Table
of Contents
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Foreword |
x |
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Preface |
xi |
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1 |
Epidemiology is |
1 |
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A Case of Food Poisoning |
3 |
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Subdisciplines of Epidemiology |
4 |
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On Epidemics |
6 |
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An Historical Epidemic |
8 |
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The Beginnings |
9 |
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What Does Epidemiology Offer? |
17 |
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What do Epidemiologists Do? |
18 |
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A Natural Experiment |
24 |
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Conclusions |
24 |
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References |
27 |
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2 |
How long is a Piece of String? Measuring Disease
Frequency |
29 |
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What are we measuring? |
30 |
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The Concepts: Prevalence and Incidence |
32 |
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Measuring Disease Occurrence in Practice: Epidemiological Studies |
38 |
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Measuring Disease Occurrence in Practice: Using Routine Data |
45 |
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Other Measures Commonly Used in Public Health |
52 |
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Measuring the ‘burden of Disease |
59 |
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Summary |
68 |
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Questions |
68 |
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References |
69 |
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3 |
Who, What, Where and When? Descriptive
Epidemiology |
71 |
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Case Reports and Case Series |
72 |
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Prevalence Surveys |
74 |
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Routine Data Collections |
76 |
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Sources of Summary Data |
83 |
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Creative Use of Existing Data |
87 |
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Confidentiality |
92 |
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Summary |
92 |
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References |
92 |
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4 |
Healthy Research: Study Designs
for Public Health |
94 |
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Observational Studies |
96 |
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Intervention Studies |
112 |
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A Word about Ethics |
117 |
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Summary |
121 |
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Questions |
121 |
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References |
122 |
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5 |
Why? Linking Exposure and Disease |
125 |
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Looking for Associations |
126 |
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Ratio Measures (Relative Risk) |
128 |
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Difference Measures (Attributable Risk) |
133 |
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Relative Risk versus Attributable Risk: an Example |
141 |
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Case-Control Studies |
143 |
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Summary |
149 |
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Questions |
149 |
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References |
153 |
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6 |
Heads or Tails: the Role of
Chance |
154 |
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Random Sampling Error |
154 |
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Confidence Intervals (CI) |
156 |
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Statistics in Epidemiology |
158 |
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Statistical versus Clinical Significance |
163 |
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A Final Word about Confidence Intervals and P-Values |
165 |
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Summary |
165 |
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Questions |
165 |
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References |
166 |
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7 |
All that Glitters is not gold:
The Problem of Error |
167 |
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Sources of Error in Epidemiological Studies |
169 |
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Selection Bias |
169 |
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Measurement or Information Error |
181 |
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Summary |
194 |
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Questions |
194 |
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References |
196 |
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8 |
Muddied Waters: the Challenge of
Confounding |
197 |
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An Example of Confounding: is Alcohol a Risk Factor for Lung
Cancer? |
198 |
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Criteria for a Confounder |
201 |
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The Effects of Confounding |
202 |
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Control of Confounding |
208 |
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Confounding: the Bottom Line |
218 |
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Questions |
219 |
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References |
220 |
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9 |
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221 |
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The Research Question and Study Design |
222 |
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The Study Sample: Selection Bias |
223 |
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Measuring Disease and Exposure: Measurement Bias |
226 |
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Confounding |
228 |
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Chance |
230 |
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Study Validity |
230 |
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Descriptive Studies |
232 |
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Writing Papers |
233 |
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Summary: One Swallow Doesn’t Make a summer |
234 |
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Questions |
235 |
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References |
235 |
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10 |
Who Sank the Boat? Association
and Causation |
237 |
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What do we mean by a Cause? |
238 |
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Association versus Causation |
242 |
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Evaluating Causation |
243 |
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Evaluating Causality in Practice: Does H. Pylori Cause Stomach Cancer? |
250 |
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And then what? |
250 |
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References |
251 |
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11 |
Assembling the Building Blocks:
Reviews and their Uses |
252 |
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What is a Systematic Review? |
253 |
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Identifying the Literature |
253 |
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Different Types of Study |
256 |
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Summarising the Data |
259 |
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Assessment of Causality |
265 |
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Assessing the Quality of a Systematic Review |
267 |
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Making Judgements in Practice |
267 |
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The End Result |
272 |
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Summary |
273 |
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References |
273 |
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12 |
Outbreaks, Epidemics and
Clusters Professor Adrian Sleigh National
Centre for Epidemiology and Population Health,
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276 |
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Outbreaks, Epidemics, Endemics and Clusters |
278 |
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Rare Disease Clusters |
279 |
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Epidemiology of Infectious Diseases |
282 |
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A Causal Model |
285 |
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What Influences the Spread of Infectious Diseases? |
286 |
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Epidemics or Outbreaks |
293 |
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Investigating Outbreaks |
295 |
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Epidemic Prevention |
299 |
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Tuberculosis: a Case Study |
300 |
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Conclusion |
304 |
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Questions |
304 |
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References |
305 |
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13 |
Watching Not Waiting:
Surveillance and Epidemiologkal
Intelligence |
307 |
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The scope of Surveillance |
309 |
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Types of Surveillance |
312 |
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Surveillance in Practice |
315 |
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Evaluation of Surveillance |
321 |
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Summary |
321 |
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References |
322 |
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14 |
Prevention: Better Than Cure? |
323 |
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Disease Prevention in Public Health |
323 |
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The Scope for Preventive Medicine |
328 |
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Strategies for Prevention |
331 |
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The Population Attributable Fraction as a Guide to Prevention |
336 |
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Prevention in Practice |
339 |
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Evaluation of Preventive Interventions in Practice |
341 |
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A Final (Cautionary) Word |
342 |
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Question |
343 |
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References |
343 |
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15 |
Early Detection: What Benefits
at What Cost? |
345 |
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Why Screen? |
346 |
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The Requirements of a Screening Programme |
349 |
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Evaluation of a Screening Programme |
361 |
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The Negative Consequences of a Screening Programme |
370 |
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Summary |
371 |
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Questions |
372 |
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References |
373 |
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16 |
A Final Word |
375 |
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What Does the Future Hold for Epidemiology? |
377 |
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Where to Now? |
382 |
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A Final Word |
385 |
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References |
386 |
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Answers
to Questions |
388 |
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Appendix 1 |
Direct Standardisation |
404 |
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Appendix 2 |
Standard
Populations |
406 |
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Appendix 3 |
Calculating
Cumulative Incidence and Lifetime Risk From the data |
407 |
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Appendix 4 |
Indirect Standardisation |
409 |
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Appendix 5 |
Calculating
Life Expectancy from a Life Table |
411 |
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Appendix 6 |
The Mantel-Haenszel
Method for Calculating Pooled |
413 |
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Appendix 7 |
Formulae
for Calculating Confidence Intervals for Common Epidemiological Measures |
416 |
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Glossary |
419 |
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Index |
435 |
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