations in two age-specific populations?
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Why may crude death rates not provide a clear picture of the mortality experience of a population?
Why may crude death rates not provide a clear picture of the mortality experience of a population?
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What is the purpose of calculating age-specific death rates?
What is the purpose of calculating age-specific death rates?
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Why are specific rates preferred over crude rates?
Why are specific rates preferred over crude rates?
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What can result in different weights for the high and low age-specific death rates?
What can result in different weights for the high and low age-specific death rates?
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What is the term for the death of a live-born infant before the completion of the infant's 28th day of life?
What is the term for the death of a live-born infant before the completion of the infant's 28th day of life?
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What is the crude birth rate?
What is the crude birth rate?
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What is the term for the death of an infant after the 28th day of life but before the first birthday?
What is the term for the death of an infant after the 28th day of life but before the first birthday?
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What is the infant mortality rate (IMR) often used as an index of?
What is the infant mortality rate (IMR) often used as an index of?
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What is the term for the death of a fetus born dead at 28 weeks of gestation or later?
What is the term for the death of a fetus born dead at 28 weeks of gestation or later?
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What is the formula for the infant mortality rate (IMR)?
What is the formula for the infant mortality rate (IMR)?
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What is the term for the death of a fetus delivered between 20 and 28 weeks of gestation?
What is the term for the death of a fetus delivered between 20 and 28 weeks of gestation?
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What is the primary advantage of using the infant mortality rate (IMR) as an index of health status?
What is the primary advantage of using the infant mortality rate (IMR) as an index of health status?
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What is the purpose of standardization of death rates?
What is the purpose of standardization of death rates?
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What is the result of applying ASDRs to a standard population?
What is the result of applying ASDRs to a standard population?
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What is the purpose of adjusting crude death rates?
What is the purpose of adjusting crude death rates?
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What is the advantage of using standardized rates?
What is the advantage of using standardized rates?
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What is the standard population used for?
What is the standard population used for?
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What is the result of standardizing death rates?
What is the result of standardizing death rates?
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Why is standardization of death rates necessary?
Why is standardization of death rates necessary?
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What is the advantage of direct standardization?
What is the advantage of direct standardization?
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What is the purpose of indirect standardization?
What is the purpose of indirect standardization?
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What is the result of multiplying the standard death rate for each age group by the number of workers in the corresponding age group?
What is the result of multiplying the standard death rate for each age group by the number of workers in the corresponding age group?
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What is the standardized mortality ratio (SMR)?
What is the standardized mortality ratio (SMR)?
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Why is it risky to compare cause-specific death rates over time or between countries?
Why is it risky to compare cause-specific death rates over time or between countries?
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What is a live birth, according to the international definition?
What is a live birth, according to the international definition?
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What is an early fetal death, also known as?
What is an early fetal death, also known as?
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What is the purpose of using cause-specific death rates?
What is the purpose of using cause-specific death rates?
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What is the general form of cause-specific death rates?
What is the general form of cause-specific death rates?
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What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
What is the result of an increase in the yearly number of new cases and the length of time that symptomatic patients survive?
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Why are rates used in public health, especially the infant mortality rate?
Why are rates used in public health, especially the infant mortality rate?
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What is the main purpose of standardizing death rates in hospitals?
What is the main purpose of standardizing death rates in hospitals?
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What is the goal of direct standardization?
What is the goal of direct standardization?
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What is the result of indirect standardization?
What is the result of indirect standardization?
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Why is indirect standardization used?
Why is indirect standardization used?
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What is the purpose of using a standard population?
What is the purpose of using a standard population?
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What is the advantage of standardized rates?
What is the advantage of standardized rates?
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What is the difference between direct and indirect standardization?
What is the difference between direct and indirect standardization?
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What is the result of applying the ASDRs of two populations to a standard population?
What is the result of applying the ASDRs of two populations to a standard population?
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What is the purpose of standardizing death rates?
What is the purpose of standardizing death rates?
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What is the advantage of using a large population as the standard population?
What is the advantage of using a large population as the standard population?
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What is the primary purpose of comparing an observed rate with a target rate?
What is the primary purpose of comparing an observed rate with a target rate?
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What is a major concern when comparing rates between two different populations at the same time?
What is a major concern when comparing rates between two different populations at the same time?
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What is the term for rates that apply to an entire population, without reference to any characteristics of the individuals in it?
What is the term for rates that apply to an entire population, without reference to any characteristics of the individuals in it?
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Why is it necessary to adjust for changes in the composition of a population over time when studying time trends?
Why is it necessary to adjust for changes in the composition of a population over time when studying time trends?
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What is the purpose of using standardized rates?
What is the purpose of using standardized rates?
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What is the main difference between comparing rates between two populations at the same time and comparing rates over time?
What is the main difference between comparing rates between two populations at the same time and comparing rates over time?
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What is a potential limitation of using crude rates to compare rates between different populations?
What is a potential limitation of using crude rates to compare rates between different populations?
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What is the purpose of using adjustments when comparing rates over time?
What is the purpose of using adjustments when comparing rates over time?
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What is the primary reason for calculating specific rates within a population?
What is the primary reason for calculating specific rates within a population?
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Which of the following statements about crude death rates is true?
Which of the following statements about crude death rates is true?
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What is the term for rates that are calculated within specific subgroups of a population, such as age-specific rates?
What is the term for rates that are calculated within specific subgroups of a population, such as age-specific rates?
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Why might investigators not use specific rates in certain circumstances?
Why might investigators not use specific rates in certain circumstances?
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What is the formula for calculating the age-specific death rate?
What is the formula for calculating the age-specific death rate?
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Why is it important to control for age when comparing mortality rates between populations?
Why is it important to control for age when comparing mortality rates between populations?
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What is the result of a difference in the relative weights of the old and young populations when comparing age-specific mortality rates between two populations?
What is the result of a difference in the relative weights of the old and young populations when comparing age-specific mortality rates between two populations?
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Why are crude death rates often misleading?
Why are crude death rates often misleading?
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What is the purpose of using age-specific death rates?
What is the purpose of using age-specific death rates?
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What is the primary purpose of indirect standardization in epidemiology?
What is the primary purpose of indirect standardization in epidemiology?
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What is the term for the number of deaths that would be expected in a population if it had the same death rates as the standard population?
What is the term for the number of deaths that would be expected in a population if it had the same death rates as the standard population?
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What is the limitation of comparing cause-specific death rates between different countries or over time?
What is the limitation of comparing cause-specific death rates between different countries or over time?
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What is the primary advantage of using cause-specific death rates in epidemiology?
What is the primary advantage of using cause-specific death rates in epidemiology?
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What is the definition of a live birth, according to the international definition?
What is the definition of a live birth, according to the international definition?
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What is the term for the ratio of the number of deaths in a population to the number of expected deaths, multiplied by 100?
What is the term for the ratio of the number of deaths in a population to the number of expected deaths, multiplied by 100?
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What is the purpose of using age-specific death rates in epidemiology?
What is the purpose of using age-specific death rates in epidemiology?
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What is the limitation of using indirect standardization in epidemiology?
What is the limitation of using indirect standardization in epidemiology?
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What is the term for the number of deaths that occur in a population during a specific time period?
What is the term for the number of deaths that occur in a population during a specific time period?
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What is the purpose of using the standardized mortality ratio in epidemiology?
What is the purpose of using the standardized mortality ratio in epidemiology?
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What is the term for the death of a live-born infant before the completion of the infant's 28th day of life?
What is the term for the death of a live-born infant before the completion of the infant's 28th day of life?
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What is the formula for the infant mortality rate (IMR)?
What is the formula for the infant mortality rate (IMR)?
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What is the term for the death of a dead fetus delivered between 20 and 28 weeks of gestation?
What is the term for the death of a dead fetus delivered between 20 and 28 weeks of gestation?
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What is the purpose of the infant mortality rate (IMR)?
What is the purpose of the infant mortality rate (IMR)?
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What is the term for the death of a live-born infant after the 28th day of life but before the first birthday?
What is the term for the death of a live-born infant after the 28th day of life but before the first birthday?
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What is the term for the number of live births divided by the midperiod population, as follows?
What is the term for the number of live births divided by the midperiod population, as follows?
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What is the formula for the cause-specific death rate?
What is the formula for the cause-specific death rate?
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What is the term for the death of a fetus born dead at 28 weeks of gestation or later?
What is the term for the death of a fetus born dead at 28 weeks of gestation or later?
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Study Notes
Frequency of Disease
- The frequency of a disease, injury, or death can be measured in different ways, depending on the research purpose and data availability.
- Two fundamental concepts in epidemiology are incidence and prevalence.
Incidence and Incident Cases
- Incidence is the frequency of new cases of a disease or condition in a population over a specific time period.
- Incident cases refer to the number of new cases that occur during a specific time period.
- Figure 2-1 shows the annual number of incident cases of AIDS in the United States from 1981 to 1992.
Prevalence and Prevalent Cases
- Prevalence is the number of existing cases of a disease or condition in a population at a specific point in time.
- Prevalent cases refer to the total number of people with a disease or condition at a specific point in time.
- Point prevalence is the number of prevalent cases at a specific point in time.
Difference between Point Prevalence and Period Prevalence
- Period prevalence is the number of persons who had a disease at any time during a specified time interval.
- Period prevalence is the sum of point prevalence at the beginning of the interval plus the incidence during the interval.
Illustration of Morbidity Concepts
- Figure 2-2 illustrates the concepts of incidence, point prevalence, and period prevalence.
- The figure shows eight persons with a given disease in a defined population, with no emigration or immigration.
Relationship between Incidence and Prevalence
- Figure 2-1 illustrates the complex relationship between incidence and prevalence, using the example of AIDS in the United States from 1981 to 1992.
- The total number of cases of an epidemic disease reported over time is its cumulative incidence.
- Prevalence is the result of many factors, including incidence, immigration, emigration, and disease duration.
Conceptual Formula for Prevalence
- Prevalence = Incidence × (average) Duration
- This formula implies that prevalence can increase as a result of an increase in incidence or disease duration.
Risk
- In epidemiology, risk is defined as the proportion of persons who are unaffected at the beginning of a study period, but who experience a risk event during the study period.
- Risk is usually expressed as a proportion or percentage.
Limitations of the Concept of Risk
- It is often difficult to determine the correct denominator for a measure of risk.
- The concept of risk has limitations, as it does not account for individual differences or variations in risk over time.
Rates
- A rate is the number of events that occur in a defined time period, divided by the average number of people at risk during the period.
- Rates are usually expressed as a multiplier (e.g., per 1000 individuals per year) to make the numerator larger and easier to discuss.
Relationship between Risk and Rate
- Risk and rate are related but distinct concepts.
- Rates are often used to estimate risk, but rates can provide a more accurate picture of the force of mortality.
Frequency of Disease
- The frequency of a disease, injury, or death can be measured in different ways, depending on the research purpose and data availability.
- Two fundamental concepts in epidemiology are incidence and prevalence.
Incidence and Incident Cases
- Incidence is the frequency of new cases of a disease or condition in a population over a specific time period.
- Incident cases refer to the number of new cases that occur during a specific time period.
- Figure 2-1 shows the annual number of incident cases of AIDS in the United States from 1981 to 1992.
Prevalence and Prevalent Cases
- Prevalence is the number of existing cases of a disease or condition in a population at a specific point in time.
- Prevalent cases refer to the total number of people with a disease or condition at a specific point in time.
- Point prevalence is the number of prevalent cases at a specific point in time.
Difference between Point Prevalence and Period Prevalence
- Period prevalence is the number of persons who had a disease at any time during a specified time interval.
- Period prevalence is the sum of point prevalence at the beginning of the interval plus the incidence during the interval.
Illustration of Morbidity Concepts
- Figure 2-2 illustrates the concepts of incidence, point prevalence, and period prevalence.
- The figure shows eight persons with a given disease in a defined population, with no emigration or immigration.
Relationship between Incidence and Prevalence
- Figure 2-1 illustrates the complex relationship between incidence and prevalence, using the example of AIDS in the United States from 1981 to 1992.
- The total number of cases of an epidemic disease reported over time is its cumulative incidence.
- Prevalence is the result of many factors, including incidence, immigration, emigration, and disease duration.
Conceptual Formula for Prevalence
- Prevalence = Incidence × (average) Duration
- This formula implies that prevalence can increase as a result of an increase in incidence or disease duration.
Risk
- In epidemiology, risk is defined as the proportion of persons who are unaffected at the beginning of a study period, but who experience a risk event during the study period.
- Risk is usually expressed as a proportion or percentage.
Limitations of the Concept of Risk
- It is often difficult to determine the correct denominator for a measure of risk.
- The concept of risk has limitations, as it does not account for individual differences or variations in risk over time.
Rates
- A rate is the number of events that occur in a defined time period, divided by the average number of people at risk during the period.
- Rates are usually expressed as a multiplier (e.g., per 1000 individuals per year) to make the numerator larger and easier to discuss.
Relationship between Risk and Rate
- Risk and rate are related but distinct concepts.
- Rates are often used to estimate risk, but rates can provide a more accurate picture of the force of mortality.
Types of Comparisons
- Three types of comparisons using rates or risks:
- Comparison of an observed rate (or risk) with a target rate (or risk)
- Comparison of two different populations at the same time
- Comparison involving the same population at different times (to study time trends)
Crude Rates vs. Specific Rates
- Crude rates: apply to an entire population without reference to any characteristics of the individuals
- Specific rates: calculated within homogeneous subgroups based on a particular characteristic of interest (e.g., age, sex/gender, race, risk factors, or comorbidity)
- Crude rates are often misleading and can be biased by age distribution
- Specific rates (e.g., age-specific rates) provide more information and should be sought whenever possible
Age-Specific Death Rate (ASDR)
- Formula: ASDR = (No. of deaths in a particular age group) / (Midperiod population of the same age group) × 1000
- ASDRs are used to compare death rates between populations with different age structures
Standardizing Death Rates
- Standardized rates (adjusted rates) control for the effects of age or other characteristics
- Two methods:
- Direct standardization: applies the ASDRs of the populations to be compared to a single standard population
- Indirect standardization: uses standard rates and applies them to the known age groups in the population to be standardized
Cause-Specific Rates
- Cause-specific death rates: compare the rates of events among comparable populations
- Formula: Cause-specific death rate = (No. of deaths due to a particular cause) / Midperiod population × 100,000
Maternal and Infant Health
- Terms related to the reproductive process:
- Live birth: delivery of a product of conception that shows any sign of life
- Fetal deaths: categorized as early, intermediate, or late
- Infant death: death of a live-born infant before the infant's first birthday
- Neonatal death: death of a live-born infant before the completion of the infant's 28th day of life
- Postneonatal death: death of an infant after the 28th day of life but before the first birthday
- Crude birth rate: number of live births divided by the midperiod population
- Infant mortality rate (IMR): often used as an overall index of the health status of a nation
Types of Comparisons
- Three types of comparisons using rates or risks:
- Comparison of an observed rate (or risk) with a target rate (or risk)
- Comparison of two different populations at the same time
- Comparison involving the same population at different times (to study time trends)
Crude Rates vs. Specific Rates
- Crude rates: apply to an entire population without reference to any characteristics of the individuals
- Specific rates: calculated within homogeneous subgroups based on a particular characteristic of interest (e.g., age, sex/gender, race, risk factors, or comorbidity)
- Crude rates are often misleading and can be biased by age distribution
- Specific rates (e.g., age-specific rates) provide more information and should be sought whenever possible
Age-Specific Death Rate (ASDR)
- Formula: ASDR = (No. of deaths in a particular age group) / (Midperiod population of the same age group) × 1000
- ASDRs are used to compare death rates between populations with different age structures
Standardizing Death Rates
- Standardized rates (adjusted rates) control for the effects of age or other characteristics
- Two methods:
- Direct standardization: applies the ASDRs of the populations to be compared to a single standard population
- Indirect standardization: uses standard rates and applies them to the known age groups in the population to be standardized
Cause-Specific Rates
- Cause-specific death rates: compare the rates of events among comparable populations
- Formula: Cause-specific death rate = (No. of deaths due to a particular cause) / Midperiod population × 100,000
Maternal and Infant Health
- Terms related to the reproductive process:
- Live birth: delivery of a product of conception that shows any sign of life
- Fetal deaths: categorized as early, intermediate, or late
- Infant death: death of a live-born infant before the infant's first birthday
- Neonatal death: death of a live-born infant before the completion of the infant's 28th day of life
- Postneonatal death: death of an infant after the 28th day of life but before the first birthday
- Crude birth rate: number of live births divided by the midperiod population
- Infant mortality rate (IMR): often used as an overall index of the health status of a nation
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Description
Learn about the fundamental concepts of epidemiology, including incidence and prevalence, and how they are measured in disease research.