Parkinson's Disease in Nursing Homes
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Questions and Answers

Which of the following factors can increase the prevalence of Parkinson’s disease in a nursing home population?

  • Shorter disease duration
  • Improved diagnostics (correct)
  • High-case fatality
  • Out-migration of cases

    • What is meant by incidence in the context of disease prevalence?

  • The total number of existing cases
  • The percentage of a population affected
  • The average duration of the disease
  • The frequency of new cases occurring (correct)

    • Which description best defines 'burden of disease'?

  • The number of deaths caused by a disease
  • The total economic cost of healthcare
  • The prevalence of diseases in a population
  • The impact of a disease on a person's quality of life (correct)

    • What does the term 'years of life lost due to death' (YLL) represent?

    <p>The difference between life expectancy and actual age at death</p> Signup and view all the answers

    Which option correctly describes a handicap?

    <p>A disadvantage resulting from an impairment or disability</p> Signup and view all the answers

    How can the proportion of a disease be expressed?

    <p>As a percentage or rate</p> Signup and view all the answers

    Which of the following factors can lead to a decrease in the prevalence of Parkinson's disease?

    <p>High-case fatality</p> Signup and view all the answers

    What impact does the out-migration of cases have on disease prevalence?

    <p>It can decrease prevalence</p> Signup and view all the answers

    What is the main purpose of a case control study?

    <p>To compare individuals with and without a certain disease based on their past risk factors.</p> Signup and view all the answers

    How does a cross-sectional study typically gather its data?

    <p>Through interviews and health surveys at a specific point in time.</p> Signup and view all the answers

    What type of bias is specifically addressed by intention to treat analysis?

    <p>Attrition bias.</p> Signup and view all the answers

    What is a characteristic feature of a case series study?

    <p>It involves multiple cases with similar characteristics to understand a particular disease.</p> Signup and view all the answers

    What is one effect of self-selection bias in a study?

    <p>It may result in non-representative samples.</p> Signup and view all the answers

    What is meant by 'strata' in the context of data analysis?

    <p>Segregation of data based on characteristics like age or health status.</p> Signup and view all the answers

    What does the Hawthorne effect refer to?

    <p>Changes in behavior due to knowledge of being studied.</p> Signup and view all the answers

    What is a common result of selection bias in a study?

    <p>Inaccurate representation of the target population.</p> Signup and view all the answers

    How can cluster sampling be described in research studies?

    <p>Grouping participants into clusters then randomly selecting clusters for analysis.</p> Signup and view all the answers

    What is the primary purpose of an intention to treat analysis?

    <p>To minimize bias from participant dropouts.</p> Signup and view all the answers

    What is the potential outcome of differential misclassification?

    <p>Systematic errors occur in specific groups.</p> Signup and view all the answers

    What does attrition bias primarily refer to?

    <p>The loss of participants during a study.</p> Signup and view all the answers

    Why is blinding important in a study?

    <p>It reduces detection bias during outcome assessment.</p> Signup and view all the answers

    What can result from the healthy volunteer effect?

    <p>Results that favor those in better health.</p> Signup and view all the answers

    What does allocation bias refer to?

    <p>Incorrect allocation methods impacting study integrity.</p> Signup and view all the answers

    Which type of bias is associated with observer differences in seeing study outcomes?

    <p>Interviewer/observer bias.</p> Signup and view all the answers

    What is a key advantage of interventional studies?

    <p>They provide good evidence of outcome</p> Signup and view all the answers

    Which of the following accurately describes a systematic review?

    <p>It synthesizes and interprets data from multiple relevant studies</p> Signup and view all the answers

    What characteristic distinguishes a randomised controlled trial from other study types?

    <p>Participants are assigned to intervention or control groups randomly</p> Signup and view all the answers

    In a case control study, what is the primary initial focus of the research?

    <p>The health outcomes or diseases of the participants</p> Signup and view all the answers

    How does a cohort study primarily gather information?

    <p>By starting with exposure and following participants for outcomes</p> Signup and view all the answers

    What defines a sufficient cause in the context of health outcomes?

    <p>It consists of several components that contribute to an outcome</p> Signup and view all the answers

    What is the primary concern when conducting an interventional study?

    <p>High cost and large sample sizes</p> Signup and view all the answers

    Which aspect is true about component causes in disease?

    <p>They represent independent factors that contribute to a disease</p> Signup and view all the answers

    What type of data is blood pressure considered?

    <p>Continuous</p> Signup and view all the answers

    Which type of interview maintains a uniform structure with the same questions for everyone?

    <p>Scheduled standardized</p> Signup and view all the answers

    Which of the following is an example of a leading question?

    <p>Do you think the new policy will be beneficial?</p> Signup and view all the answers

    Which of the following is NOT a type of disease transmission?

    <p>Reflexive</p> Signup and view all the answers

    What does a mean difference of 0 indicate?

    <p>No effect or difference between groups</p> Signup and view all the answers

    Which type of data is collected through self-administered forms?

    <p>Questionnaire data</p> Signup and view all the answers

    What characterizes ordinal data?

    <p>It has a defined order</p> Signup and view all the answers

    Which aspect of observation can significantly influence the results of a study?

    <p>The setting of the study</p> Signup and view all the answers

    Study Notes

    Prevalence of Parkinson's in Nursing Homes

    • In 2016, a significant portion of nursing home residents had Parkinson's disease.
    • Factors affecting prevalence:
      • Increased by:
        • Longer disease duration
        • In-migration of cases
        • Out-migration of healthy people
        • Improved diagnostics
        • Increase in new cases
      • Decreased by:
        • Shorter duration of disease
        • High-case fatality
        • Out-migration of cases
        • Improved cure rate of cases
        • Decrease in incidence (new cases)

    Incidence vs. Proportion

    • Incidence:
      • Frequency of new cases
      • Measures risk (as people in the denominator can be part of the numerator)
      • Quantifies the number of problems developing in a population at risk over time
      • Usually given as the number of cases
      • To calculate:
        • Number of people in the defined population
        • Number of people developing the condition in that time period
        • Specified time period
    • Proportion:
      • Expresses counts with recognition that those people are part of a bigger population
      • Expressed as a percentage or rate

    Rates and Burden of Disease

    • Rates incorporate the time each person is at risk of an outcome.
    • Burden of disease:
      • How a disease affects the quality of life of people
      • Impacted by:
        • Impairment: Any loss or abnormality of psychological or anatomic structure/function
        • Restriction: A result of an impairment, limiting task performance
        • Handicap: A disadvantage for an individual resulting from an impairment or disability
    • Years of life lost due to death (YLL):
      • Takes someone's life expectancy to when they actually die
      • Influenced by factors like family history, money involved, and knowledge of the disease.

    Bias in Studies

    • Self-selection bias:
      • Non-representativeness of the target population due to self-selection.
    • Healthy volunteer effect:
      • Needs to be considered in occupational studies.
    • Allocation bias:
      • Introduced if the randomisation list is not concealed.
      • Randomisation is a two-step process:
        • Establishing the randomisation sequence
        • Protecting the sequence or allocation.
    • Hawthorne effect:
      • People behave differently knowing they're in a study.
    • Placebo effect:
      • People have different expectations knowing they're in a study or on a treatment.
    • Attrition bias:
      • People leaving the study, and why they are leaving.
      • Overcome by intention-to-treat analysis.
    • Detection bias:
      • Researchers or assessors may be aware of the treatment group, potentially influencing their observations.
      • Blinding researchers and assessors to avoid this bias is important.

    Misclassification Bias

    • Nondifferential Misclassification:
      • Errors occur equally in all groups being compared.
      • Leads to random error and instrument bias.
    • Differential Misclassification:
      • Likely to occur in one group more than another due to systematic error, like recall, response, or observer bias.

    Study Types

    • Case series/study:
      • Describes characteristics of people with a specific disease and exposure.
    • Cross-sectional study:
      • Measures prevalence, taking a snapshot in time.
      • Assesses exposures, outcomes, and health needs.
    • Case-control study:
      • Compares cases (people with a disease) to controls without the disease.
      • Looks at previous risk factors.
    • Cohort study:
      • Follows a group of people with a specific exposure over time, analyzing the outcome.
    • Interventional study:
      • An intervention is given to a group of people, and the outcome is studied.
      • Randomization ensures equal chance of receiving intervention and similar characteristics in each group.
    • Systematic review:
      • Identifies relevant studies on a topic, assesses their quality, synthesizes findings, and presents an impartial and unbiased summary.
      • Uses data from multiple studies with similar designs, providing a single summary result.
    • Randomized controlled trial:
      • Experimental study design with an intervention and placebo/control.

    Types of Causes

    • Component cause:
      • A factor contributing to a disease.
    • Sufficient cause:
      • A combination of components leading to the effect.

    Types of Data

    • Numerical:
      • Continuous: e.g., blood pressure.
      • Discrete: e.g., number of children.
    • Categorical:
      • Nominal: e.g., blood type, hair color.
      • Ordinal: e.g., pain scale.

    Data Collection Methods

    • Observation:
      • The study setting can influence the results.
    • Interviews:
      • Scheduled standardized interview: everyone is asked the same questions in a structured way.
      • Non-scheduled standardized interview: the same questions, but in a more relaxed manner.
      • Non-standardized interview: a conversation.
    • Questionnaires:
      • Participants fill out the questionnaire themselves.
      • Include demographic questions to describe the sample and generalize results.

    Question Types

    • Open: allows for detailed data.
    • Closed: allows for limited responses.
    • Double-barreled: asks two questions in one.
    • Leading: guides respondents in a specific direction.

    Types of Scales

    • Visual analog scale:
      • Measures intensity of a subjective experience with a line.
    • Likert scale:
      • Measures agreement or disagreement with a series of statements.
    • Semantic differential scale:
      • Measures attitudes and perceptions on a bipolar scale.

    Significance

    • Statistical significance:
      • If a result does not include 1 in its confidence interval.
    • Clinical significance:
      • Whether the result is meaningful or impactful in a practical sense.

    Mean Difference

    • The absolute difference between means of two continuous variables.
    • A mean difference of 0 indicates no effect.

    P-value

    • The probability that an event is due to chance.
    • A lower p-value suggests a statistically significant result.

    Disease Transmission

    • Direct: Transmitted directly, e.g., through touch.
    • Indirect:
      • Vehicle-borne: Transmitted through inanimate objects, e.g., contaminated food.
      • Vector-borne: Transmitted through animals, e.g., mosquito bites.
    • Airborne:
      • Droplet: Larger particles from the respiratory tract, e.g., coughing or sneezing.
      • Dust: Smaller particles.

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    Description

    This quiz explores the prevalence and incidence of Parkinson's disease among nursing home residents, highlighting various factors that can impact these rates. Understand the distinction between incidence and proportion as it relates to public health and aging populations.

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