Download presentation
Presentation is loading. Please wait.
1
Epidemiology & Critical Thinking D. Morse 433 1 st Avenue Tel: 89217 E-mail: dem5@nyu.edudem5@nyu.edu Office Hours: 4:00-5:00 (M & W)
2
Epidemiology & Critical Thinking Syllabus Readings –VitalBook –Required / Non-required readings Examinations –Mid-term 40% (10/14) –Final 60% (cumulative) (12/11) –Format Slides Notes
3
Epidemiology The study of the distribution determinants of disease in human populations
6
Epidemiology in Dentistry Which posterior composite holds up the best over time? Does fluoride prevent caries in older adults? –What about an OTC fluoride mouthrinse? –What about drinking fluoridated drinking water? –What about chlorhexidene rinses to prevent root caries? Does mouthwash use increase the risk of oral cancer? Does periodontal disease increase the risk of heart disease?
7
Past Achievements: Epidemiology & Oral Health Water fluoridation and dental caries Fluoridated toothpaste and dental caries in children Smoking and oral cancer
11
Past Achievements: Epidemiology & Oral Health Water fluoridation and dental caries Fluoridated toothpaste and dental caries in children Smoking and oral cancer
12
Past Achievements: Epidemiology & Oral Health Water fluoridation and dental caries Fluoridated toothpaste and dental caries in children Smoking and oral cancer
13
Epidemiologic Terms Endemic –The usual occurrence of a disease in a given population Epidemic –A meaningful increase in the occurrence of a disease in a given population Pandemic
15
Epidemiologic Terms Validity Generalizability Reliability
16
Statistical vs. Clinical Significance Statistical significance –Relates to the probability that chance is responsible of an observed difference –P-value or confidence interval –Sample size is important –Says nothing about Magnitude of difference Clinical relevance Quality of the study Clinical significance –Relates to whether the findings are important from a clinical standpoint
17
Independent vs. Dependent Variables Independent Variable: Exposure of Interest E D Dependent Variable: Outcome of Interest E D
18
Levels of Prevention Primary prevention –prevent the disease Secondary prevention –catch the disease early –prompt treatment Tertiary Prevention –limit disability
19
Generalized Relationship Between Stage of Disease / Ease of Detection / Ease of Cure Stage of Disease LowHigh Ease of CureEase of Detection Difficult Easy
20
Scope of Epidemiology Infectious disease epidemiology Chronic disease epidemiology Occupational epidemiology Clinical epidemiology Molecular epidemiology
21
Laboratory/Animal Model vs. Epidemiologic Research
22
Process of Epidemiologic Reasoning Suspicion of an E D relationship Hypothesis formation Test E D hypothesis Rule out alternative explanations –chance –bias –confounding
24
Criteria for Assessing Causality Strength of the association Dose-response relationship Temporal sequence Biologic credibility Consistency of findings across studies
25
Criteria for Assessing Cause-Effect Relationship Strength of the Association Is there a strong E – D relationship? (e.g., smoking and lung cancer) –Less likely due to uncontrolled confounding –Measures of association: OR, RR, RD But, doesn’t imply that a small association can’t be judged as cause and effect
26
Criteria for Assessing Cause-Effect Relationship Dose-Response Relationship Does risk increase with increased exposure? But, may be a threshold effect
27
Relative Risk of Lung Cancer by Level of Cigarette Smoking, Chinese Men Smoking 30-39 Yrs Relative to lifelong nonsmokers
28
Temporal sequence Does the exposure precede the disease? Criteria for Assessing Cause-Effect Relationship
29
Biologic credibility Is there a known biologic basis for the relationship? (e.g., tobacco and lung cancer) But, depends on current state of knowledge Criteria for Assessing Cause-Effect Relationship
30
Consistency of findings across studies Do multiple studies report similar findings regarding the E – D relationship? (e.g., tobacco and lung cancer) Studies can differ by –investigator –methodology –study population Temporal sequence Criteria for Assessing Cause-Effect Relationship
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.