Essential Epidemiology An Introduction for Students and Health Professionals 3rd Edition PDF

Foreword page ix
Preface xi
List of Contributors xv
1 Epidemiology is … 1
A case of food poisoning 3
Subdisciplines of epidemiology 4
On epidemics 6
An historical epidemic 8
The beginnings 11
What does epidemiology offer? 17
What do epidemiologists do? 19
A natural experiment 24
Conclusions 27
2 How long is a piece of string? Measuring disease frequency 31
What are we measuring? 33
The concepts: prevalence and incidence 34
Measuring disease occurrence in practice: epidemiological studies 41
Measuring disease occurrence in practice: using routine data 48
Other measures commonly used in public health 55
Global health indicators 59
Summary 72
Questions 72
3 Who, what, where and when? Descriptive epidemiology 75
Case reports and case series 76
Vital statistics and mortality data 77
Morbidity data 86
Creative use of existing data 93
Confidentiality 100
Summary 100
Questions 100
4 Healthy research: study designs for public health 104
The ideal study 106
Intervention studies or trials 108
v
Observational studies 114
A word about ethics 130
Summary 133
Questions 135
5 Why? Linking exposure and disease 139
Looking for associations 140
Ratio measures (relative risk) 142
Difference measures (attributable risk) 147
Relative risk versus attributable risk: an example 155
Case–control studies 156
Looking for associations when the measures are continuous 163
Summary 163
Questions 165
6 Heads or tails: the role of chance 169
Random sampling error 170
Statistical significance: could an apparent association have arisen
by chance? 171
Confidence intervals 173
Power: could we have missed a true association? 175
Interpreting p-values and confidence intervals 177
Statistical versus clinical significance 181
Summary 183
Questions 183
7 All that glitters is not gold: the problem of error 185
Sources of error in epidemiological studies 187
Selection bias 187
Measurement or information error 200
Summary 213
Questions 214
8 Muddied waters: the challenge of confounding 217
An example of confounding: is alcohol a risk factor for
lung cancer? 219
Characteristics of a confounder 221
The Effects of confounding 223
Control of confounding 228
Confounding: the bottom line 243
Questions 244
9 Reading between the lines: reading and writing
epidemiological papers 248
The research question and study design 250
vi Table of contents
Internal validity 251
So what? are the results important? 260
Generalisability (external validity) 262
Descriptive studies 263
Writing papers 264
Summary: one swallow doesn’t make a summer 265
Questions 266
10 Who sank the boat? Association and causation 269
What do we mean by a cause? 271
Association versus causation 275
Evaluating causation 276
An example: does H. pylori cause stomach cancer? 285
Conclusion 286
Questions 286
11 Assembling the building blocks: reviews and their uses 288
What is a systematic review? 289
Identifying the literature 291
Appraising the literature 292
Summarising the data 294
Drawing conclusions 300
Assessing the quality of a systematic review 303
Making judgements in practice 303
The end result 307
Conclusion 309
Questions 310
12 Surveillance: collecting health-related data for epidemiological
intelligence and public health action 313
Martyn Kirk and Adrian Sleigh
The scope of surveillance 314
Why conduct surveillance? 315
Surveillance essentials 316
Types of surveillance 322
Summary 329
Questions 329
13 Outbreaks, epidemics and clusters 333
Martyn Kirk and Adrian Sleigh
Outbreaks, epidemics, and clusters 335
Epidemiology of infectious diseases 336
Non-infectious clusters and outbreaks 343
Outbreak management and investigation 345
Table of contents vii
Evidence for causation 350
Summary 352
Questions 353
14 Prevention: better than cure? 356
Disease prevention in public health 357
The scope for preventive medicine 362
Strategies for prevention 365
The population attributable fraction as a guide to prevention 370
Prevention in practice 373
Evaluation of preventive interventions in practice 376
A final (cautionary) word 378
Questions 378
15 Early detection: what benefits at what cost? 381
Why screen? 382
The requirements of a screening programme 385
Evaluation of a screening programme 401
Summary 412
Questions 413
16 Epidemiology and the public’s health 417
Translating epidemiological research into practice 418
Challenges 420
Synthesis and integration 422
Limiting error 424
Improving measurement 424
A final word 427
Answers to questions 430
Appendix 1: Direct standardisation 451
Appendix 2: Standard populations 453
Appendix 3: Calculating risk and lifetime risk from routine data 455
Appendix 4: Indirect standardisation 457
Appendix 5: Calculating life expectancy from a life table 459
Appendix 6: Why the odds ratio approximates the relative risk for a
rare disease 461
Appendix 7: Formulae for calculating confidence intervals for common
epidemiological measures 462
Appendix 8: The Mantel–Haenszel method for calculating pooled
odds ratios 464
Glossary
Essential Epidemiology An Introduction for Students and Health Professionals 3rd Edition PDF Ebook

Penny Webb is a Principal Research Fellow at the QIMR Berghofer Medical Research Institute and Honorary Professor at the School of Public Health, University of Queensland.
Chris Bain is a Visiting Scientist at the Queensland Institute of Medical Research.
Andrew Page is Professor of Epidemiology at the Centre for Health Research, School of Medicine, University of Western Sydney. –This text refers to the paperback edition.