Epidemiology Kept Simple (eBook)

An Introduction to Traditional and Modern Epidemiology

B. Burt Gerstman (Autor)

eBook Download: PDF

2013 | 3. Auflage
John Wiley & Sons (Verlag)
978-1-118-52541-8 (ISBN)

Infos

Epidemiology Kept Simple introduces the epidemiological principles and methods that are increasingly important in the practice of medicine and public health. With minimum use of technical language it fully explains terminology, concepts, and techniques associated with traditional and modern epidemiology. Topics include disease causality, epidemiologic measures, descriptive epidemiology, study design, clinical and primary prevention trials, observational cohort studies, case-control studies, and the consideration of random and systematic error in studies of causal factors. Chapters on the infectious disease process, outbreak investigation, and screening for disease are also included. The latter chapters introduce more advanced biostatistical and epidemiologic techniques, such as survival analysis, Mantel-Haenszel techniques, and tests for interaction.

This third edition addresses all the requirements of the American Schools of Public Health (ASPH) Epidemiological Competencies, and provides enhanced clarity and
readability on this difficult subject. Updated with new practical exercises, case studies and real world examples, this title helps you develop the necessary tools to interpret epidemiological data and prepare for board exams, and now also includes review questions at the end of each chapter.

Epidemiology Kept Simple continues to provide an introductory guide to the use of epidemiological methods for graduate and undergraduate students studying public health, health education and nursing, and for all practicing health professionals seeking professional development. 

B. Burt Gerstman, Professor in Department of Health Science, San Jose University, CA USA.

Inhalt

Cover???????????????????????? 1
Title Page?????????????????????????????????? 5
Copyright???????????????????????????????? 6
Contents?????????????????????????????? 9
Preface to the Third Edition?????????????????????????????????????????????????????????????????????? 13
Preface to the First Edition?????????????????????????????????????????????????????????????????????? 15
Acknowledgments???????????????????????????????????????????? 17
Chapter 1 Epidemiology Past and Present???????????????????????????????????????????????????????????????????????????????????????????? 19
1.1 Epidemiology and its uses???????????????????????????????????????????????????????????????????????? 20
What is epidemiology????????????????????????????????????????????????????????? 20
What is public health??????????????????????????????????????????????????????????? 20
What is health????????????????????????????????????????????? 21
Additional useful terms???????????????????????????????????????????????????????????? 21
Uses of epidemiology?????????????????????????????????????????????????????? 22
1.2 Evolving patterns of morbidity and mortality?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 23
Twentieth century changes in demographics and disease patterns?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 23
Mortality trends since 1950???????????????????????????????????????????????????????????????????? 25
Trends in life expectancy???????????????????????????????????????????????????????????????? 25
1.3 Selected historical figures and events?????????????????????????????????????????????????????????????????????????????????????????????????? 26
Roots of epidemiology???????????????????????????????????????????????????????? 27
John Graunt???????????????????????????????????? 29
Germ theory???????????????????????????????????? 30
M´edecine d'observation and La M´ethode Numerique (Pinel and Louis) 32
The London Epidemiological Society?????????????????????????????????????????????????????????????????????????????????? 35
William Farr?????????????????????????????????????? 35
John Snow???????????????????????????????? 37
Twentieth-century epidemiology?????????????????????????????????????????????????????????????????????????? 43
Emile Durkheim?????????????????????????????????????????? 43
Joseph Goldberger???????????????????????????????????????????????? 44
The British Doctors Study???????????????????????????????????????????????????????????????? 46
1.4 Chapter summary???????????????????????????????????????????????????? 48
Epidemiology and its uses???????????????????????????????????????????????????????????????? 48
Evolving patterns of morbidity and mortality?????????????????????????????????????????????????????????????????????????????????????????????????????? 48
Selected historical figures and events?????????????????????????????????????????????????????????????????????????????????????????? 49
Review questions?????????????????????????????????????????????? 49
References?????????????????????????????????? 50
Chapter 2 Causal Concepts???????????????????????????????????????????????????????????????? 54
2.1 Natural history of disease?????????????????????????????????????????????????????????????????????????? 54
Stages of disease???????????????????????????????????????????????? 54
Stages of prevention?????????????????????????????????????????????????????? 58
2.2 Variability in the expression of disease?????????????????????????????????????????????????????????????????????????????????????????????????????? 58
Spectrum of disease???????????????????????????????????????????????????? 58
The epidemiologic iceberg???????????????????????????????????????????????????????????????? 58
2.3 Causal models???????????????????????????????????????????????? 59
Definition of cause???????????????????????????????????????????????????? 59
Component cause model (causal pies)???????????????????????????????????????????????????????????????????????????????????? 60
Causal web?????????????????????????????????? 62
Agent, host, and environment?????????????????????????????????????????????????????????????????????? 63
2.4 Causal inference?????????????????????????????????????????????????????? 66
Types of decisions?????????????????????????????????????????????????? 66
Report of the Advisory Committee to the U.S. Surgeon General, 1964?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 67
Hill's framework for causal inference???????????????????????????????????????????????????????????????????????????????????????? 68
Philosophical considerations?????????????????????????????????????????????????????????????????????? 74
Exercises???????????????????????????????? 76
Review questions?????????????????????????????????????????????? 79
References?????????????????????????????????? 81
Chapter 3 Epidemiologic Measures?????????????????????????????????????????????????????????????????????????????? 84
3.1 Measures of disease frequency???????????????????????????????????????????????????????????????????????????????? 85
Background?????????????????????????????????? 85
Incidence proportion (risk)???????????????????????????????????????????????????????????????????? 87
Incidence rate (incidence density)?????????????????????????????????????????????????????????????????????????????????? 88
Prevalence?????????????????????????????????? 90
3.2 Measures of association???????????????????????????????????????????????????????????????????? 92
Background?????????????????????????????????? 92
Absolute versus relative comparisons?????????????????????????????????????????????????????????????????????????????????????? 93
Absolute measures of effect???????????????????????????????????????????????????????????????????? 93
Relative measures of effect???????????????????????????????????????????????????????????????????? 94
Odds ratios???????????????????????????????????? 95
Relation between the RR and RD?????????????????????????????????????????????????????????????????????????? 96
3.3 Measures of potential impact?????????????????????????????????????????????????????????????????????????????? 97
Attributable fraction in the population???????????????????????????????????????????????????????????????????????????????????????????? 97
Attributable fraction in exposed cases?????????????????????????????????????????????????????????????????????????????????????????? 99
Preventable fraction?????????????????????????????????????????????????????? 100
3.4 Rate adjustment???????????????????????????????????????????????????? 100
Background?????????????????????????????????? 101
Direct adjustment???????????????????????????????????????????????? 102
Indirect adjustment???????????????????????????????????????????????????? 103
Adjustment for multiple factors???????????????????????????????????????????????????????????????????????????? 107
Section summary???????????????????????????????????????????? 108
Notation used in Section 3.4?????????????????????????????????????????????????????????????????????? 108
Exercises???????????????????????????????? 108
Review questions?????????????????????????????????????????????? 116
References?????????????????????????????????? 117
Addendum: additional mathematical details???????????????????????????????????????????????????????????????????????????????????????????????? 119
Chapter 4 Descriptive Epidemiology?????????????????????????????????????????????????????????????????????????????????? 122
4.1 Introduction?????????????????????????????????????????????? 122
What is descriptive epidemiology????????????????????????????????????????????????????????????????????????????????? 122
Case series???????????????????????????????????? 123
Surveillance systems?????????????????????????????????????????????????????? 123
National health surveys and vital record systems?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 125
4.2 Epidemiologic variables???????????????????????????????????????????????????????????????????? 126
Person?????????????????????????? 127
Place???????????????????????? 129
Time?????????????????????? 129
4.3 Ecological correlations???????????????????????????????????????????????????????????????????? 134
Aggregate-level data?????????????????????????????????????????????????????? 134
The ecological fallacy?????????????????????????????????????????????????????????? 137
Other types of aggregate-level variables?????????????????????????????????????????????????????????????????????????????????????????????? 138
Exercises???????????????????????????????? 139
Review questions?????????????????????????????????????????????? 141
References?????????????????????????????????? 142
Chapter 5 Introduction to Epidemiologic Study Design?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 144
5.1 Etiologic research?????????????????????????????????????????????????????????? 144
Hypothesis statement?????????????????????????????????????????????????????? 144
Variables???????????????????????????????? 146
Data?????????????????????? 146
5.2 Ethical conduct of studies involving human subjects???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 147
5.3 Selected study design elements?????????????????????????????????????????????????????????????????????????????????? 148
Necessity of a referent ("control") group 148
Experimental versus observational study designs???????????????????????????????????????????????????????????????????????????????????????????????????????????? 149
Unit of observation???????????????????????????????????????????????????? 150
Longitudinal versus cross-sectional observations?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 151
Cohort versus case-control samples?????????????????????????????????????????????????????????????????????????????????? 153
5.4 Common types of epidemiologic studies???????????????????????????????????????????????????????????????????????????????????????????????? 155
Exercises???????????????????????????????? 156
Review questions?????????????????????????????????????????????? 158
References?????????????????????????????????? 159
Chapter 6 Experimental Studies?????????????????????????????????????????????????????????????????????????? 160
6.1 Introduction?????????????????????????????????????????????? 160
6.2 Historical perspective?????????????????????????????????????????????????????????????????? 162
Comment regarding use of the term "natural experiment" 163
6.3 General concepts?????????????????????????????????????????????????????? 164
The control group???????????????????????????????????????????????? 164
Randomization and comparability???????????????????????????????????????????????????????????????????????????? 166
Checking group comparability?????????????????????????????????????????????????????????????????????? 167
Recruitment and eligibility criteria?????????????????????????????????????????????????????????????????????????????????????? 167
Follow-up and outcome ascertainment???????????????????????????????????????????????????????????????????????????????????? 169
Intention-to-treat analysis versus per-protocol analysis?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 169
6.4 Data analysis???????????????????????????????????????????????? 170
Measures of effect?????????????????????????????????????????????????? 170
Statistical inference???????????????????????????????????????????????????????? 171
Sample size requirements?????????????????????????????????????????????????????????????? 173
Exercises???????????????????????????????? 174
Review questions?????????????????????????????????????????????? 175
References?????????????????????????????????? 175
Chapter 7 Observational Cohort Studies?????????????????????????????????????????????????????????????????????????????????????????? 177
7.1 Introduction?????????????????????????????????????????????? 177
7.2 Historical perspective?????????????????????????????????????????????????????????????????? 179
7.3 Assembling and following a cohort???????????????????????????????????????????????????????????????????????????????????????? 181
7.4 Prospective, retrospective, and ambidirectional cohorts???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 182
7.5 Addressing the potential for confounding?????????????????????????????????????????????????????????????????????????????????????????????????????? 183
7.6 Data analysis???????????????????????????????????????????????? 184
7.7 Historically important study: Wade Hampton Frost's birth cohorts?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 188
Exercises???????????????????????????????? 192
Review questions?????????????????????????????????????????????? 195
References?????????????????????????????????? 195
Chapter 8 Case-Control Studies?????????????????????????????????????????????????????????????????????????? 198
8.1 Introduction?????????????????????????????????????????????? 198
8.2 Identifying cases and controls?????????????????????????????????????????????????????????????????????????????????? 200
Ascertainment of cases?????????????????????????????????????????????????????????? 200
Selection of controls???????????????????????????????????????????????????????? 201
Number of controls per case???????????????????????????????????????????????????????????????????? 202
Sample size considerations?????????????????????????????????????????????????????????????????? 202
8.3 Obtaining information on exposure???????????????????????????????????????????????????????????????????????????????????????? 203
8.4 Data analysis???????????????????????????????????????????????? 204
Dichotomous exposure?????????????????????????????????????????????????????? 204
Multiple levels of exposure???????????????????????????????????????????????????????????????????? 204
Matched pairs???????????????????????????????????????? 207
Matched tuples?????????????????????????????????????????? 209
8.5 Statistical justifications of case-control odds ratio as relative risks???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 211
Incidence density sampling?????????????????????????????????????????????????????????????????? 211
Cumulative incidence sampling???????????????????????????????????????????????????????????????????????? 212
Exercises???????????????????????????????? 212
Review questions?????????????????????????????????????????????? 216
References?????????????????????????????????? 217
Chapter 9 Error in Epidemiologic Research???????????????????????????????????????????????????????????????????????????????????????????????? 219
9.1 Introduction?????????????????????????????????????????????? 219
Random error and systematic error???????????????????????????????????????????????????????????????????????????????? 219
Parameters and estimates?????????????????????????????????????????????????????????????? 220
9.2 Random error (imprecision)?????????????????????????????????????????????????????????????????????????? 221
Probability???????????????????????????????????? 221
Introduction to statistical inference???????????????????????????????????????????????????????????????????????????????????????? 223
Estimation (confidence intervals)???????????????????????????????????????????????????????????????????????????????? 224
Hypothesis testing (p-values) 226
9.3 Systematic error (bias)???????????????????????????????????????????????????????????????????? 227
Selection bias?????????????????????????????????????????? 228
Information bias?????????????????????????????????????????????? 230
Confounding???????????????????????????????????? 231
Exercises???????????????????????????????? 235
Review questions?????????????????????????????????????????????? 237
References?????????????????????????????????? 238
Chapter 10 Screening for Disease?????????????????????????????????????????????????????????????????????????????? 240
10.1 Introduction???????????????????????????????????????????????? 241
10.2 Reliability (agreement)?????????????????????????????????????????????????????????????????????? 242
Essential background?????????????????????????????????????????????????????? 242
The kappa statistic???????????????????????????????????????????????????? 243
The kappa paradox???????????????????????????????????????????????? 245
10.3 Validity???????????????????????????????????????? 246
Sensitivity and specificity???????????????????????????????????????????????????????????????????? 247
Predictive value positive and predictive value negative???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 248
True prevalence and apparent prevalence???????????????????????????????????????????????????????????????????????????????????????????? 249
Relation between prevalence and the predictive value of a positive test???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 250
Relation between prevalence and the predictive value of a negative test???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 252
Selecting a cutoff point for positive and negative test results???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 253
Key points?????????????????????????????????? 256
Reliability notation?????????????????????????????????????????????????????? 256
Validity notation???????????????????????????????????????????????? 257
Summary???????????????????????????? 256
Exercises???????????????????????????????? 257
Review questions?????????????????????????????????????????????? 261
References?????????????????????????????????? 261
10.4 Chapter addendum (case study)?????????????????????????????????????????????????????????????????????????????????? 262
Screening for antibodies to the human immunodeficiency virus?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 262
Further reading-screening for HIV???????????????????????????????????????????????????????????????????????????????? 266
Further reading-general concepts of screening???????????????????????????????????????????????????????????????????????????????????????????????????????? 266
Answers to case study: screening for antibodies to the human immunodeficiency virus???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 267
Chapter 11 The Infectious Disease Process???????????????????????????????????????????????????????????????????????????????????????????????? 273
11.1 The infectious disease process???????????????????????????????????????????????????????????????????????????????????? 273
Agents?????????????????????????? 274
Reservoirs?????????????????????????????????? 275
Portals of entry and exit???????????????????????????????????????????????????????????????? 277
Transmission?????????????????????????????????????? 278
Host immunity???????????????????????????????????????? 279
11.2 Herd immunity?????????????????????????????????????????????????? 283
What is herd immunity??????????????????????????????????????????????????????????? 283
Stemming an outbreak through herd immunity?????????????????????????????????????????????????????????????????????????????????????????????????? 283
Epidemic modeling???????????????????????????????????????????????? 285
Exercises???????????????????????????????? 285
Review questions?????????????????????????????????????????????? 286
References?????????????????????????????????? 288
Chapter 12 Outbreak Investigation???????????????????????????????????????????????????????????????????????????????? 289
12.1 Background???????????????????????????????????????????? 290
Initial detection of outbreaks?????????????????????????????????????????????????????????????????????????? 290
Goals and methods of outbreak investigations?????????????????????????????????????????????????????????????????????????????????????????????????????? 290
12.2 CDC prescribed investigatory steps???????????????????????????????????????????????????????????????????????????????????????????? 291
Step 1: Prepare for field work?????????????????????????????????????????????????????????????????????????? 291
Step 2: Establish the existence of an outbreak?????????????????????????????????????????????????????????????????????????????????????????????????????????? 291
Steps 3 and 4: Verify diagnoses of cases and search for additional cases?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 292
Step 5: Conduct descriptive epidemiologic studies???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 293
Step 6: Develop hypotheses?????????????????????????????????????????????????????????????????? 297
Steps 7 and 8: Evaluate hypotheses as necessary, reconsider or refine hypotheses and conduct additional studies??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
Step 9: Implement control and prevention measures???????????????????????????????????????????????????????????????????????????????????????????????????????????????? 299
Step 10: Communicate findings???????????????????????????????????????????????????????????????????????? 300
Review questions?????????????????????????????????????????????? 300
References?????????????????????????????????? 301
Drug-disease outbreak???????????????????????????????????????????????????????? 301
Answers to case study: a drug-disease outbreak?????????????????????????????????????????????????????????????????????????????????????????????????????????? 303
References-a drug-disease outbreak?????????????????????????????????????????????????????????????????????????????????? 304
Food borne outbreal in Rhynedale, California?????????????????????????????????????????????????????????????????????????????????????????????????????? 304
Answers to case study: food-borne disease outbreak?????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 318
Chapter 13 Confidence Intervals and p-Values?????????????????????????????????????????????????????????????????????????????????????????????????????? 320
13.1 Introduction???????????????????????????????????????????????? 321
Parameters and estimates?????????????????????????????????????????????????????????????? 321
Population and sample???????????????????????????????????????????????????????? 321
Statistical inference???????????????????????????????????????????????????????? 321
13.2 Confidence intervals???????????????????????????????????????????????????????????????? 322
Estimation?????????????????????????????????? 322
Confidence intervals for proportions (incidence proportion and prevalence)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 322
Confidence intervals for rates?????????????????????????????????????????????????????????????????????????? 324
Confidence intervals for proportion ratios (risk ratios and prevalence ratios)?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 324
Confidence intervals for rate ratios?????????????????????????????????????????????????????????????????????????????????????? 326
Confidence intervals for proportion differences (risk differences and prevalence differences)???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 326
Confidence intervals for rate differences???????????????????????????????????????????????????????????????????????????????????????????????? 327
Confidence intervals for odds ratios, independent samples???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 328
Confidence intervals for odds ratios, matched pairs???????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 328
13.3 p-Values 330
Hypothesis tests of statistical significance?????????????????????????????????????????????????????????????????????????????????????????????????????? 330
Fallacies of p-values and statistical testing 331
Testing a proportion?????????????????????????????????????????????????????? 332
Testing a rate?????????????????????????????????????????? 333
Chi-square test of association?????????????????????????????????????????????????????????????????????????? 333
Fisher's exact test???????????????????????????????????????????????????? 335
Testing independent rates???????????????????????????????????????????????????????????????? 336
McNemar’s test for matched pairs 337
13.4 Minimum Bayes factors?????????????????????????????????????????????????????????????????? 337
Introduction?????????????????????????????????????? 337
Bayes factor?????????????????????????????????????? 338
Interpretation of the Bayes factor?????????????????????????????????????????????????????????????????????????????????? 338
Prior odds?????????????????????????????????? 338
Method to calculate a minimum Bayes factor?????????????????????????????????????????????????????????????????????????????????????????????????? 338
References?????????????????????????????????? 340
Chapter 14 Mantel-Haenszel Methods?????????????????????????????????????????????????????????????????????????????????? 341
14.1 Ways to prevent confounding?????????????????????????????????????????????????????????????????????????????? 341
14.2 Simpson's paradox?????????????????????????????????????????????????????????? 343
14.3 Mantel-Haenszel methods for risk ratios?????????????????????????????????????????????????????????????????????????????????????????????????????? 343
Mixing of effects???????????????????????????????????????????????? 343
Homogeneity assumption?????????????????????????????????????????????????????????? 344
Mantel-Haenszel summary risk ratio?????????????????????????????????????????????????????????????????????????????????? 345
Confidence interval for the Mantel-Haenszel risk ratio?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 346
Mantel-Haenszel test statistic?????????????????????????????????????????????????????????????????????????? 347
14.4 Mantel-Haenszel methods for other measures of association?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 347
Differences between proportions (incidence proportion difference and prevalence difference)???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 348
Odds ratios???????????????????????????????????? 348
Rate ratios???????????????????????????????????? 349
Rate differences?????????????????????????????????????????????? 351
Test statistic for stratified person-time data?????????????????????????????????????????????????????????????????????????????????????????????????????????? 351
Exercise?????????????????????????????? 353
References?????????????????????????????????? 353
Chapter 15 Statistical Interaction: Effect Measure Modification???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 355
15.1 Two types of interaction???????????????????????????????????????????????????????????????????????? 355
Types of interaction?????????????????????????????????????????????????????? 355
Biological interaction?????????????????????????????????????????????????????????? 355
Statistical interaction???????????????????????????????????????????????????????????? 356
15.2 Chi-square test for statistical?????????????????????????????????????????????????????????????????????????????????????? 358
15.3 Strategy for stratified analysis???????????????????????????????????????????????????????????????????????????????????????? 360
Exercises???????????????????????????????? 362
References?????????????????????????????????? 363
Chapter 16 Case Definitions and Disease Classification?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 365
16.1 Case definitions???????????????????????????????????????????????????????? 365
Establishing a case definition?????????????????????????????????????????????????????????????????????????? 365
Multiple-choice criteria?????????????????????????????????????????????????????????????? 366
Chronic fatigue syndrome, as an example???????????????????????????????????????????????????????????????????????????????????????????? 366
Evolution of the AIDS case definition, as an example 368
Classification of case status based on certainty?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 368
16.2 International classification of disease?????????????????????????????????????????????????????????????????????????????????????????????????????? 369
16.3 Artifactual fluctuations in reported rates???????????????????????????????????????????????????????????????????????????????????????????????????????????? 371
16.4 Summary?????????????????????????????????????? 372
References?????????????????????????????????? 373
Chapter 17 Survival Analysis?????????????????????????????????????????????????????????????????????? 374
17.1 Introduction???????????????????????????????????????????????? 374
17.2 Stratifying rates by follow-up time?????????????????????????????????????????????????????????????????????????????????????????????? 377
17.3 Actuarial method of survival analysis?????????????????????????????????????????????????????????????????????????????????????????????????? 378
17.4 Kaplan-Meier method of survival analysis???????????????????????????????????????????????????????????????????????????????????????????????????????? 380
17.5 Comparing the survival experience of two groups?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 382
Risk differences and risk ratios at selected points in time???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 383
Comparing survival functions as a whole???????????????????????????????????????????????????????????????????????????????????????????? 384
Cochran-Mantel-Haenszel chi-square statistic 386
Exercises???????????????????????????????? 387
References?????????????????????????????????? 389
Chapter 18 Current Life Tables?????????????????????????????????????????????????????????????????????????? 391
18.1 Introduction???????????????????????????????????????????????? 391
18.2 Complete life table?????????????????????????????????????????????????????????????? 392
Predicting probabilities from rates???????????????????????????????????????????????????????????????????????????????????? 393
Special circumstances surrounding the first year of life?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 394
General formula???????????????????????????????????????????? 395
Constructing a complete life table?????????????????????????????????????????????????????????????????????????????????? 395
18.3 Abridged life table?????????????????????????????????????????????????????????????? 398
Exercises???????????????????????????????? 401
References?????????????????????????????????? 402
Chapter 19 Random Distribution of Cases in Time and Space???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? 403
19.1 Introduction???????????????????????????????????????????????? 403
19.2 The Poisson distribution???????????????????????????????????????????????????????????????????????? 404
Use of the Poisson formula?????????????????????????????????????????????????????????????????? 405
Calculating the expected number of cases?????????????????????????????????????????????????????????????????????????????????????????????? 405
Post hoc identification of clusters 407
19.3 Goodness of fit of the Poisson distribution?????????????????????????????????????????????????????????????????????????????????????????????????????????????? 408
Fitting the Poisson distribution?????????????????????????????????????????????????????????????????????????????? 408
19.4 Summary?????????????????????????????????????? 412
Exercises???????????????????????????????? 413
References?????????????????????????????????? 414
Answers to Exercises and Review Questions 416
Index???????????????????????? 473

Rezensionen

"This edition does a good job of updating the previous editions,
which have not covered the ASPH epidemiology competencies."
(Doody's, 21 February 2014)

Produkt-Details

• Erscheint lt. Verlag: 13.2.2013
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Studium ► Querschnittsbereiche ► Epidemiologie / Med. Biometrie
• Schlagworte: Addendum • Additional • association • Disease • Disease Frequency • Edition • epidemiology • Expression • First • History • Introduction • measures • Medical Science • Medical Statistics & Epidemiology • Medizin • Medizinische Statistik u. Epidemiologie • Morbidity • Patterns • Potential • study design • Third • Variability
• ISBN-10: 1-118-52541-8 / 1118525418
• ISBN-13: 978-1-118-52541-8 / 9781118525418