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Epidemio l o gy

Measures of disease occurrence -an introduction
Pasi Penttinen

T Ancelle / A Bosman / D Coulombier / A Moren / P Sudre / M Valenciano/ P Penttinen

Objectives • Define and use – Risk – Incidence .Cumulative incidence (CI) .Attack rate (AR) .Incidence rate (IR) – Prevalence – Odds .

RISK .

RISK • Non-technical definition – Vague. culture-dependent – Unexpected. dangerous/negative events • Epidemiologic definition – Probability that an event will occur – Estimated by: • Observing events among a population during a specified time . unusual.

000 1.6/1000 during a year .250 3.Cumulative Incidence (CI) (Incidence Proportion) Number of NEW cases of disease during a period Population of interest during this period Example of bilharziasis in Guadeloupe in 1979: Population New cases Cumulative incidence 350.

58 per year x x disease onset Month12 .Cumulative Incidence CI assumes that entire population at risk followed up for specified time period x x x x x x Month 1 CI = 7/12 per year = 0.

600 – Attack rate = 2. from the first to the last case • Not really a rate but a proportion! Ex: Outbreak of cholera in country X in March 1999 – Number of cases = 490 – Population at risk = 18.Attack Rate (AR) • Cumulative incidence during an outbreak Usually expressed for the entire epidemic period.6% .

RISK RISK = The probability that an event will occur – a proportion = Cumulative incidence = Attack rate .

Expressed as a percentage Example of bilharziasis in Guadeloupe in 1979: Population Cases Prevalence 350.Prevalence (point prevalence) Number of cases of disease at a specific time Population of interest at that time Proportion of a population affected by a disease at a given time.000 96.6% .200 27.

5 .0 8.5 x 5.0 35.0 x 6.Person-time 90 91 92 93 94 95 96 97 98 99 00 Time at risk A B 6.time followed x disease onset 10.0 C D E Total years at risk -.

0 x 6.5 person.years = 0.5 IR = 2 / 35.056 / person-year .Incidence rate (IR) (Incidence density) 90 91 92 93 94 95 96 97 98 99 00 Time at risk A B 6.0 35.time followed x disease onset 10.5 x 5.0 C D E Total years at risk -.0 8.

Incidence rate Number of NEW cases of disease during a period Total person-time of observation Rate Denominator: .the sum of each individual’s time at risk and free from disease .is a measure of time .

Incidence Duration Prevalence Deaths.CEPIQ98 . Merci à Jean-Luc Grenier .. Lost. Cured..

07 .Odds Probability that an event will happen Probability that an event will not happen Won Lost EPIET facilitator team 1995-2004 14 1 Total 15 ------------------------------------------------------------------------------------------------------------------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------- 14 / 15 Odds of winning = ------------1 / 15 Odds of winning Odds of not winning = = 14 : 1 = 14 1 : 14 = 0.

goal = 1/141 = 0.007 .Odds of a rare event ~ RISK The number of goals made by teams during EPIET courses Facilitators Participants Total -----------------------------------------------------------------------------------EPIET courses 140 1 141 1995-2004 ------------------------------------------------------------------------------------ Odds of a part. goal= 1 / 141 ------------140 / 141 = 0.007 Risk (CI) of a part.

Buring JE. Giesecke J. Last J. Henneckens CH.If it’s not clear… • Epidemiology. Rothman KJ. • Epidemiology in Medicine. • Dictionary of epidemiology. . Edited by Mayrent SL. • Modern infectious disease epidemiology. an introduction.