Application of Epidemiology Concepts Essay

IntroductionEpidemiology is defined as the arna of the distribution and determinants of wellness-related stated or events in specific existences and the practical coat of this reading to control of health problems (Gordis 2003). Over the past grade Cohort 7 has grown to appreciate the value of the epidemiology and thepractical application of this knowledge. As contemporary and future leaders in healthc atomic number 18 systems, it is important to not entirely to understand the concepts learnt in epidemiology, but to use these concepts in the drafting of form _or_ system of government, the pattern of programs and in making contributions to national, regional and international healthc be systems. The three epidemiological concepts to be discussed are estimating hazard, playing field design and honest & professional issues in epidemiology. The basics of each concept and its importance shall be outlined followed by a discussion of the perceived benefits to indemnity cle rics and populations at large and the application of each concept individually. For the purpose of this discourse, I restrain selected the chronic non-communicable indisposition, fictitious character 2 diabetes to illustrate the applications of the listed concepts through the eyes of a polity nobleman and programme designer. This paper shall be closed with a summary of the application of the concepts and a conclusion.Concept I Estimating RiskRisk has been defined as the probability of an event occurring (BMJ). In our current course of ingest, epidemiology, bumpiness is frequently used to express the likely-hood that a particular outcome go away get after a particular pictorial matter. It is important to understand risk and mental picture in the capacity of policy maker. Chronic-Non-Communicable-Disease (CNCDs) is a growing concern nationally, regionally and internationally. In Trinidad & Tobago the prevalence of diabetes is estimated to be as high as 1 in 5 of all adul ts (Ministry of Health 2010). Diabetes is the second leading develop of death and the leading cause of adult blindness in Trinidad & Tobago.The measurements of risk are inviolable risk or incident rate, congenator risk, credited(predicate) risk and betting odds ratio. According to Gordis 2003, absolute risk is the relative incidence of the disorder in the population, i.e. the number of new matters of the disease in a condition population over a condition time. The incidence of diabetes in Trinidad & Tobago has been estimated as 1,000 cases per stratum (John Hopkins 2012). This information about the absolute risk of diabetes has an important consequence in public health policy formation. It tells the policy designer in the Ministry of Health that on that point would be an estimated 1,000 new cases of casing 2 diabetes per year and so the current out-patient clinics for diabetics would need to be expanded.With that number of newcases per year there will be a greater demand situated on the Ministry of Healths Chronic Disease Assistance course of instruction (CDAP) and more(prenominal) livelihood will have to be allocated to deal with diabetes. Since absolute risk gives no consideration to risk factors or exposure, it is necessary for the policy designers and planners to look at the other measurements of risk to formulate appropriate plans to write out spending associated with the morbidity and mortality of this CNCD. This benefits the country as it im certifys the well-being of the homophile resource. Relative risk is defined as the probability of exposed persons ontogeny disease compared to non-exposed persons developing disease (Gordis 2003) while attributable risk is the add of a disease incidence that female genitalia be attributed to a disposed exposure. The odds ratio or carnal knowledge odds after part just now be defined as a measure of association surrounded by an exposure and an outcome.It represents the odds that an outcome wi ll occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Knowledge of the risk factors for fictitious character 2 diabetes is valuable in looking at the relative risk, attributable risk and relative odds of type 2 diabetes. A risk factor is a variable associated with an increased risk of disease (Burt 2001). The risk factors for type 2 diabetes are family history of diabetes, increasing age, ethnic background, inactivity, metabolic syndrome, being overweight and history of gestational diabetes in women (Joseph 2010). In designing policies and programs to combat type 2 diabetes, there would be an examine to target members of the population with these risk factors. It would be prudent to provide funding to institutions which are conducting studies to clarify relative risk, attributable risk and relative odds in diabetes as these studies would help in the understanding of the etiology of type 2 diabetes.Concept II Study Des ignThere are four basic reflect designs cross-sectional studies, case-control studies, age bracket studies and randomized clinical trials. As stated previously, it would be prudent to fund institutions conducting studies to clarify relative risk, attributable risk and relative odds in type 2 diabetes as such studies would aid in the understanding of the etiology of type 2 diabetes. In clarifying the etiology of type 2 diabetes in a givenpopulation better strategies for anxiety and prevention of the diseases can be adopted. In the capacity of policy and programme designer, it is effectual to have an understanding of teach design so that the proposals for studies which can produce the great data on etiology in the shortest time-span can be selected for funding. In cross-sectional studies both the exposure and disease outcome are resolute simultaneously for each subject (Gordis 2003). The prevalence of the disease can be determined with this type of study hence the study can in addition be called a prevalence study. The prevalence of diabetes in Trinidad & Tobago is one in every five adults (Ministry of Health 2010).Cross-sectional studies are useful to policy writers and programme designers as it provides a snap shot of how galore(postnominal) individuals at heart the population have the disease. However the association with the risk factors does not prove temporal relationship. For the justification of policy and programmes, aetiologic relationships moldiness be established. These etiological relationships can be justified through case-control and cohort studies. Case-control studies are useful in examining the possible relation of an exposure to a certain disease. At the beginning of the study individuals with the disease (cases) and individual without the disease (controls) are set. The exposure of both of these groups is wherefore compared. So in the case of type 2 diabetes, persons with type 2 diabetes can be identified (cases) so garbled int o ii groups on the basis or exposure to a given risk factor. Persons without type 2 diabetes (controls) can also be identified than separated on the basis of exposure to the same risk factor. thence the two groups of exposed individuals can be compared. By identifying cases & controls and looking at exposure, the relative risk, attributable risk and odds ratio can be calculated.Case-control studies are invaluable in finding the etiology of disease. In cohort studies the queryers select a group of individuals from a given population. These individuals are then categorized as either exposed or non-exposed. Cohort studies can either be prospective or retrospective. In prospective cohort studies the exposed and non-exposed individuals are followed forward in time and the development of disease is observed. In retrospective cohort studies the end result, i.e. disease or no disease is noted at the starting point. The look intoer can then trace the individuals backwards through time to determine their exposure or non-exposure.Prospective cohort studies are expensive and time consuming as they may take many years to be completed. In the case of diabetes, it may take many years for exposure to lead to disease. ex post facto cohort studies may be better for proving causal relations in diabetes, but records may not be easily available.The high prevalence of diabetes is a good justification for conducting a cohort study. Once again relative risk, attributable risk and odds ratio can be calculated. A randomized clinical trial is an experiment in which the military posture of a mode of treatment is evaluated. Cross-sectional, case-control and cohort studies are all empiric studies. However, in randomized clinical trials, the effectiveness of treatment modalities are measured. unremarkably individuals for the study are assessed for eligibility before hand and subsequently randomly put into one or an alternative treatment group. The merits of preventive strategies c an outflank be illustrated by means of randomized clinical trial. Considerable scat has been done in ascertaining the risk factors of type 2 diabetes. After study of the literature I have concluded that there is the need for more experimental studies for better management of type 2 diabetes. As a policy writer and programme designer it is critical to ensure that approvals are granted for ethically sound randomized clinical trials. It is important to note that a good knowledge of study design is essential to a policy makers/ programme designers. The type of study to approve for funding will undoubtedly be based on maximum benefit to the population, be effectiveness and ethical considerations.Concept III honorable & Professional Issues in EpidemiologyThe ultimate objective of epidemiology, according to Gordis, is to improve human health. Ethical consideration moldiness be high on the agenda in public health since epidemiological findings are socially relevant, often publicly funde d and the research is conducted on human subjects. As discussed previously, there are two broad types of studies in epidemiology the observational studies which include the cross-sectional, case-control and cohort studies and the experimental study or randomized clinical trial. As a policy writer and programme designer, I am obligated to ensure that investigators and researchers obtain sensible consent from their subjects, where possible, and that there is privacy and confidentiality. There is aneed for research on type 2 diabetes to be conducted in Trinidad & Tobago and the wider region so that there is relevant and timely data for the implementation and improvement of policies for cut back the morbidity and mortality associated with type 2 diabetes.There have been many studies which contribute to the body of knowledge compiled by the International Diabetes Federation. While there is merit in conducting observational studies, I believe that there must be more experimental studies aimed at improving the prevention and management of diabetes. In the design and execution of experimental studies, the rights of the individuals and the welfare of society must be balanced. Careful oversight of experimental research can defend individual confidentiality while ensuring that there is no conflict with the welfare of society. pull down though there is the objective of improving human health, there is ponder on how much of the findings should be made available to the subjects in both observational and experimental studies. While I believe that the findings of research should be held in the public domain, it is important not to create undue dread or hope of a miracle cure when print results.SummaryEpidemiology is the study of the distribution and determinants of health-related stated or events in specific populations and the application of this study to control of health problems. Consequently the objective of epidemiology is to improve human health (Gordis 2003). T he three epidemiological concepts discussed were, estimating risk, study design and ethical & professional issues in epidemiology using the disease type 2 diabetes for illustration. It is important for a policy writer/ programme designer to understand risk and the measurement of risk so that there are policies and programmes that benefit the greatest proportion of the population are designed and implemented in the reduction of the prevalence and incidence of type 2 diabetes and its associated morbidity and mortality.Studies, both observational and experimental, should be advance but these studies must be conducted within the confines of ethics and professionalism. morals and professional are integral building blocks of study design since the findings are socially relevant, public funds are often used and the research is conducted in human subjects. There must also be publishing ofthe findings of these studies but researchers should neither create undue panic nor give fabricated h ope.ConclusionThe three epidemiological concepts discussed for this paper were estimating risk, study design and ethical & professional issues in epidemiology. These were discussed concepts through the eyes of a policy maker and programme designer using the disease type 2 diabetes for illustrations. poring over the distribution and determinants of health-related states is not simply a course that constitutes part of a masters degree that a student must upset or get over but rather a control principle to be incorporated into decision making, so that the application of this study can truly be used to control health problems. These health problems can range in simplicity from common childhood ailments to pandemics. hence participants in this course of study are expected to make superlative contributions to national, regional and international healthcare systems based on understand of concepts lettered in epidemiology.Bibliography1. Burt BA. Definitions of Risk. Department of Epid emiology School of Public Health University of Michigan, 2001.2. Center for Statistics in Medicine BMJ Statistics Notes. (Undated) Retrieved May 13, 2014. URLhttp//www.csm-oxford.org.uk/index.aspx?0=12923. Gordis Leon. Epidemiology. 3rd edition. Philadelphia Elsevier 2004.4. Josepha Joseph, Johan Svartberg, Inger Njlstad, Henrik Schirmer. incidence of and risk factors for type 2 diabetes in a general population. The Troms Study. Scand J of Public Health, 201038 (7)768-775. 5.6. Last JM, ed. A dictionary of epidemiology. 4th edition. new York Oxford University Press, 2001.