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Statistical Approaches for Epidemiology From Concept to Application Reference Book Download

The book 'Statistical Approaches for Epidemiology: From Concept to Application' aims to bridge the gap between theoretical statistical concepts and their practical applications in epidemiology. It provides a comprehensive guide with real-life examples, case studies, and step-by-step instructions for using statistical software like SPSS, SAS, R, and Python. Targeted at graduate students and researchers in public health, the book covers a wide range of topics including clinical trials, bias, confounding, and the epidemiology of COVID-19.
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0% found this document useful (0 votes)
39 views17 pages

Statistical Approaches for Epidemiology From Concept to Application Reference Book Download

The book 'Statistical Approaches for Epidemiology: From Concept to Application' aims to bridge the gap between theoretical statistical concepts and their practical applications in epidemiology. It provides a comprehensive guide with real-life examples, case studies, and step-by-step instructions for using statistical software like SPSS, SAS, R, and Python. Targeted at graduate students and researchers in public health, the book covers a wide range of topics including clinical trials, bias, confounding, and the epidemiology of COVID-19.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Statistical Approaches for Epidemiology From Concept to

Application

Visit the link below to download the full version of this book:

https://medidownload.com/product/statistical-approaches-for-epidemiology-from-co
ncept-to-application/

Click Download Now


I dedicate this book to my beloved family,
whose unwavering love and support have
been the foundation of my journey.
To Ratna, my most beautiful and caring life
partner, your constant encouragement has
provided me with the strength to overcome
obstacles and reach for the stars. To my two
precious children, Amlan and Paromita, and
my son-in-law, Tim, you are my greatest
sources of inspiration. Your boundless
curiosity, resilience, and unwavering belief
in chasing dreams have motivated me to push
my limits and strive for greatness. This
dedication is a small token of my gratitude
for the love, sacrifices, and endless support
you have showered upon me. Thank you for
standing by my side through thick and thin
and for believing in me even when I
doubted myself.
May this book serve as a tribute to the
incredible individuals who have shaped me
into the person I am today. Your love and
presence have made all the difference, and I
am forever grateful.
Preface

You will find many epidemiology textbooks available in the market. Why another?
The reason is simple. This unique textbook provides readers with basic concepts of
epidemiology while preparing them with skills to apply statistical tools in real-life
situations. Students, in general, struggle with statistical theories and their practical
applications. This book makes statistical concepts easy to understand by focusing
on real-life examples, case studies, and exercises. The book also provides step-by-­
step guides for data analysis and interpretation using standard statistical software
such as SPSS, SAS, R, Python, and GIS as appropriate, illustrating the concepts. In
this book, you will find most of the things you need for a graduate-level course on
epidemiology and research methods, all in one place.
What features distinguish this textbook from others?
• Practical examples of the use of the epidemiologic concepts
• Use of real-life data
• Plenty of step-by-step solutions to problems
• Use of statistical tools such as SPSS, SAS, Python, R, and GIS
• Special topics such as applications of artificial intelligence and machine learn-
ing, methods for handling missing data, systematic review and meta-analysis,
tools for survival analysis, using SAS for multivariate analysis, clinical trials,
steps of epidemic investigations, and many others
• An update on the epidemiology of COVID-19, and more importantly,
• Authorship with extensive teaching and research background
The 23 chapters of the book were chosen based on several factors: (1) the authors’
and the editor’s teaching and research experience in public health, the health sci-
ences, and related disciplines; (2) the evolving nature of epidemiology, especially in
the fields of data science, vaccine development, and epidemics due to infectious
diseases, including COVID-19; and (3) a continued demand for a book of this nature
from public health students and researchers from several countries with which the
editor is affiliated.

vii
viii Preface

Next, a little more perspective about the book’s contents: Readers will primarily
learn how to apply statistical methods in epidemiological studies and problem-solv-
ing. All the chapters first introduce the basic concepts related to the topic and then
illustrate them using real-life examples. The book proceeds from an introduction to
descriptive and analytical epidemiology (Chap. 1), to descriptions and applications
of different types of epidemiologic studies (Chaps. 2, 3, and 4), descriptions of the
epidemiologic measures of the distribution and determinants of diseases and events
(Chap. 5), to clinical trials and ethical issues in human studies (Chap. 6), to the
application of screening tools (Chap. 7), to surveillance methods (Chap. 8), to meth-
ods of standardization of rates (Chap. 9), and to the concept and application of Hill’s
criteria for causal association (Chap. 10). Readers will then learn about the concept
of bias, confounding variables and effect modifiers, and methods of dealing with
bias and confounders in research (Chap. 11), a step-by-step account of methods of
investigation of an epidemic (Chap. 12), methods of population projection (Chap.
13), advanced techniques such as the use of GIS and spatial epidemiology (Chap.
14), survival analysis using SAS (Chap. 15), methods of systematic review and
meta-analysis (Chap. 16), sample size estimation (Chap. 17), handling missing data
(Chap. 18), and the use of prediction models such as artificial intelligence and
machine learning using Python (Chap. 19). Chapters 20, 21, and 22 guide readers in
using SPSS and SAS in data analysis illustrating real-life data. Finally, due to the
COVID-19 pandemic, Chap. 23 describes the epidemiology of COVID-19 and
offers techniques for assessing premature deaths due to the pandemic.
Each chapter is written by eminent scientists and experts worldwide, including
contributors from institutions in the United States, Canada, Bangladesh, India,
Hong Kong, Malaysia, and the Middle East. The book should be helpful in both
developed and developing countries.
Statistical Approaches for Epidemiology: From Concept to Application is pri-
marily targeted at graduate students, faculty, and researchers in public health and
other branches of health sciences. However, the book is also helpful for graduate
students and faculty in many related disciplines, such as data science, nursing, envi-
ronmental health, occupational health, computer science, statistics, and biology.
My authors and I welcome your feedback, which will be valuable for future
editions.

Jackson, MS, USA Amal K. Mitra


Contents

1 Descriptive and Analytical Epidemiology����������������������������������������������    1


Kiran Sapkota
2 Cross-Sectional Study: The Role of Observation
in Epidemiological Studies����������������������������������������������������������������������   19
Jean H. Kim
3 Case–Control Study ��������������������������������������������������������������������������������   43
Noraini Abdul Ghafar
4 Cohort Studies������������������������������������������������������������������������������������������   57
Deepa Valvi and Steven Browning
5 Epidemiological Measures����������������������������������������������������������������������   77
Praphul Joshi
6 Clinical Trials ������������������������������������������������������������������������������������������   91
Michael Bennish and Wasif Ali Khan
7 Screening�������������������������������������������������������������������������������������������������� 115
Amal K. Mitra
8 Surveillance: The Role of Observation in Epidemiological
Studies ������������������������������������������������������������������������������������������������������ 129
Adetoun F. Asala
9 Standardization���������������������������������������������������������������������������������������� 147
Anwar T. Merchant
10 Causal Association ���������������������������������������������������������������������������������� 155
Amal K. Mitra
11 
Bias, Confounding, and Effect Modifier������������������������������������������������ 169
Dipak Kumar Mitra and Abdullah H. Baqui

ix
x Contents

12 
Epidemic Investigation and Control������������������������������������������������������ 183
Rajat Das Gupta and Sanjoy Kumar Sadhukhan
13 Population Projection������������������������������������������������������������������������������ 203
Mohammad Mainul Islam and Amal K. Mitra
14 
Geospatial Applications in Epidemiology: Location, Location,
Location���������������������������������������������������������������������������������������������������� 217
Stephen Scroggins
15 
Survival Analysis and Applications Using SAS and SPSS�������������������� 235
Rafiqul Chowdhury and Shahariar Huda
16 Systematic Review and Meta-Analysis: Evidence-Based
Decision-Making in Public Health���������������������������������������������������������� 257
Aliyar Cyrus Fouladkhah and Minoo Bagheri
17 Sample Size Estimation �������������������������������������������������������������������������� 275
Amal K. Mitra
18 
Missing Data Imputation: A Practical Guide���������������������������������������� 293
Enayetur Raheem
19 
Artificial Intelligence and Machine Learning �������������������������������������� 317
Hamidreza Moradi
20 A Step-by-Step Guide to Data Analysis Using SPSS: Iron
Study Data������������������������������������������������������������������������������������������������ 343
Amal K. Mitra
21 
Data Analysis Using SPSS: Jackson Heart Study �������������������������������� 363
Clifton C. Addison and Brenda W. Campbell Jenkins
22 Multiple Linear Regression and Logistic Regression
Analysis Using SAS���������������������������������������������������������������������������������� 381
Azad R. Bhuiyan and Lei Zhang
23 
Epidemiology of the COVID-19 Pandemic: An Update ���������������������� 411
Amal K. Mitra

Index������������������������������������������������������������������������������������������������������������������ 427
Contributors

Clifton C. Addison is an Associate Professor at Department of Biostatistics and


Epidemiology, School of Public Health, Jackson State University (JSU). He is a
Senior Research Scientist with the Jackson Heart Study (JHS) Graduate Training
and Education Center (GTEC).

Adetoun Faith Asala is an Epidemiologist Team Lead at Mississippi State


Department of Health, Office of Preventive Health, Mississippi. She serves as an
adjunct professor at St. George’s University School of Medicine, Department of
Public Health and Preventive Medicine.

Minoo Bagheri is a research instructor in the Department of Cardiovascular


Medicine at Vanderbilt University of Medical Sciences. She completed a predoc-
toral and two postdoctoral fellowships at Harvard University, the University of
Alabama in Birmingham, and at Vanderbilt University of Medical Sciences,
respectively.

Abdullah H. Baqui is a Professor of Department of International Health and


Director of the International Center for Maternal and Newborn Health, Johns
Hopkins Bloomberg School of Public Health, Baltimore, MD. He demonstrated the
effectiveness of simple but effective strategies to reduce preventable newborn deaths
in developing countries.

Michael Bennish is a pediatrician with subspecialty training in infectious dis-


eases. He has been active in international health for 40 years and has conducted
numerous clinical trials. He is currently the Executive Director of Mpilonhle, a
nonprofit organization in rural South Africa.

Azad R. Bhuiyan is a Full Professor of the JSU School of Public Health. He is


conducting research on health disparities and minority health in Mississippi. Earlier
in his career, he served as a Research Associate of the Bogalusa Heart Study.

xi
xii Contributors

Steven Browning is an Associate Professor in the Department of Epidemiology in


the College of Public Health of the University of Kentucky. Dr. Browning is also the
Assistant Director of the Central Appalachian Regional Education and Research
Center and an associate faculty member in the Kentucky Injury Prevention and
Research Center.

Rafiqul Chowdhury is an Instructor at Department of Mathematics and Statistics,


University of Fraser Valley Abbotsford, British Columbia, Canada. His major
research includes multistage models for big data from repeated measures and
prediction.

Aliyar Cyrus Fouladkhah is currently a tenured associate professor of Public


Health Microbiology at Tennessee State University and the founding director of the
Public Health Microbiology Foundation in Nashville. He is a graduate of Yale
School of Public Health with a degree in Applied Biostatistics and Epidemiology.

Noraini Abdul Ghafar is a senior lecturer at the School of Health Sciences,


Universiti Sains Malaysia. She graduated from the National University of Malaysia
with a Ph.D. in Epidemiology and Biostatistics. She is currently teaching under-
graduates and postgraduates courses, including Epidemiology, Biostatistics, and
Research Methodology.

Rajat Das Gupta is medical graduate from Dhaka Medical College, University of
Dhaka, and completed his MPH from Brac University, Dhaka, Bangladesh. He is a
doctoral student in Epidemiology at Arnold School of Public Health, University of
South Carolina.

Shahariar Huda received his Ph.D. in Statistics from Imperial College, London,
United Kingdom. Currently, he is a Professor of Statistics at Kuwait University,
Kuwait. Earlier, he served in several capacities in King Saud University, Saudi
Arabia; University of Dhaka; and the Indian Statistical Institute in Kolkata.

Mohammad Mainul Islam received his Ph.D. in Demography from the Institute
of Population Research, Peking University, China. He is currently a professor and
former Chairman of the Department of Population Sciences at the University of
Dhaka, Bangladesh. In 2010, he was named the Nick Simons Scholar of the New
Investigator in Global Health Program, Washington, DC.

Brenda W. Campbell Jenkins is an investigator and Director of Training and


Education with the Jackson Heart Study (JHS) Graduate Training and Education
Center (GTEC). She has also been Principal Investigator of Project Health, a cardio-
vascular disease prevention and intervention program to address risk factors for
cardiovascular diseases.
Contributors xiii

Praphul Joshi is a full professor and coordinator of graduate programs in the


Department of Public Health at Sam Houston State University. Over the last 3 years,
he has led the surveillance efforts for COVID-19 in Southeast Texas.

Wasif Ali Khan completed his MBBS from Chittagong Medical College,
Bangladesh, and MHS from Johns Hopkins Bloomberg School of Public Health. He
has been working as a Scientist at a premier health research institute in Bangladesh
(icddr,b). His current research in collaboration with McGill University is on early
detection of hepatocellular carcinoma and breast cancer.

Jean H. Kim has a background in both laboratory science and social sciences with
training in molecular biology and anthropology. With a Ph.D. from Harvard
University and with the Harvard University’s Sinclair-Kennedy scholarship, she
joined the Chinese University of Hong Kong and serves there as an Associate
Professor of public health.

Anwar T. Merchant is a Professor of Epidemiology at the Department of


Epidemiology and Biostatistics, University of South Carolina in Columbia, South
Carolina. He completed a Doctor of Science with majors in Epidemiology and
Nutrition, an MPH from Harvard University, and a Doctor of Dental Medicine from
Shiraz University, Iran.

Dipak Kumar Mitra is a Professor of Epidemiology in the Department of Public


Health of North South University, Bangladesh. He obtained his PhD from Johns
Hopkins Bloomberg School of Public Health and an MPH from Harvard School of
Public Health, USA. His research interests are to design and evaluate maternal,
neonatal and child health, and nutrition interventions in developing countries.

Hamidreza Moradi is an assistant professor of data sciences at the University of


Mississippi Medical Center. He received his Ph.D. degree in Computer Science in
2020 from the University of Texas at San Antonio. As a multidisciplinary researcher,
his research interests include applied deep learning and artificial intelligence, model
explainability, and cloud computing.

Enayetur Raheem holds a Ph.D. in Statistics from the University of Windsor,


Ontario, Canada, and is currently serving as Head of Research, Biomedical Research
Foundation, in Dhaka, Bangladesh. His research focuses on applying statistical and
machine learning techniques in pharmaceutical manufacturing and drug discovery.

Sanjoy Kumar Sadhukhan is the Director and Professor in the Department of


Epidemiology at All India Institute of Hygiene and Public Health (AIIH&PH). He
has 26 years of teaching and research experience in Public Health in India.
xiv Contributors

Kiran Sapkota after obtaining his Ph.D. in cancer epidemiology, joined the
College of Health Sciences at Sam Houston State University in Huntsville, Texas,
as an Assistant Professor in the Department of Public Health. His research focus is
on chronic disease epidemiology, risk factors identification, immigrant health, and
global health.

Stephen Scroggins is a spatial epidemiologist and researcher at Saint Louis


University, College for Public Health and Social Justice, where his research focuses
on exploring social and environmental factors impacting health outcomes. He
received his Ph.D. in Public Health from Saint Louis University and M.Sc. degree
in Health Sciences from Indiana State University.

Deepa Valvi is a Data Research Analyst in the Department of Surgery in the


Division of Transplant Surgery at the University of Kentucky. She continues to
coordinate clinical research. She has been an Asthma Epidemiologist at the State
Department of Health, Frankfort, Kentucky.

Lei Zhang is Professor and Associate Dean for research and scholarship in the
School of Nursing at the University of Mississippi Medical Center. Earlier, he
served as director and chief research biostatistician of the Office of Health Data and
Research at the Mississippi State Department of Health.
Editors and Contributors
About the Editor

Amal K. Mitra, MD, MPH, DIH, DrPH, is an internationally recognized scien-


tist and leader in the field of public health. He has a dual background in medicine
and in public health. He was a pioneer in developing a Master’s degree program in
Epidemiology and Biostatistics at The University of Southern Mississippi in 1998.
He was the Founding Program Director of Public Health in the Faculty of Medicine
at Kuwait University. Currently, Dr. Mitra is a tenured Professor of Epidemiology
and Biostatistics at Jackson State University (JSU) in Jackson, Mississippi. He has
been serving as the Director of Global Health Program Initiatives at JSU School of
Public Health. He is collaborating with several institutions in Bangladesh, Hong
Kong, India, Kuwait, Nepal, and Malaysia. Dr. Mitra is the recipient of many
awards, including the Fulbright-Nehru Academic and Professional Excellence
Award 2022–2023, Lifetime Achievement Award 2013, the Fulbright Scholar Award
2007–2008, the Innovation Award for Applied Research 2004, the Distinguished
Teaching Award 2000, and the Distinguished Faculty Researcher Award 1999. He is
the author of Epidemiology for Dummies published by Wiley & Sons in 2023.

xv
Abbreviations

AGRICOLA AGRICultural Online Access


AGRIS International System for Agricultural Science and Technology
AHI Apnea-hypopnea index
AI Artificial intelligence
AIDS Acquired immunodeficiency syndrome
ANN Artificial neural networks
ANOVA Analysis of variance
aOR Adjusted odds ratio
ARDS Acute respiratory distress syndrome
ARIC Atherosclerosis risk in communities
AUC Area under the ROC curve
BIH Bogalusa Heart Study
BIRPERHT Bangladesh Institute for Research for Promotion of Essential and
Reproductive Health Technologies
BMI Body mass index
BPA Bisphenol A
BRFSS Behavioral risk factor surveillance system
BSE Breast self-exam
CACE Complier average causal effect
CCP Cohort component method of projection
CDC Centers for Disease Control and Prevention
CDR Crude death rate
CFR Case fatality rate
CHD Coronary heart disease
CHS Cardiovascular Health Study
CI Confidence interval
CIOMS Council for International Organizations of Medical Sciences
CNN Convolutional neural networks
CONSORT Consolidated Standards of Reporting Trials
COPD Chronic obstructive pulmonary disease
COTC Community-operated treatment center

xvii
xviii Abbreviations

COVID-19 Coronavirus disease 2019


CT Computerized tomography
CV Coefficient of variation
DL Deep learning
DMSB Data monitoring and safety board
DPCP Detectable preclinical phase
EBMT European Group for Blood and Marrow Transplantation
ECMO Extracorporeal membrane oxygen
EDA Exploratory data analysis
EM Expectation-Maximization (EM) algorithm
FDA Federal Drug Administration
FEV-1 Forced expiratory volume in 1 second
FIR First information report
GBDT Gradient Boosting Decision Tresses
GFR Glomerular filtration rate
H2RA Histamine 2 receptor antagonist
HBC Hyperimmune bovine colostrum
HCC Hepatocellular carcinoma
HFNC Hospitalized and requires high-flow nasal- cannula oxygen
HIV Human immunodeficiency virus
HPV Human papillomavirus
HRT Hormone replacement therapy
hs-CRP high-sensitivity C-reactive protein
ICD International Classification of Diseases
ICDDR,B International Center for Diarrheal Disease Research, Bangladesh
ICH International Conference (now Council) for Harmonization
IND Investigational new drug
IRB Institutional Review Board
JHS Jackson Heart Study
KM analysis Kaplan-Meier analysis
KNN K-nearest neighbor
K-S test Kolmogorov–Smirnov test
LDCT Low-dose computed tomography
LISA Local indicator of spatial autocorrelation
LOCF Last observation carried forward
LSTM Long short-term memory
MAR Missing at random
MCAR Missing completely at random
MERS Middle East respiratory syndrome
ML Machine learning
MLF Maximum likelihood function
MMR Mumps, measles, rubella
MNAR Missing not at random
MRI Magnetic resonance imaging
mRNA Messenger ribonucleic acid
Abbreviations xix

NCHS National Center for Health Statistics


NHANES National Health and Nutrition Examination Survey
NHIS National Health Interview Survey
NHLBI The National Heart, Lung and Blood Institute
NHS Nurses’ Health Study
NIH National Institutes of Health
NIMHD The National Institute on Minority Health and Health Disparities
NLP Natural language processing
NN Neural networks
NOCB Next observation carried backward
NSAIDs Non-steroidal anti-inflammatory drugs
OMB Office of Management and Budget
ONS The United Kingdom Office for National Statistics
OR Odds ratio
OSA Obstructive sleep apnea
PCR Polymerase chain reaction
PH model Proportional Hazards model
PKU Phenylketonuria
PM 2.5 Particulate matter 2.5
PMR Proportional mortality ratio
PPI Proton pump inhibitor
PRISMA Preferred Reporting Items for Systematic Reviews and
Meta-Analyses
PSA Prostate-specific antigen
PYLL Potential years of life lost
Q-Q plot Quantile-quantile plot
RCT Randomized controlled trial
REACT Real-time assessment of community transmission
RF Random forests
RNN Recurrent neural networks
ROC Receiver operating characteristic
RR Relative risk
RRR Relative risk ratio
RRT Rapid response team
SARS Severe acute respiratory syndrome
SARS-CoV-2 Severe acute respiratory syndrome coronavirus
SHAP SHapley Additive exPlanation
SJMC Subang Jaya Medical Centre
SMD Standardized mean difference
SMR Standardized mortality ratio
SMART Simple, measurable, achievable, relevant, and time-bound
SOPs Standard operating procedures
STI Sexually transmitted infection
S-W test Shapiro–Wilk test
TB Tuberculosis
xx Abbreviations

TMH Tata Memorial Hospital


TPCP Total preclinical phase
UMMC Universiti Malaya Medical Centre; University of Mississippi
Medical Center
USDA The United States Department of Agriculture
USPSTF The United States Preventive Services Task Force
UV Ultraviolet
VIF Variance inflation factor
WHO World Health Organization
WIC Special supplemental nutrition program for women, infants, and
children
WUS Wake up stroke
YPLL Years of potential life lost
YRBSS Youth Risk Behavior Surveillance System
List of Figures

Fig. 1.1 A person–place–time model����������������������������������������������������������������� 2


Fig. 1.2 Types of epidemiological studies. Used with permission
from John Wiley & Sons, Inc. from Chapter 17:
Investigating the Types of Epidemiologic Studies,
Mitra AK, first edition, 2023; permission conveyed
through Copyright Clearance Center, Inc. [11]������������������������������������ 8
Fig. 2.1 An overview of a cross-sectional study design���������������������������������� 27
Fig. 2.2 Prevalence of obesity among US adults (in 1990, 2000,
and 2010). (Source: https://www.cdc.gov/obesity/data/
prevalence-­maps.html#downloads)���������������������������������������������������� 29
Fig. 3.1 Case–control study design [5]. Used with permission
of John Wiley & Sons, Inc. from Chapter 17: Investigating
the Types of Epidemiologic Studies, Mitra AK, first edition,
2023; permission conveyed through Copyright Clearance
Center, Inc������������������������������������������������������������������������������������������ 44
Fig. 4.1 Design of a cohort study��������������������������������������������������������������������� 59
Fig. 4.2 Prospective cohort study��������������������������������������������������������������������� 61
Fig. 4.3 Retrospective cohort study����������������������������������������������������������������� 63
Fig. 5.1 Estimated teen birth rates for females aged 15–19 years
by county in the United States for 2020. (Source: The National
Center for Health Statistics, CDC [3])����������������������������������������������� 81
Fig. 5.2 Teen births by state in the United States for 2020. (Source: The
National Center for Health Statistics, CDC [3])��������������������������������� 82
Fig. 5.3 Number of births to unmarried women by age group in United
States from 1940 to 2015. (Source: Ventura and Bachrach,
2000 [2])��������������������������������������������������������������������������������������������� 83
Fig. 5.4 Comparison of overall deaths, crude mortality rates,
and age-adjusted mortality rates in the United States
from 1935 to 2010. (Source: Centers for Disease
Control and Prevention [3])���������������������������������������������������������������� 84

xxi
xxii List of Figures

Fig. 5.5 Infant mortality rates in the United States across the states
for the year 2020. (Source: National Center for Health
Statistics, CDC (2000) [3])����������������������������������������������������������������� 85
Fig. 5.6 Differences between crude and adjusted cause-specific
mortality rates due to chronic obstructive pulmonary
disease (COPD) in the United States from 2001 to 2020.
(Data Source: CDC Wonder (wonder.cdc.gov) [4])��������������������������� 85
Fig. 5.7 Trends in COPD mortality rates by 10-year age groups
from 2001 to 2020. (Data source: CDC Wonder (wonder.cdc.
gov) [4])���������������������������������������������������������������������������������������������� 86
Fig. 5.8 Years of potential life lost (YPLL) due to Covid-19
by gender in Brazil in 2020.(Source: Castro et al. 2021 [5])������������� 87
Fig. 6.1 CONSORT flow diagram of the progress through the phases
of a parallel randomized trial of two groups [30]����������������������������� 104
Fig. 7.1 Validity and reliability [2]. (Used with permission
of John Wiley & Sons, Inc. from Chapter 15: Identifying
Diseases by Screening, Mitra AK, first edition, 2023;
permission conveyed through Copyright Clearance
Center, Inc.)�������������������������������������������������������������������������������������� 118
Fig. 7.2 A hypothetical model of cervical cancer������������������������������������������ 120
Fig. 7.3 Example of an ROC curve using hypothetical data�������������������������� 123
Fig. 7.4 Effect of changing the cutoff point on sensitivity
and specificity of the test [2]. (Used with permission
of John Wiley & Sons, Inc. from Chapter 15: Identifying
Diseases by Screening, Mitra AK, first edition, 2023;
permission conveyed through Copyright Clearance
Center, Inc.)�������������������������������������������������������������������������������������� 126
Fig. 8.1 Newsworthy headlines highlighting past epidemics
which public health surveillance provided information
about. (Source – Centers for Disease Control
and Prevention [1])��������������������������������������������������������������������������� 131
Fig. 8.2 Processes involved in conducting a surveillance������������������������������ 133
Fig. 8.3 Public health approach to surveillance summarized.
(Source – Centers for Disease Control and Prevention [1]) ������������ 135
Fig. 8.4 Disease reporting system for surveillance programs������������������������ 137
Fig. 8.5 A public health surveillance system������������������������������������������������� 141
Fig. 9.1 Age distribution of US population in 1978 [1]��������������������������������� 148
Fig. 9.2 Age distribution of US population in 2019 [2]��������������������������������� 149
Fig. 10.1 A schematic diagram showing the effect of a confounder��������������� 156
Fig. 10.2 A schematic diagram of Rothman’s causal pie, modified [13]��������� 164
Fig. 11.1 Effect of confounding����������������������������������������������������������������������� 174
Fig. 11.2 Effect of confounding eliminated����������������������������������������������������� 175

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