How could you use descriptive epidemiological methods in your practice?
DNP 825 Topic 2 Discussion Question One
How could you use descriptive epidemiological methods in your practice? Provide an example where you could use descriptive epidemiology to improve care. Explain your rationale.
Descriptive epidemiology aims to describe the distributions of diseases and determinants. It provides a way of organizing and analyzing these data to describe the variations in disease frequency among populations by geographical areas and over time (i.e., person, place, and time). Descriptive epidemiology can thus generate hypotheses of etiologic research.
Ecologic study and cross-sectional study (see Chapter 4) are the most commonly applied in descriptive epidemiologic studies. For example, the National Health and Nutrition Examination Survey is a cross-sectional study. In the study, participants’ health
DNP 825 Topic 2 Discussion Question One
DNP 825 Topic 2 Discussion Question One
conditions, including the prevalence of CHD, heart failure, stroke, diabetes, and cancers, are measured through standard survey instruments.41
Descriptive epidemiology uses observational studies of the distribution of disease in terms of person, place, and time. The study describes the distribution of a set of variables, without regard to causal or other hypotheses. Personal factors include age, gender, SES, educational level, ethnicity, and occupation. The place of occurrence can be defined by natural or political boundaries, and can also include such variables as location of residence, work, school, or recreation. Time factors include time trends, which are generally divided into three types:
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secular trends – long-term variations
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cyclic changes – periodic fluctuations on an annual or other basis
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epidemic disease outbreaks – short-term fluctuations.
Time trends contribute to our understanding of the natural history of epidemics of acute infectious diseases such as measles or waterborne disease, as well as NCDs such as stroke or cancer. The study of a “natural experiment” when a public health situation is occurring may provide valuable experience and hypothesis for further investigation. Epidemiology also examines the frequency and distribution of potential health indicators and health-related events (such as smoking).
Natural experiments allow observation of the effects of events not in the control of the observer. Increases in legal speed limits are associated with increases in the incidence and severity of traffic collisions, and deaths as velocity increases. Fluoridation of community water supplies is associated with reductions in dental caries and poor dental health of children and elderly people. The observations are consistent and show a strong association, but are denied by ideologues as “not proven”.
Laws on smoking restrictions are important in reducing this previously highly prevalent risk factor for CVD and cancer, but this cannot be demonstrated by usual epidemiological methods. Yet it was the good epidemiology that provided the strong association between smoking and these diseases which justified the legal restrictions imposed by many civil societies. Natural experiments are an important part of the evidence base for public health where in many circumstances more definitive epidemiological research methods such as RCTs are neither feasible nor ethical.
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