the descriptive epidemiologic variable age is related to:

As part of this analysis, we compared the frequency of being up-to-date (UTD) for HPV vaccination based on age at first vaccine dose, and compared vaccine uptake epidemiology across multiple socio-demographic measures. While the proportion of adolescents initiating HPV vaccination at 910years was relatively low, series up-to-date status among these adolescents was consistently high (ranging from 93% to 100% across age- and sex-groups). 3. People in our study sample with no viral load measurement in 2019 are lost to follow-up. Age at HPV vaccine series initiation, stratified by adolescent age and sex, and proportion of initiators in each group who were up-to-date for the HPV vaccine series, national immunization survey-teen, 2020. Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP), Prevention and control of meningococcal disease. Discuss both the direction and magnitude of any potential bias. Little is known about the epidemiology of age at HPV vaccination, and the frequency of vaccination occurring at 910years of age. To the extent to which the mismeasured outcome is a poor substitute for the true outcome, our inferences will be biased. dietary restrictions or restrictions on drinking alcohol or tobacco use. In the presence of competing events, we have the option to report the conditional or unconditional risk (i.e., cumulative incidence function) (35). Descriptive epidemiology includes both numbers and rates to document how much of a health condition is present or occurring in a population. Provider experience recommending HPV vaccination before age 11 years, The 2020 national immunization survey - teen. Pingali C, Yankey D, Elam-Evans LD, Markowitz LE, Valier MR, Fredua B, Crowe SJ, Stokley S, Singleton JA. For example, when describing temporal trends for the incidence of HIV diagnoses since the beginning of the epidemic in the 1980s, there will be people who were not born (not at risk for the outcome) in the 1980s who should be counted in the target population in the 2010s. Risk is arguably the most easily interpretable measure of disease occurrence for the general public (33). The figure below shows the usual cycle of . We can adjust for possible associations between censoring and the outcome (and resultant selection bias) using inverse probability of censoring weights (40). Little is known about the epidemiology of age at HPV vaccination, and the frequency of vaccination occurring at 9-10 years of age. These characteristics are carefully considered when a disease outbreak occurs, because they provide important clues regarding the source of the outbreak. Example 1: Stomach Cancer by Location in the US. A Framework for Descriptive Epidemiology - PubMed Basic Principles of Epidemiology - Merck Veterinary Manual Analyzing the study sample as if it were a random sample of the target population is akin to assuming that data are missing completely at random. One interesting finding from this analysis was that for the adolescents who initiated HPV vaccination at 910years of age, series up-to-date status rates were consistently greater than 93%, with little difference by age or sex. Descriptive epidemiologic studies seek to characterize what is happening in the world to inform public health priorities, target interventions, and occasionally contrast with counterfactual scenarios to estimate intervention effects (46, 47). Prentice RL, Chlebowski RT, Stefanick ML, et al. Describe any relevant features of the place and time in which the target population resides and across which data were collected. 1. Accessibility Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. One should consider changes in disease frequency on several different scales depending upon the disease of interest. Offord C. How (not) to do an antibody survey for SARS-CoV-2. B. identifies problems to be . Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, Bocchini JA, Unger ER. A well-defined descriptive question aims to quantify and characterize some feature of the health of a population and must clearly state: 1) the target population, characterized by In this paper, we propose a framework for thinking through the design and conduct of descriptive epidemiologic studies. Except in special cases (e.g., when the selected estimand is the one scale on which effect measure modification is absent), if absolute measures differ between the sample and the target, most contrasts of the outcome across exposure groups in the sample will also be biased for the same contrasts in the target population (causal results will be biased) (1416). While up-to-date status rates for initiators older than 910years are lower, they do consistently increase with increasing adolescent age. For each NIS-Teen record, we used the available data to create new variables to document HPV vaccine initiation: not initiated, initiated at 910years of age, initiated at 1112years of age, initiated at 1314years of age, and initiated at 1517years of age. When data are available on a full census of the target population (e.g., through administrative records or public health surveillance), no sampling is needed. The estimation challenge for descriptive analyses is that we may not completely observe all of the actual outcomes. Descriptive epidemiology uses observational studies of the distribution of disease in terms of person, place, and time. Decreases in tobacco smoking were followed by a decline in frequency of lung cancer, and modern methods of food preservation led to a decrease in stomach cancer. Summarize the target population and provide an informative and balanced summary of estimated disease occurrence in the abstract. One strategy to improve HPV vaccination is starting the vaccine series at the first opportunity currently as young as 9years of age. Variables can be classified into one of four types, depending on the type of scale used to characterize their values (Table 2.2). The monthly cases of toxic shock syndrome in 1980-1981 are shown in the graph below [from A. Reingold et al., Toxic shock syndrome surveillance in the United States, 1980-1981. All rights reserved. Health disparities in human papillomavirus vaccine coverage: trends analysis from the national immunization survey-teen, 2008-2011. Many descriptive and causal questions are answered using convenience samples without a clear sampling frame (e.g., people recruited using Web-based surveys, frequent clinic attendees, or people who sought medical care in a particular hospital system) and implicitly assume that the study sample is a random sample (perhaps conditional on covariates with known sampling probabilities) of the target population. However, some of the other continuous variables do differ across the exposure groups, e.g., body mass index, alcohol consumption, and dietary cholesterol. Alternatively, people who do not have a viral load measurement may have dropped out of clinical care and may not have access to antiretroviral therapy. Respond to The Importance of Descriptive Epidemiology' and 'Invited Commentary: The Importance of Descriptive Epidemiology' (doi: 10.1093/aje/kwac152, 10.1093/aje/kwac153). Location. exam 2 Flashcards | Chegg.com Changes in incidence due to environmental or life-style changes. Notably, as birth cohorts age into the recommended ages for HPV vaccination, high cohort-level HPV vaccine uptake is not typically seen for approximately three to four years, extending out to a substantial level of initiation at ages 1314years. No potential conflict of interest was reported by the author(s). To be concise, we ignore prediction questions here. Thus, the number of people with HIV infection may be inaccurate. Epidemiology quiz questions for exam 2 Flashcards | Quizlet Principles of Epidemiology: Lesson 4 Quiz|Self-Study Course SS1978|CDC National, regional, state, and selected local area vaccination coverage among adolescents aged 1317 years United States, 2020, A users guide for the 2020 public-use data file. The descriptive epidemiologic variable AGE is related to: a. Homicides and suicides b. Mortality from unintentional injuries c. the occurrence of chronic disease d. congenital malformations and infectious disease incidence in childhood e. all of the above This problem has been solved! (e.g., tuberculosis, polio), Does frequency of disease vary in a cyclic way that relates to the seasons? However, this approach can lead to incorrect interpretations of the results and inappropriate recommendations for actions (44). (e.g., influenza), Has it changed over the course of days? The epidemic curves for Guinea, Liberia, and Sierra Leone show that the number of Ebola cases began to rise in March 2014, peaked in mid 2015, and then gradually fell by January 2016. PDF Descriptive Epidemiology - University of South Florida However, use of convenience samples often results in study samples that are different from the target population in unmeasurable ways, particularly when subjects must actively seek out or opt into participation (13). False Large international variations in rates of infectious and communicable diseases as well as other conditions are most likely explained by The width we are willing to tolerate might depend on how frequently we anticipate viral load changes in the population. Another benefit of rates is that they are straightforward to estimate when we do not have individual-level data, which is more common in descriptive analyses than in causal or predictive epidemiologic analyses. Summarize potential sources of selection bias and measurement error and any attempts to mitigate these biases. For example, of adolescents with an 1112year old well-child visit, HPV series initiation was 77.8%, Tdap vaccination was 91.6%, and MCV4 vaccination was 91.1%; among those without an 1112year old well-child visit, those proportions are 66.2%, 84.8%, and 83.5%, respectively HPV vaccine series initiation and up-to-date status were higher for adolescents living below the poverty line compared to those at or above poverty, and for racial and ethnic minorities compared to White and non-Hispanic/Latino adolescents, respectively. A well-defined research question (causal or descriptive) states: 1) the target population, characterized by person and place, and anchored in time; 2) the outcome, event, or health state or characteristic; and 3) the measure of occurrence that will be used to summarize the outcome (e.g., incidence, prevalence, average time to event, etc.). a. Homicides and suicides Autism: This slide shows the increase in the number of children diagnosed with Autism from 1992 to 2006. Research reported in this publication was supported by the American Lebanese and Syrian Associated Charities (ALSAC) of St. Jude Childrens Research Hospital and by grant 1R37CA234119 from the National Cancer Institute (NCI). Okulicz JF, Marconi VC, Landrum ML, et al. Overall, 4.0% of US adolescents initiated HPV vaccination at 910years of age, with higher initiation among younger birth cohorts (4.8% for 13-year-olds and 5.1% for 14-year-olds) than older cohorts (3.1% for both 16 and 17year-olds). Note that rates of stomach cancer tend to be high in counties in the north-central part of the country in both males and females. Bednarczyk RA, Curran EA, Orenstein WA, Omer SB. Competing events are events that preclude the event of interest from occurring and are theoretical if not practical problems for all outcomes other than all-cause mortality (34). Application of this framework highlights biases that may arise from missing data, especially 1) differences between the target population and the analytical sample; 2) measurement error; 3) competing events, late entries, loss to follow-up, and inappropriate interpretation of the chosen measure of outcome occurrence; and 4) inappropriate adjustm. The target population might be, for example, the population for which we will be providing public health services. Rebeiro PF, Althoff KN, Lau B, et al. One possibility is that once the Japanese move here, they begin to shift to an American diet, and this trend is even stronger in their children. In this paper, we propose a framework for thinking through the design and conduct of descriptive epidemiologic studies. official website and that any information you provide is encrypted Reasons for gender differences in mortality may include: Example: We illustrate application of this framework to description of one portion of the human immunodeficiency virus (HIV) care continuum (11): What was the prevalence of viral suppression on December 31, 2019, among adults living with HIV who had been linked to HIV care (i.e., saw a clinician who was aware of their HIV status and had the ability to prescribe antiretroviral therapy) in the United States? Is this due to a genetic difference? As a field epidemiologist, you will collect and assess data from field investigations, surveillance systems, vital statistics, or other sources. While there was some catch-up vaccination through adolescence, only 20% of 1317year old had initiated HPV vaccination at 1317years of age (16% [95% CI 15.0%-17.0%] at 1314years, when two doses are required to complete the series, and 4% [95% CI 3.4%-4.4%] at age 1517years). Therefore, we might use surveillance data for our primary analyses, but we might conduct secondary analyses that leverage the relative strengths of the different study samples and, for example, reweight NA-ACCORD data that include visits to resemble the target population implied by the surveillance data. However, despite these mandates, not all diagnoses are reported, and people who move across state lines may be double-counted because of challenges with deduplication. A wider window risks assigning a viral load value to December 31 that is inaccurate because viral load has changed since measurement, while a narrower window will result in a larger proportion of the cohort with a missing viral-load value. The study sample is the enumerated set of individuals whose information is captured in a data set, among whom we attempt to measure occurrence of the outcome (after inclusion and exclusion criteria have been applied, if data were not collected using these criteria (e.g., administrative data)). View question 3 feedback The descriptive epidemiologic variable AGE is related to: Question options: variations in age-specific disease rates variations in mortality from unintentional injuries the occurrence of chronic disease infectious disease incidence in childhood all of the above Descriptive studies include case reports, case studies, and cross-sectional studies. These are all basic epidemiologic principles that also affect the success of our attempts at causal effect estimation. Post any question and get expert help quickly. However, complete removal of the competing event is a hypothetical intervention, and the conditional risk is the risk under that often-infeasible intervention. Broder KR, Cortese MM, Iskander JK, Kretsinger K, Slade BA, Brown KH, Mijalski CM, Tiwari T, Weston EJ, Cohn AC, et al. Does it vary among cities or neighborhoods? Even the Centers for Disease Control and Prevention's own text quickly pivots from "[descriptive epidemiology conveys] the extent and pattern of the public health problem being investigated" to "this information in turn provides important clues to the causes of the disease" (23, p. 1-31) as if descriptive epidemiology is merely a . Descriptive epidemiology is a general term used to refer to a broad array of epidemiologic activities whose primary purpose is to describe disease occurrence and generate hypotheses and ideas about cause. Shortly after that, Rely tampons were taken off the market, and the incidence declined sharply. It is also implied by the exponential formula for converting rates to risks. First, by looking at the data carefully, the epidemiologist becomes very familiar with the data. Onset of ASD symptoms typically occurs by age 3, although symptoms may not fully manifest until school age or later, and some research suggests symptoms can emerge between 6 and 18 months ().More severely affected children are more likely to be identified and reliably diagnosed at younger ages than milder cases().The hallmark of ASD is impaired social interaction and . Robert E. Fontaine Organizing Epidemiologic Data Characterizing The Cases (What?) Population-level weights, accounting for the multi-level sample strategy are developed to weight the results to the US adolescent population.15 We conducted all analysis using appropriate weighting, as documented in the NIS-Teen Data Users Guide.16. For a descriptive question, we define the target population as the group in which we would like to characterize the distribution of the outcome. Cole SR, Hudgens MG, Brookhart MA, et al. Age, sex, and race/ethnicity are almost always variables of potential interest since the frequency of health outcomes can vary markedly with these characteristics. Risk (the proportion of people free from disease at baseline who develop the outcome during the study period) is the foundation of many causal epidemiologic studies (33), particularly as the target trial framework (1) has gained in popularity. This can help determine whether a disease primarily occurs seasonally, such as influenza in winter, or at any time, such as hepatitis B. The epidemiologist generally handles age in two ways: as a continuous variable, or as a categorised variable by combining a number of adjacent ages into a joint category. Does it vary within different parts of a large workplace? Achieving a representative sample may involve considerable work and may be very resource-intensive (12). State the motivation for the study, including, where relevant, the action that might be informed by the results. To account for socio-demographic characteristics, we used available covariate data on adolescents sex, age, history of 1112year old well visit, poverty status (recoded to at/above poverty and below poverty), race, and Hispanic ethnicity. Lesko CR, Buchanan AL, Westreich D, et al. Typically, researchers accept viral loads measured within a time window around some key date as indicative of the viral load on that key date. Copyright 2023 Johns Hopkins Bloomberg School of Public Health. The conditional risk is the proportion of people free from disease at baseline that we would expect to develop the outcome during the study period if all competing events were prevented without changing the hazard of the event of interest; it is the risk conditional on removal of the competing event. The point is that there is rarely a single, perfect, existing study sample that can stand in for the target population. Introduction Field investigations are usually conducted to identify the factors that increased a person's risk for a disease or other health outcome. Indeed, without a clear sampling frame, we do not even know how many rows are missing from our ideal data set (and we cannot quantify the amount of missing data from this ideal study). Answers: A. provides the basis for planning and evaluation of health services. Lesko CR, Sampson LA, Miller WC, et al. Time (When?) Walker TY, Elam-Evans LD, Singleton JA, Yankey D, Markowitz LE, Fredua B, Williams CL, Meyer SA, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 1317 years United States, 2016. For permissions, please e-mail: journals.permissions@oup.com. Using 2020 National Immunization Survey-Teen (NIS-Teen) data, we analyzed age at HPV vaccine initiation and proportion of initiators completing the HPV vaccine series relative to age at initiation. Provides the basis for planning and evaluation of health services. -infectious disease incidence in childhood. Inclusion in an NLM database does not imply endorsement of, or agreement with, Compiling and analyzing data by time, place, and person is desirable for several reasons. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (, Childhood and life-course socioeconomic position and cognitive function in adult population of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), Comparing per-protocol effect estimates for population health RCTs: A re-analysis of the Feeding America Intervention Trial for Health for Diabetes Mellitus, Phenotypic associations with the HMOX1 GT(n) repeat in European populations, Large-scale data harmonization across prospective studies: The Preconception Period Analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium, More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization, About the Johns Hopkins Bloomberg School of Public Health, SPECIFYING THE TARGET POPULATION (AND ITS RELATIONSHIP TO THE STUDY SAMPLE), https://www.the-scientist.com/news-opinion/how-not-to-do-an-antibody-survey-for-sars-cov-2-67488, https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-26-no-2.pdf, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, Receive exclusive offers and updates from Oxford Academic, DIRECTOR, CENTER FOR SLEEP & CIRCADIAN RHYTHMS, Academic Pulmonary Sleep Medicine Physician Opportunity in Scenic Central Pennsylvania. Gender The category, or, variable gender has been frequently misused as an equivalent of sex, but in reality sex is not the same as gender. Editors note:An invited commentary on this article appears on page 2071, and the authors response appears on page 2073. Before Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Fredua B, Singleton JA, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 1317 Years United States, 2018. A well-defined question specifies the target population a priori. Consider the following examples: Descriptive epidemiology provides a way of organizing and analyzing data on health and disease in order to understand variations in disease frequency geographically and over time and how disease varies among people based on a host of personal characteristics (person, place, and time). A descriptive analysis might be cross-sectional or longitudinal; it might concern a dichotomous, categorical, or continuous outcome; and it might attempt to summarize the outcome in any number of ways (e.g., median time to some event, mean value, etc.). While not a focus of this analysis, the data presented on series completion by age at initiation and adolescent age at time of NIS-Teen survey show that maximal series completion within birth cohorts takes about three to four years after initiation. * This table describes the stages of breast cancer. The estimand for causal analyses is a contrast of potential outcomes in a single population, where the potential outcomes are those we would expect to observe under some hypothetical intervention (1, 47). descriptive epidemiology - SlideShare Explicitly state that this is a descriptive study in the title or the abstract. Describing the demographic characteristics of persons with acute aflatoxin poisoning in District A Prescribing an antibiotic to treat a patient with community-acquired methicillin-resistant Staphylococcus aureus infection We might instead report weekly, monthly, or yearly HIV diagnosis risk, but the wider the time interval across which we measure risk becomes, the greater the number of people in our target population who are not at risk at the start of the interval. d. congenital malformations and infectious disease incidence in childhood While specific dates of birth are not available, we approximated birth cohorts for analysis by analyzing the data by adolescents age, in years. The maps below show death rates from stomach cancer in females and males in different US counties. Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Mbaeyi SA, Fredua B, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 1317 years United States, 2017, National and state vaccination coverage among adolescents aged 13 through 17 yearsUnited States , 2010. Consider a large outbreak of hepatitis A that occurred in Pennsylvania in 2003. Finally, we stratified the sample by sex and age in years, to compare the distribution of age at HPV vaccine series initiation within these sex-age categories. Table 1 presents a summary of adolescent vaccine uptake, stratified by sex, age, history of an 1112year old well-check, poverty status, race, and ethnicity.

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