Epidemiology: a very basic

start….

Gavin Shaddick
Department of Mathematical Sciences
University of Bath

UBC, September 2008

 What is epidemiology?
• “The study of skin diseases?”
 What is epidemiology?
• “The study of skin diseases?”
• “The study of the distribution and
determinants of health-related states in
specified populations, and the
application of this study to control health
problems."
The early days…John Snow and
the Broad Street Pub
The early days…John Snow and
the Broad Street Pump
 Number of cholera cases in
proximity to water pump, 1854
 Overview of epidemiological
framework
• Incidence
– Proportion of people who develop the disease
during specified period
• Risk
– Probability of developing disease within a
specified time interval (between 0 and 1)
• Relative Risk
– The ratio of risks under two exposure distributions
 Relative risks and confidence
intervals
• RR is a ratio
– Values ‘significantly’ >1 indicate increase in risk with
increased exposure
– Values ‘significantly’ <1 indicate protective effect of exposure
– Values ‘close’ to 1 indicate no significant effect

• 95% confidence interval

– Gives a range of values within which we are ‘confident’ the
true relative risk lies
– Interest in values with the lower limit greater than one
 Confidence intervals

• 95% confidence interval

– Gives a range of values within which we
are ‘confident’ the true relative risk lies
– Interest in values with the lower limit
greater than one
RR = 1.3

0.9 1.1 1.5 1.7

1
 Temporal relationships between
exposure and effect
Acute Latent
Lead
time Latency

Time Time
Exposure and Effect

Chronic Endemic

Time Time
SIRs for (a) lung and (b) brain
cancer in North-West England,
1991-91