Académique Documents
Professionnel Documents
Culture Documents
DISCUSSION
1) Epidemiologic measures of disease frequency. 2) Measurement of disease incidence and prevalence.
Count: Number of individuals who meet the definition of the case. Simple and useful Example:
Proportion: A fraction of (A/A+B) A= numerator: Includes only number of indivuals who meet the case definition. A+B= denominator: Total numbers of individuals meet the case definition + those in the study population who do not meet the case definition and are at risk. Not dependant upon time. May be present in fraction or percentage. Linked to estimating risk. Example: 30% of persons over the age of 50 have been screen for colon cancer.
B= denominator
Rate: Nomerator is disease frequency. Denominator is the population size. Dependant upon time. Example: 44 cases of colon cancer per 100,000 population in Pennsylvania during 2000.
Risk: Probability of an individual meeting the case definition. Dependent upon time. Example:
Incidence:
Measures new cases of disease develop over period of time. Identify risk factors. Estimated from clinical trials. Assess aetiology.
Prevalence:
Measures both new and existing cases of disease at a particular time or over period of time. Does not consider person die before the study begins. Estimated from cross-sectional studies and case-control studies. Useful in planning of health services.
To illustrate how incidence and prevalence differ, we consider our experience with AIDS. The number of annual incident cases of AIDS in gay men decreased in the US from the mid-1980's to the late 1990's. This has resulted primarily both from recent antiretroviral treatment approaches and from prevention strategies for reducing high risk sexual behaviour. In contrast, the annual prevalent cases of AIDS in gay men has greatly increased in the US during the same period because recent treatment approaches for AIDS have been successful in prolonging life of persons with the HIV virus and/or AIDS.