Epidemiology and Sex(ually Transmitted Diseases) The Basics.pptVIP

SpermMicro101 Epidemiology and Sex(ually Transmitted Diseases): The Basics Willard Cates, Jr., MD, MPH Family Health International Objectives To understand basic definitions of epidemiology To describe components of descriptive, observational and experimental epidemiology To know advantages and disadvantages of case-control and cohort designs Cholera in London, 1854 The Etymology of Epidemiology epi = upon demos = people logy = study of e.g. Population Level Science Definition of Epidemiology The study of the distribution and determinants of disease and health in human populations. Stedman’s Epidemiology The science of making the obvious obscure Clinician Epidemiology I0 = (480)(2)/106/yr (9.1 x 0.955) + 0.045 The science of long division Statistician Epidemiology The worst-taught course in medical school Anonymous Med Student Epidemiology The study of skin diseases Atlanta Native Epidemiology’sFundamental Axioms Non-randomness Etiologic thinking Preventability Epidemiology Quantitative basic science Method of causal reasoning Vehicle for clinical and public health action Exposure Variable – “E” Characteristic of interest Risk factor Predictor variable Independent variable Putative causal factor Outcome or Disease Variable – “D” Health event of interest Illness, injury, infection Response variable Dependent variable Effect variable E-D Relationships – STD Examples Gonorrhea – PID PID – ectopic pregnancy Age – chlamydia infection HPV – cervical cancer Alcohol – high risk behavior Circumcision – HIV infection Categories of Study Design Descriptive Analytic Experimental Knowledge Continuum Descriptive Studies Patterns of occurrence No comparison group Generate hypotheses about E-D relationships Descriptive Studies: Examples from STD Epidemiology of chlamydia in Norway Prevalence of sexual behaviors among a sample of the general population Trends in the first 20 years of AIDS in the US Analytic Studie