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Lec.26 Epidemiology This lecture is just introduction to epidemiology Epidemiology, literally meaning "the study of what is upon the people", is derived from Greek epi,meaning "upon",demos,meaning "people",and ."logos,meaning "study Epidemiology is a very important course and we need it in various branches of medicine for many reasons ,for exampe if one decides to make a research or article(published scientific paper),he need to study this course as well as biostat( well cover this course in the 3rd year) in order to know the main principles and necessary terms for such researches One of the most important requirements for specialization in USA after graduation and residency is having published research and if . you don't , it will be difficult to get a chance to specialize there -" There are several designs for epidemiological studies that are -: cross sectional study -1 its a type of study designs in epidemiology that involve observation of all population or representative sample(mainly) at one specific point in time it seems that this study is very easy and any one can do it ,that's why 99% . of epidemiological studies in Jordan have been done using it rate=( X/Y)*K X: number of the cases Y: number of sample or population K: constant -:Some rates have specific constant for example Infant mortality rate is calculated per 1000childs while the maternal mortality rate is calculated per 100,000 mothers ? We have another term called attack rate ,so what does it mean Attack rate is number of exposed persons infected with disease by the .total exposed persons ,it always represent percentage Each country has its specific attack rate for each out-breaked disease

e.g: the attack rate of diarrhea(caused by food poising) differs from . Saudi Arabia to Jordan we read in some articles that there is an out-break of cholera in south Africa ,and its attack rate is 22/1000 ,but it's false expression because the attack rate is percentage ,so we must say 22% field work in which students are divided into groups and each group make a research a bout certain subject is implemented in 3rd year medical students in JU e.g :one of the researches done by some students is smoking among females in JU in order to know the percentage of females that smoke and what are the main reasons for this problem and other information . about this phenomenon Back to cross-sectional study which is very common in Jordan -: these examples which explain this type of epidemiological designs -: myopia among 14 years old Childssurvey is done in Jordan proves that 25% of this category have myopia

-: (Myocardial infraction (MIthe prevalence rate for this disease 2% in Jordan let's assume that prevalence rate is the total number of cases in the population, divided by the number of individuals in the population. It is used as an estimate of how common a disease is within a population over a .certain period of time -: violence against women in south Jordan Tafeeleh was chosen for this study because its accessible(reachable) .geographical site In this study ,a questionnaire ( group of questions ) is administered to a sample from the target population . After collecting the answered questionnaire and analyzing the answers ,we'll able to create a strategic . (plan to overcome this problem(violence against women The process of designing one's own questionnaire is often timeconsuming and may become quite expensive because it need a very . sensitive questions

The sample that is chosen in cross-sectional study is said to be representative sample ,and there is a criteria for choosing this sample -: which is summarized by three significant properties that are enough size :- for example if we want to make a study about the level -1 of health services in the hospital of JU , we can't ask just 4 or 5 individuals about that issue , we must have enough size to do that . research saturation : - it must contain both genders ; male and female -2 randomness-3

-: case controlled study -2 -: cohort study -3 -:(clinial trials (experimental study -4

-: e.g few years ago a survey has been done in the the university of Jordan hospital about efficacy of Ampicillin which is used as treatment for (septicemia (blood infection the out come of this clinical study prove that efficacy of Ampicillen is 40%(which means that this drug is not enough good to treat septicemia ), . so we need more efficient drug it's clear that these designs of epidemiological studies are very important , because they're widely used in different branches of medicine e.g :-if we have a patient with shoulder dislocation and in order know details about this defect we read an article about that and we find that this defect is associated with age(as age increases, the incidence rate becomes -:higher) and we find some value like RR-=2.3(relative risk) P=0.02 (Peaky value) 90CI=2.5-2.8 SO we need to know the meanings of these values by studying epidemiology and biostat otherwise we can't understand articles . &researches

Done by Ja'far Al-Zo3bi