BE 100 - LEC
M11.1 MEASURES OF DISEASE FREQUENCY AND MORBIDITY
Prof. Cristela Mae C. Candelario, RMT, MSMT| March 29, 2022
I. FREQUENCY MEASURES IV. PROPORTION
• Disease Frequency ® Type of ratio in which the numerator is contained in
- Ratio the denominator
- Proportion ® Tells us what fraction of the population is affected
- Rate ® Expressed as a decimal, percentage, or fraction
® Commonly expressed in percentage
• Others
- Risk
- Cohort
- Odds
• Morbidity Disease Frequency
- Incidence
Incidence Proportion
Incidence Rate
- Prevalence
Point Prevalence
V. RATIO VS PROPORTION
Period Prevalence
EXAMPLE PROBLEM FOR RATIO
II. FREQUENCY
® Number of disease, injury, death & etc.
® Compare one part of distribution to another part of
the distribution or to entire population.
To calculate measures of disease frequency:
1. Count of events
2. Population Size
3. Period of Observation
4. Constant, K
- Arbitrary multiplier of some power of 10 used to
express and compare measures in similar
population units.
EXAMPLE PROBLEM FOR PROPORTION
III. RATIO
® Division of one quantity by another.
® Comparison of any two values.
® Includes any expression with a numerator and a
denominator.
® Can be used as descriptive (male:female ratio).
® Analytic tools (risk ratio, rate ratio, odds ratio)
EXAMPLE PROB. FOR BOTH RATIO AND PROPORTION
Example:
• Vehicular Fatalities 18:1 male to female
ü Both the numerator and denominator are divided by
the value of either the numerator or denominator so
that either can be equal to 1.
• Death-to-Case Ratio
- Commonly used epidemiologic ratio.
- Number of deaths attributed to a
particular disease during a specified VI. RATE
period divided by number of new ® Measure of the frequency with which an event
cases of that disease identified during occurs in a defined population over a specified
the same period. period of time.
- Measure of severity of illness. ® Describes how quickly disease occurs in a
population.
Trans maker: Barte, A.J. 1
Editor: Destreza, M.A. & Ismael, Y.
BE 100 - LEC
M11.1 MEASURES OF DISEASE FREQUENCY AND MORBIDITY
Prof. Cristela Mae C. Candelario, RMT, MSMT| March 29, 2022
Example: X. MORBIDITY
• 70 new cases of breast cancer per 1000 ® State of being symptomatic or unhealthy for a
women per year disease/ condition.
® Presence of disease in a population
VII. OTHERS ® Two categories of measurement to describe
• Risks frequency of disease in a specified population:
- Proportion of persons who are • Incidence (new cases)
unaffected at the beginning of a study • Prevalence (existing cases – old and
period, but who experiences a risk new)
event DURING the study period.
• Cohort • Comorbidity
- Constitutes the people at risk for the - State of having two or more morbidity,
event at the BEGINNING of the study example: you are obese and diabetic
period.
• Odds
- The probability of an event that will
occur (P) divided by the probability
that the event will not occur (1/P).
Example:
VIII. EPIDEMIOLOGIC MEASURES CATEGORIZED
AS RATIO, PROPORTION, OR RATE
XI. INCIDENCE/INCIDENT CASES
® Occurrence of new cases of events (disease, injury,
death, etc.) in a population at risk over a specified
period of time.
® Number of transitions (well-ill, uninjured-injured,
alive-dead).
® Types:
• Incidence Proportion/ Risk
• Incidence Rate/ Person-Time Rate
1. Incidence Proportion/Risk
- The proportion of initially disease-free
population that develop new cases of
disease in a specified period of time.
- Measures probability that healthy
people will develop disease during a
specified time
- Also known as Attack rate, Incidence
Risk, Probability of developing
disease, Cumulative Incidence
IX. MORBIDITY FREQUENCY MEASURES
• Incidence
- Incidence Proportion
- Incidence Rate
• Prevalence
- Point Prevalence
- Period Prevalence
-
Trans maker: Barte, A.J. 2
Editor: Destreza, M.A. & Ismael, Y.
BE 100 - LEC
M11.1 MEASURES OF DISEASE FREQUENCY AND MORBIDITY
Prof. Cristela Mae C. Candelario, RMT, MSMT| March 29, 2022
Example:
• Incidence proportion of ovarian cancer
Numerator: new cases of ovarian cancer
Denominator: number of women
Criteria needed:
1. Knowledge of health status of the study population
Example:
2. Time of onset (acute vs. chronic) ✓ Specification of
numerator
3. Specification of numerator
4. Specification of population “at risk”
- Denominator shouldn’t include people who are
NOT susceptible
-Number of persons at risk varies over time. If so,
consider using population size at mid-point of the EXAMPLE PROBLEMS FOR INCIDENCE RATE/PERSON-
time period. TIME RATE
5. Period of observation
- Usually 1 year
A. IF THE POPULATION WAS OBSERVED ENTIRE
STUDY PERIOD
EXAMPLE PROBLEMS FOR INCIDENCE
PROPORTION/RISK
B. IF POPULATION ARE OBSERVED IN
DIFFERENT LENGTH OF TIME
C. CALCULATING INCIDENCE RATE
Important: Assume everybody in the area is at risk
2. Incidence Rate/Person-Time Rate
- AKA incidence density
- Measure of incidence that
incorporates time directly into the
denominator.
- Estimates how quickly people are
acquiring the disease
- Calculated from long-term cohort
follow up study
Trans maker: Barte, A.J. 3
Editor: Destreza, M.A. & Ismael, Y.
BE 100 - LEC
M11.1 MEASURES OF DISEASE FREQUENCY AND MORBIDITY
Prof. Cristela Mae C. Candelario, RMT, MSMT| March 29, 2022
• Period prevalence
- Proportion of persons with a
particular disease or attribute at any
time during the interval.
KEY POINTS FOR PREVALENCE:
• Used by health planners for
determining workload
• For monitoring control programs for
chronic conditions
• If incidence data is not available,
can use prevalence to estimate
importance of disease
XIV. INCIDENCE VS PREVALENCE
XII. INCIDENCE PROPORTION VS INCIDENCE
RATE
EXAMPLE PROBLEMS FOR INCIDENCE AND
PREVALENCE
A. EXAMPLE OF INCIDENCE AND PREVALENCE
XIII. PREVALENCE
® Not a measure of risk
® Proportion of persons in a population who have a
particular disease or attribute at a specified point in
time/period.
® Usually expressed as a percentage
® Used to express burden of disease (new + old/pre- B. RELATIONSHIP OF INCIDENCE AND PREVALENCE
exisiting cases)
® Types of prevalence:
• Point prevalence
- Proportion of persons with a
particular disease or attribute on a
particular date.
Trans maker: Barte, A.J. 4
Editor: Destreza, M.A. & Ismael, Y.
BE 100 - LEC
M11.1 MEASURES OF DISEASE FREQUENCY AND MORBIDITY
Prof. Cristela Mae C. Candelario, RMT, MSMT| March 29, 2022
C. PROBLEM SAMPLE #1
Suppose we followed a population of 150 persons for 1
year, and 25 had the disease of interest at the start of
follow-up and another 15 new cases developed during the
year.
• What is the period prevalence for the year?
• What is the point prevalence at the start of the
period?
• What is the cumulative incidence for the one
year period?
1. What is the period prevalence for the
year?
• pp = (25+15)/150 = 0.27 or 27%
2. What is the point prevalence at the start
of the period?
• p = 25/150 = 0.17 = 17%
3. What is the cumulative incidence for the
1 year period?
• CI = 15/125 = 0.12 = 12%
ü Reason why it is important to choose
denominator wisely: only include those who are
susceptible
D. PROBLEM SAMPLE #2
Trans maker: Barte, A.J. 5
Editor: Destreza, M.A. & Ismael, Y.
