Sonam Christopher_Problem Set 1

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Name: Sonam Christopher Date: February 14, 2023 GPHP 2010: Problem Set 1 Surveillance and Measures of Disease Occurrence Part 1. CDC WONDER Analysis The CDC WONDER (Wide-ranging Online Data for Epidemiological Research) database is an integrated information and communication system for public health. This database includes public information data on United States Cancer Statistics . Use the cancer incidence data and answer each question in 1-3 complete sentences. For incidence statistics, use the age-adjusted rates and the 2000 U.S. Standard Million population. 1. According to the CDC website : The primary source of data on cancer incidence is medical records. Staff at healthcare facilities abstract data from patients’ medical records, enter it into the facility’s own cancer registry (if it has one), and then send the data to the regional or state registry. Other data sources include physicians’ offices, radiation facilities, freestanding surgical centers, and pathology laboratories. Based on this description, would you say that the incidence data in CDC WONDER were collected as part of a passive or active surveillance system? Explain your answer. (1 point) The incidence data in CDC WONDER was collected as part of passive surveillance since it is abstracted from exposures submitted from hospitals, clinics and public health units. 2. What are some advantages and disadvantages of the approach described in question 1? (List at least 2 advantages and 2 disadvantages). (2 points) Some of the advantages of passive surveillance are that it is relatively inexpensive compared to active surveillance. It also allows for international comparisons because some agencies may have programs or methods in instituted for easy passive reporting for a number of infectious diseases. Some of the disadvantages of passive surveillance are that it is reliant on the hospital to report the data accurately, and it might not be reported in a timely manner. Another disadvantage is that sometimes local outbreaks in small communities may be missed because the small number of cases may be missed or diluted inside of a large population of a country or state. 1

3. Describe how the number of incident cases of lung and bronchus cancer changed from 1999 to 2019 across the United States. (1 point) Between 1999 to 2019 the number of incident cases of lung and bronchus cancer increased from 191,786 people to 221,097 people in the United States. 4. Describe how the incidence of lung and bronchus cancer changed from 1999 to 2019 across the United States. (1 point) The incidence of lung and bronchus cancer decreased from 70.8 to 52.9 per 100,000 people in the United States between 1999 to 2019. 5. Given your response to question 4, how do you expect the prevalence of lung and bronchus cancer would have changed from 1999 to 2019 across the United States? Explain your reasoning. (1 point) Since prevalence is the incidence multiplied by the duration, with the duration a constant for this purpose, I expect the prevalence to stay the same from 1999 to 2019 in the United States. 6. What are three possible reasons that could explain why the incidence data may have changed from 1999 to 2019? List at least one reason related to health care policy or practice, and another related to the reporting or measurement of cases. (1.5 points) Some reasons for why the incidence data may have changed from 1999 to 2019 regarding lung and bronchus cancer could be changes to health care policy or practice such as laws enacted to prohibit smoking in public places such as restaurants and other indoor settings. There were also no smoking campaigns and the FDA regulation posted on cigarette packaging. Some reasons that are related to reporting or measurement would be that the standards of reporting may have changed. 2

7. Using Excel or a similar program, create a line graph showing how the incidence of lung or bronchus cancer changed from 1999 to 2019 by sex (i.e., there should be one line for females and one line for males). Be sure to label your axes (with units) and create a figure title. Interpret this figure. (3 points) The incidence of lung and bronchus cancers in the United States between 1999 to 2019 generally decreased for both males and females, yet the decrease was sharper among males. This could be because of lower smoking cessation rates among women compared to men, and the age of onset of smoking may have lowered among women. 3

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Part 2. Measures of Occurrence A group of 10 friends went to a picnic on Sunday afternoon. Hannah brought an egg salad, which everyone ate except for Bob. Unfortunately, this egg salad was infected with Salmonella, and some people developed food poisoning over the next few days, as indicated by an X in the table below. Monday Tuesday Wednesday Thursday Person-days Alfred X 2 Bob 0 Cindy X 2 Darlene X 1 Earl 4 Frida X 3 Greg 4 Hannah X 1 Isaac X 3 Justine 4 Questions 7 through 12 refer to the results in this table. Show your work for all calculations. Round all calculations to the nearest whole number. Answer each question in 1-3 complete sentences. 8. What was the point prevalence of food poisoning on the Monday following the picnic? Interpret your findings. (2 points) The point prevalence is the prevalence of the disease in the population at a specified time. In this case, it would be the prevalence of food poisoning on Monday among everyone who went to the picnic on Sunday. This would be 2 10 = numberof people withfood poisoning numberof people who went ¿ the picnic ¿ = .2 or 20%. 20% of the people who went to the picnic on Sunday had food poisoning on Monday. 9. What was the period prevalence of food poisoning over the 3 days following the picnic? Interpret your findings. (2 points) 4

The period prevalence is the prevalence of a disease in the population over a period of time. So, numberof people with food poisoning the 3 days followingthe picnic number of people who went ¿ the picnic ¿ = 6 10 = .6 or 60%. 60% of people who went to the picnic on Sunday had food poisoning over the three days following the picnic. 10. How many incident cases of food poisoning were there over the three days following the picnic? (1 point) There are six new incident cases of food poisoning over the three days following the picnic. 11. What was the cumulative incidence of food poisoning over the three days following the picnic? Interpret your findings. (2 points) The cumulative incidence of food poisoning over the three days following the picnic are as follows the number of new casesof food poisoning the three days followingthe picnic numberof people at risk of getting food poisoningby eatingtheegg salad . = 6 9 =0.67 or 67%. So, 67% of people developed food poisoning over the three days following the picnic . 12. Fill in the column for person-days in the table above to show how many days each person contributed to this analysis. (1 point) 13. What was the incident rate of food poisoning per person week over the 4 days following the picnic? Round your answer to the nearest integer. Interpret your findings. (2 points) The incidence rate of food poisoning per person week over the 4 days following the picnic would be calculated as thenumber of newcases of food poisoning per person week the 4 days followingthe picnic total persontime at risk . = 6 24 = .25 x 7(7 days/1 week)= 1.75. So 2 people developed food poisoning per 7 person days over the 4 days following the picnic. 5

Sonam Christopher_Problem Set 1

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