By Ward, Helen
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Extra info for Oxford handbook of epidemiology for clinicians
46 Patient-centred decision-making 48 27 28 CHAPTER 2 Management decisions Decisions, decisions . . the principles of clinical management Once a diagnosis has been made, both doctor and patient will want to know what to do for the best to get the patient better. To recommend a course of action you need to be aware of: • What happens in the absence of treatment (natural history and prognosis)? • What treatments/approaches can improve the outcome? • What is the best treatment for this patient? • How much will this alter the natural history?
Planning healthcare resources with the additional beneﬁt of relating these to population size. 170, 206). 179. Deﬁnition: the number of new cases of the disease in a deﬁned population over a deﬁned period of time. Incidence measures events (a change from a healthy state to a diseased state). Incidence Number of new cases in a defined population g over a period of time Number of disease-free people in a defined population g at the start of timeperiod • It is also referred to as risk, since it indicates the probability of acquisition of a disease over a period of time, or cumulative incidence.
Quantifying risk factors Epidemiological research is largely concerned with exploring the relationship between risk factors (exposures) and disease (outcomes). The following parameters describe the association: • Relative risk. • Attributable risk. • Odds ratio. • Correlation. 145–95). 179–80) tells you how much more likely a disease will be in a person with a risk factor than a person without it. e. Ie/Io. 25 times more likely to develop breast cancer than a woman who has never taken HRT. 179–80) tells you the absolute increase in incidence of disease that is associated with the risk factor, and is also estimated from cohort studies from Ie− Io.