300 likes | 395 Vues
is for Epi. Epidemiology basics for non-epidemiologists. Session II Part II. An Epidemiologist’s Toolkit. Data and Technology “Tools”. Data. Key Sources Surveillance
E N D
is for Epi Epidemiology basics for non-epidemiologists
Session IIPart II An Epidemiologist’s Toolkit
Data Key Sources • Surveillance “The ongoing systematic collection, analysis, and interpretation of health data, essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination to those who need to know.” • Questionnaires and Interviews
Standardized data collection County and state health departments and CDC who analyze data using statistical methods -Physicians -Laboratories -STD clinics -Community health clinics Dissemination to those who need to know Public health evaluation Dissemination to those who need to know Change in public health practice (vaccination, reduction of risk factors, medical intervention, etc.) -Public health officials -Health directors -Health policy officials Public health planning and intervention
Surveillance as a Tool • Determine baseline for detection of epidemics • Early detection of epidemics • Estimate magnitude of the problem • Determine geographical distribution
Surveillance as a Tool North Carolina Salmonella Rates by County: 2002 Rate numerators: NC Communicable Disease Data for 2000 Rate denominators: U.S. Census population data, by county, for 2000
Outbreak Investigations Questionnaires and Interviews Rapid Needs Assessments
Questionnaires and Interviews:2 other applications 1.Contact tracing Contact’s Contact case High Risk Contact • 2. Case follow up
Data Management and Analysis • Computer software packages • Epi Info • SAS • SPSS • Stata
Epi Info Softwarehttp://www.cdc.gov/epiinfo/downloads.htm Features: • Relational database structure • On screen data entry form • Data analysis • Data graphing • Data mapping
Epi Info Software Traininghttp://www.sph.unc.edu/nccphp/training • "Introduction to Screen Components And Analysis Commands" • "Importing and Exporting Data Tables" • "Relating and Merging Data Tables" • "Manipulating Data Prior to Analysis Part A" • "Manipulating Data Prior to Analysis Part B“ • “Generating and Interpreting Analysis Output Part A” • “Generating and Interpreting Analysis Output Part B”
Data Management and Analysis Rely on software to: Store databases • Surveillance systems • Outbreak investigations • Medical records Generate Descriptive Statistics • Frequencies, proportions, rates • Graphs: bar, line, histogram (Epi Curves) • Maps: census tracts; counties; districts Generate Test Statistics • Odds ratios, risk ratios, and corresponding measures of association
Data Management and Analysis Rely on Epidemiologists to: Generate Hypotheses • Make judgments about linkages between exposure and outcome Interpret Data • Identify or correct mistakes • Interpret laboratory tests Make Decisions • Evidence-based • Determine if an epidemic is in progress
Media Applications • Risk and crisis communication • Reaching people potentially exposed in an outbreak • Press releases • Regional Public Information Officers http://www.vdh.state.va.us/news/PRcontacts.asp
Working with the Media • Crisis communication strategy employed by the Toronto health department during the SARS outbreak • Harnessed the power of the media to disseminate timely, accurateinformation to the public and physicians “SARS: When a Global Outbreak Hits Home” (October 2003). GrandRounds@sph.unc.edu
CDC as a Tool • Training • Technical Support • Surveillance and Reporting
CDC: Training • Division of Applied Public Health Training • Epidemic Intelligence Service program • Division of Public Health Surveillance and Informatics • Public Health Informatics Fellowship Program • Numerous satellite broadcasts, continuing education training, printed education materials on a broad range of topics
CDC: Technical Support • Epidemic Intelligence Service Officers • National Center for Infectious Diseases
CDC: Surveillance and Reporting • Division of Public Health Surveillance and Informatics • NETSS • Morbidity and Mortality Weekly Reports • FoodNet • PulseNet • Sentinel Surveillance - Influenza
Universal Epidemiological Methods • Descriptive epidemiology • Analytic epidemiology
References and Resources • Association of Public Health Laboratories http://www.aphl.org • Centers for Disease Control and Prevention web site (January 2005). http://www.cdc.gov • Centers for Disease Control and Prevention (2003). Smallpox Response Plan Guide. http://www.bt.cdc.gov/agent/smallpox/response-plan. • Division of Laboratory Systems, Centers for Disease Control and Prevention (2004). The National Laboratory System: Public and Private Benefits. http://www.phppo.cdc.gov/mlp/nls.aspx
References and Resources • Jenkins, P. ( 2004). Anatomy of a Food borne Outbreak Investigation. North Carolina Center for Public Health Preparedness Training web site: http://www.sph.unc.edu/nccphp/training • North Carolina Center for Public Health Preparedness (2004). Recognizing an Outbreak. Public Health Training and Information Network program. http://www.sph.unc.edu/nccphp/training • North Carolina Center for Public Health Preparedness (2004). Risk Communication. Public Health Training and Information Network program. http://www.sph.unc.edu/nccphp/training • Salyers, M. (2004). Incident Command Systems for Public Health. North Carolina Center for Public Health Preparedness Training web site: http://www.sph.unc.edu/training.
References and Resources • Stehr-Green P., Stehr-Green J. (2005). Environmental Health Studies: Conducting Traceback Investigations. North Carolina Center for Public Health Preparedness, UNC Chapel Hill. • Trust for America’s Health (June 2003). Public Health Laboratories: Unprepared and Overwhelmed. http://healthyamericans.org/reports/files/LabReport.pdf • University of North Carolina at Chapel Hill School of Public Health and the Centers for Disease Control and Prevention (October 2003). SARS: When a Global Outbreak Hits Home. Public Health Grand Rounds Broadcast. www.PublicHealthGrandRounds.unc.edu. • University of North Carolina at Chapel Hill School of Public Health and the Centers for Disease Control and Prevention (September 2003). Disease, Disaster, and Detection: Partnering with Public Health Laboratories. Public Health Grand Rounds Broadcast. www.PublicHealthGrandRounds.unc.edu.