STATISTICAL METHODS

IN EPIDEMIOLOGY
• Epidemiology is the study and analysis of the distribution and
determinants of health, and disease conditions in defined
population.
• It shapes policy decisions and evidence based practice by identifying
risk factor for disease and targets for preventive healthcare
• - Epidemiologists help with
• study design-
• collection-
• Statistical analysis of data-
• amend interpretation
• Dissemination of results (peer review + occasional systematic review)
• Epidemiological Markers:
• They include-
• specific protein-
• Polysaccharide antigens-
• Genes, in case of microorganisms-
• threshold value of chemicals
• Physical factors of chemical and physical agents
• These markers are used to identity
• Genera
• Species
• Strains
• Types of microorganisms
• The typing markers are of two types:-
• Phenotypic markers
• Genotypic makers.
Phenotypic markers
• This include cell wall specific proteins and Polysaccharides
Genotypic markers
• Gene structure of microorganism is a genotypic marker.
Terminology
• Fertility rate- study related to the birth
• Mortality rate - study related to the death
• Morbidity rate- study related to the disease condition
OBJECTIVES OF EPIDEMIOLOGY
• To determine the rates of disease by person, place and time -
Absolute risk ( incidence, prevalence)
• To identify the risk factors for the disease - Relative risk (or odds ratio)
• To develop approaches for disease prevention - Attributable risk /
fraction
INCIDENCE
• It tells how often an event occurs in a population over a period of time, such as
week, month, year, et cetera
• WHO expert committee on health statistics, recommend that incidence rate is
used to measure frequency of illness that commenced during the defined period,
i.e., occurrence of new cases during a specified week, month or year
• Spell of sickness means duration of one illness only. In a defined period one may
have two spells
• Example 2 colds in six months
• Incident rate is defined as a number of new cases of a disease occurring in a
specified time period divided by the number of individuals at risk of developing
the disease during the same time.
• The denominator for calculation of rates is population exposed to risk
• Incidence or inception rate =
PREVALENCE
• Prevalence indicates how common is an event in a population.
• Prevalence rate is related to the total number of cases, there is new
or old existing at a point of Time with total population.
• Prevalence is defined as a total number of affected individuals
population at a specified time period divided by the number of
individuals in the population at that time
• It is of two types:
• Period Prevalence
• Point Prevalence
• Life time Prevalence
TYPES OF PREVALENCE
Point prevalence
• It is related to prevalence with respect to a specific point in time
• Point prevalence is a proportion of a population that has the condition at a specific point
in time
• Example- Did you have an asthma attack on Monday?
Period prevalence
• Related to prevalence over a period of time
• Period Prevalence is the proportion of a population that has the condition at some time
during the given period (example 12 month prevalence), and includes people who
already have the condition at the start of the study period as well as those who acquired
during that period.
• Example, Did you have an asthma attack in January?
Lifetime prevalence
• Lifetime prevalence is a proportion of a population that at some point
in their life.
• After the time of assessment have experienced the condition.
• Example- Have you ever had an asthma attack?
Applications of incidence and
prevalence
• Monitoring of family planning program
• Monitoring of illness in the community
• Calculate expectancy of life
• Proportional mortality indicator
• Life expectancy at birth
• Death rate
RELATIVE RISK
• It is used when the study involves comparing the likelihood or chance
of an event occurring between two groups
• It is considered as descriptive statistic
• It requires examination of two dichotomy variables where one
variable measures event, other variable measures the groups
• It is calculated by dividing the probability of an event occurring for a
group one divided by the probability of an event occurring for a group
two
• In statistics on epidemiology, relative risk or risk ratio is a ratio of the
probability and event occurring, (for example, developing a disease,
being injured) in an exposed group to the probability of event
occurring in a comparison, non-exposed group
• Categorical data in medical or health or nutrition, investigations are
frequently used to calculate the risk of the disease who are exposed
to a specific character not exposed to specific character.
• The basic requirement of the study is 2 x 2 giving number of disease,
the cases in those exposed and in those unexposed
Attributable risk
• Attributable risk is a portion of disease incident in this exposed that is
due to the exposure
• Therefore, equal the incidence of the disease in the exposed that
would be eliminated if the exposure were eliminated
• In epidemiology, the attributable risk is the difference in the rate of
condition between the risk in exposed subjects and unexposed
subjects is called attributable risk.
• This can also be understood as risk difference
• Attribute risk is mostly calculated in studies where individual
individuals are assembled on exposure status and followed over a
period of time.
• Attributable risk gives more valid information to the health managers
than the relative risk.
• This happens, particularly when the diseases occur several times
more frequently for particular antecedent is present
• Better index of the public health importance of the risk factor in terms
of the impact, its reduction can make an overall incidence of disease