Transcript Data and Technology “Tools” - UNC Center for Public Health

is for Epi
Epidemiology basics
for non-epidemiologists
Session II
Part II
An Epidemiologist’s Toolkit
Data and Technology
“Tools”
Data
Key Sources
• Surveillance
“The ongoing systematic collection, analysis,
and interpretation of health data, essential to the
planning, implementation, and evaluation of
public health practice, closely integrated with the
timely dissemination to those who need to
know.”
• Questionnaires and Interviews
-Physicians
Standardized
data collection
-Laboratories
-STD clinics
-Community
health clinics
County and state health
departments and CDC
who analyze data using
statistical methods
Dissemination to those
who need to know
Public health
evaluation
Dissemination
to those who
need to know
Change in public
health practice
(vaccination,
reduction of risk
factors, medical
intervention, etc.)
Public health planning
and intervention
-Public health officials
-Health directors
-Health policy officials
Surveillance as a Tool
• Determine baseline for detection of
epidemics
• Early detection of epidemics
– Estimate magnitude of the problem
– Determine geographical distribution
Surveillance as a Tool
Surveillance as a Tool
North Carolina Salmonella Rates by County: 2002
Rate numerators: NC Communicable Disease Data for 2000
Rate denominators: U.S. Census population data, by county, for 2000
Questionnaires and Interviews
Outbreak
Investigations
Rapid Needs
Assessments
Questionnaires and Interviews:
2 other applications
1. Contact tracing
case
High Risk
Contact’s
Contact
Contact
2. Case follow up
Data Management and Analysis
• Computer software packages
– Epi Info
– SAS
– SPSS
– Stata
Epi Info Software
http://www.cdc.gov/epiinfo/downloads.htm
Features:
– Relational database structure
– On screen data entry form
– Data analysis
– Data graphing
– Data mapping
Epi Info Software Training
http://www.sph.unc.edu/nccphp/training
• "Introduction to Screen Components And
Analysis Commands"
• "Importing and Exporting Data Tables"
• "Relating and Merging Data Tables"
• "Manipulating Data Prior to Analysis Part A"
• "Manipulating Data Prior to Analysis Part B“
• “Generating and Interpreting Analysis Output
Part A”
• “Generating and Interpreting Analysis Output
Part B”
Data Management and Analysis
Rely on software to:
Store databases
– Surveillance systems
– Outbreak investigations
– Medical records
Generate Descriptive Statistics
– Frequencies, proportions, rates
– Graphs: bar, line, histogram (Epi Curves)
– Maps: census tracts; counties; districts
Generate Test Statistics
– Odds ratios, risk ratios, and corresponding measures
of association
Data Management and Analysis
Rely on Epidemiologists to:
Generate Hypotheses
– Make judgments about linkages between exposure
and outcome
Interpret Data
– Identify or correct mistakes
– Interpret laboratory tests
Make Decisions
– Evidence-based
– Determine if an epidemic is in progress
The Media
as a “Tool”
Media Applications
• Risk and crisis communication
• Reaching people potentially exposed in an
outbreak
• Press releases
– Regional Public Information Officers
http://www.vdh.state.va.us/news/PRcontacts.asp
Media
Applications
Working with the Media
•
•
Crisis communication strategy employed
by the Toronto health department during
the SARS outbreak
Harnessed the power of the media to
disseminate timely, accurate information
to the public and physicians
“SARS:
When a Global Outbreak Hits Home” (October
2003). [email protected]
Centers for Disease Control
and Prevention
http://www.cdc.gov
CDC as a Tool
• Training
• Technical Support
• Surveillance and Reporting
CDC: Training
• Division of Applied Public Health Training
– Epidemic Intelligence Service program
• Division of Public Health Surveillance and
Informatics
– Public Health Informatics Fellowship Program
• Numerous satellite broadcasts, continuing
education training, printed education
materials on a broad range of topics
CDC: Technical Support
• Epidemic Intelligence Service Officers
• National Center for Infectious Diseases
CDC: Technical Support
CDC: Surveillance and Reporting
• Division of Public Health Surveillance and
Informatics
– NETSS
– Morbidity and Mortality Weekly Reports
• FoodNet
• PulseNet
• Sentinel Surveillance - Influenza
Universal Epidemiological
Methods
•
Descriptive epidemiology
•
Analytic epidemiology
References and Resources
• Association of Public Health Laboratories
http://www.aphl.org
• Centers for Disease Control and Prevention web site
(January 2005). http://www.cdc.gov
• Centers for Disease Control and Prevention (2003).
Smallpox Response Plan Guide.
http://www.bt.cdc.gov/agent/smallpox/response-plan.
• Division of Laboratory Systems, Centers for Disease
Control and Prevention (2004). The National Laboratory
System: Public and Private Benefits.
http://www.phppo.cdc.gov/mlp/nls.aspx
References and Resources
• Jenkins, P. ( 2004). Anatomy of a Food borne Outbreak
Investigation. North Carolina Center for Public Health Preparedness
Training web site: http://www.sph.unc.edu/nccphp/training
• North Carolina Center for Public Health Preparedness (2004).
Recognizing an Outbreak. Public Health Training and Information
Network program. http://www.sph.unc.edu/nccphp/training
• North Carolina Center for Public Health Preparedness (2004). Risk
Communication. Public Health Training and Information Network
program. http://www.sph.unc.edu/nccphp/training
• Salyers, M. (2004). Incident Command Systems for Public Health.
North Carolina Center for Public Health Preparedness Training web
site: http://www.sph.unc.edu/training.
References and Resources
• Stehr-Green P., Stehr-Green J. (2005). Environmental Health
Studies: Conducting Traceback Investigations. North Carolina
Center for Public Health Preparedness, UNC Chapel Hill.
• Trust for America’s Health (June 2003). Public Health Laboratories:
Unprepared and Overwhelmed.
http://healthyamericans.org/reports/files/LabReport.pdf
• University of North Carolina at Chapel Hill School of Public Health
and the Centers for Disease Control and Prevention (October 2003).
SARS: When a Global Outbreak Hits Home. Public Health Grand
Rounds Broadcast. www.PublicHealthGrandRounds.unc.edu.
• University of North Carolina at Chapel Hill School of Public Health
and the Centers for Disease Control and Prevention (September
2003). Disease, Disaster, and Detection: Partnering with Public
Health Laboratories. Public Health Grand Rounds Broadcast.
www.PublicHealthGrandRounds.unc.edu.