Epidemiology for public health practice

Robert H. Friis, PhD: Professor and Chair, Department of Health Science, California State University, Long Beach
Thomas A. Sellers, PhD, MPH: Associate Center Director, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa

Preface	p. ix
Acknowledgments	p. xi
About the Authors	p. xv
Introduction	p. xvii
Chapter 1 The History and Scope of Epidemiology	p. 1
Introduction	p. 2
Epidemiology Defined	p. 5
Foundations of Epidemiology	p. 14
Historical Antecedents of Epidemiology	p. 22
Recent Applications of Epidemiology	p. 34
Conclusion	p. 40
Study Questions and Exercises	p. 40
Chapter 2 Practical Applications of Epidemiology	p. 45
Introduction	p. 46
Applications for the Assessment of the Health Status of Populations and Delivery of Health Services	p. 48
Applications Relevant to Disease Etiology	p. 66
Conclusion	p. 81
Study Questions and Exercises	p. 81
Appendix 2 Data for Study Question 9	p. 85
Chapter 3 Measures of Morbidity and Mortality Used in Epidemiology	p. 87
Introduction	p. 88
Definitions of Count, Proportion, Ratio, and Rate	p. 88
Risk Versus Rate	p. 97
Interrelationship Between Prevalence and Incidence	p. 99
Applications of Incidence Data	p. 100
Crude Rates	p. 100
Specific Rates	p. 109
Adjusted Rates	p. 112
Conclusion	p. 121
Study Questions and Exercises	p. 122
Appendix 3 Data for Study Questions 2 Through 5	p. 125
Chapter 4 Descriptive Epidemiology: Person, Place, Time	p. 127
Introduction	p. 128
Characteristics of Persons	p. 132
Characteristics of Place	p. 152
Characteristics of Time	p. 163
Conclusion	p. 169
Study Questions and Exercises	p. 169
Appendix 4 Project: Descriptive Epidemiology of a Selected Health Problem	p. 176
Chapter 5 Sources of Data for Use in Epidemiology	p. 179
Introduction	p. 180
Criteria for the Quality and Utility of Epidemiologic Data	p. 181
Computerized Bibliographic Databases	p. 182
Confidentiality, Sharing of Data, and Record Linkage	p. 182
Statistics Derived from the Vital Registration System	p. 190
Reportable Disease Statistics	p. 191
Screening Surveys	p. 197
Disease Registries	p. 198
Morbidity Surveys of the General Population	p. 198
Insurance Data	p. 201
Hospital Data	p. 203
Diseases Treated in Special Clinics and Hospitals	p. 203
Data from Physicians' Practices	p. 205
Absenteeism Data	p. 206
School Health Programs	p. 206
Morbidity in the Armed Forces: Data on Active Personnel and Veterans	p. 207
Other Sources of Data Relevant to Epidemiologic Studies	p. 208
Conclusion	p. 209
Study Questions and Exercises	p. 209
Chapter 6 Study Designs: Ecologic, Cross-Sectional, Case-Control	p. 213
Introduction	p. 214
Observational Versus Experimental Approaches in Epidemiology	p. 215
Overview of Study Designs Used in Epidemiology	p. 216
Ecologic Studies	p. 220
Cross-Sectional Studies	p. 227
Case-Control Studies	p. 234
Conclusion	p. 247
Study Questions and Exercises	p. 248
Chapter 7 Study Designs: Cohort Studies	p. 253
Introduction	p. 254
Cohort Studies Defined	p. 254
Sampling and Cohort Formation Options	p. 264
Temporal Differences in Cohort Designs	p. 269
Practical Considerations	p. 272
Measures of Interpretation and Examples	p. 276
Nested Case-Control Studies	p. 284
Summary of Cohort Studies	p. 286
Comparisons of Observational Designs	p. 287
Conclusion	p. 287
Study Questions and Exercises	p. 290
Chapter 8 Experimental Study Designs	p. 295
Introduction	p. 296
Hierarchy of Study Designs	p. 296
Intervention Studies	p. 298
Clinical Trials	p. 299
Community Trials	p. 311
Conclusion	p. 321
Study Questions and Exercises	p. 323
Chapter 9 Measures of Effect	p. 327
Introduction	p. 328
Absolute Effects	p. 328
Relative Effects	p. 331
Statistical Measures of Effect	p. 336
Evaluating Epidemiologic Associations	p. 339
Conclusion	p. 341
Study Questions and Exercises	p. 342
Appendix 9 Cohort Study Data for Coffee Use and Anxiety	p. 344
Chapter 10 Data Interpretation Issues	p. 345
Introduction	p. 346
Validity of Study Designs	p. 346
Sources of Error in Epidemiologic Research	p. 350
Techniques to Reduce Bias	p. 355
Methods To Control Confounding	p. 358
Bias in Analysis and Publication	p. 362
Conclusion	p. 363
Study Questions and Exercises	p. 364
Chapter 11 Screening for Disease in the Community	p. 369
Introduction	p. 370
Screening for Disease	p. 370
Appropriate Situations for Screening Tests and Programs	p. 374
Characteristics of a Good Screening Test	p. 377
Evaluation of Screening Tests	p. 377
Sources of Unreliability and Invalidity	p. 381
Measures of the Validity of Screening Tests	p. 382
Effects of Prevalence of Disease on Screening Test Results	p. 384
Relationship Between Sensitivity and Specificity	p. 386
Evaluation of Screening Programs	p. 388
Issues in the Classification of Morbidity and Mortality	p. 389
Conclusion	p. 392
Study Questions and Exercises	p. 392
Appendix 11 Data for Problem 6	p. 396
Chapter 12 Epidemiology of Infectious Diseases	p. 397
Introduction	p. 398
Agents of Infectious Disease	p. 399
Characteristics of Infectious Disease Agents	p. 401
Host	p. 402
The Environment	p. 404
Means of Transmission-Directly or Indirectly from Reservoir	p. 405
Measures of Disease Outbreaks	p. 411
Procedures Used in the Investigation of Infectious Disease Outbreaks	p. 415
Epidemiologically Significant Infectious Diseases in the Community	p. 416
Conclusion	p. 437
Study Questions and Exercises	p. 441
Appendix 12 Data from a Foodborne Illness Outbreak in a College Cafeteria	p. 444
Chapter 13 Epidemiologic Aspects of Work and the Environment	p. 445
Introduction	p. 446
Health Effects Associated with Environmental Hazards	p. 447
Study Designs Used in Environmental Epidemiology	p. 447
Toxicologic Concepts Related to Environmental Epidemiology	p. 450
Types of Agents	p. 452
Environmental Hazards Found in the Work Setting	p. 458
Noteworthy Community Environmental Health Hazards	p. 460
Conclusion	p. 468
Study Questions and Exercises	p. 468
Chapter 14 Molecular and Genetic Epidemiology	p. 475
Introduction	p. 476
Definitions and Distinctions: Molecular Versus Genetic Epidemiology	p. 477
Epidemiologic Evidence for Genetic Factors	p. 485
Causes of Familial Aggregation	p. 485
Shared Family Environment and Familial Aggregation	p. 487
Gene Mapping: Segregation and Linkage Analysis	p. 490
Application of Genes in Epidemiologic Designs	p. 497
Genetics and Public Health	p. 504
Conclusion	p. 507
Study Questions and Exercises	p. 507
Chapter 15 Psychologic, Behavioral, and Social Epidemiology	p. 513
Introduction	p. 514
Research Designs Used in Psychologic, Behavioral, and Social Epidemiology	p. 518
The Social Context of Health	p. 519
Independent Variables	p. 520
Moderating Factors in the Stress-Illness Relationship	p. 526
Outcome Variables: Physical Health, Mental Health, Affective States	p. 537
Conclusion	p. 543
Study Questions and Exercises	p. 543
Appendix A Guide to the Critical Appraisal of an Epidemiologic/Public Health Research Article	p. 551
Appendix B Answers to Selected Study Questions	p. 557
Glossary	p. 567
Index	p. 585

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