Question

5. Different measures of disease are useful to evaluate and assess public health programs and needs in different situations. For each of the following items, (a) state which measure would best support your goal and (b) explain why you chose that measure.

Measures of disease: I = incidence rate P = prevalence proportion C = case fatality proportion M = mortality rate A = absolute number of cases (counts)

a) To demonstrate that railroad crossings need to be safer to prevent car-train crashes.

b) To demonstrate that a primary prevention program is successful.

c) To demonstrate that a new leukemia treatment is successful.

d) To estimate the number of health care facilities needed to support Alzheimer’s patients.  

e) To argue that AIDS is a serious public health problem.

f) To argue that heart disease should get more funding than AIDS.

g) To demonstrate that a new screening program for breast cancer is effective.  

Answer 1

1. To demonstrate that railroad crossings need to be safer to prevent car-train crashes.

a. Best supportive measure: A = Absolute number of cases (counts).

b. Reason to choose this measure: The absolute number of car-train crashes occurring in an area is the main decisive factor in choosing this measure. The total number of crashes in railroad crossings will be minimum to nil in safer crossings.

2. To demonstrate that a primary prevention program is successful

a. Best supportive measure: I = Incidence rate.

b. Reason to choose this measure: The number of incidents of the disease after the successful primary prevention program for a given time period after the program is nil.

3. To demonstrate that a new leukemia treatment is successful.

a. Best supportive measure: M = Mortality rate

b. Reason to choose this measure: The new leukemia treatment is successful means the mortality rate was much reduced after the new leukemia treatment. This means the deaths from this particular cause or disease was much reduced because of effective treatment.

4. To estimate the number of healthcare facilities needed to support Alzheimer’s patients.

a. Best supportive measure: P = Prevalence proportion

b. Reason to choose this measure: To find out the number of healthcare facilities required for any particular group of people affected by a disease, one should always have knowledge of the proportion of a population affected by that disease condition.

5. To argue that AIDS is a serious public health problem.

a. Best supportive measure: C = Case fatality proportion.

b. Reason to choose this measure: The number of cases of AIDS ending in death compared to the number of AIDS cases is a reasonably good argument to prove this as a serious public health concern.

6. To argue that heart disease should get more funding than AIDS.

a. Best supportive measure: P = Prevalence proportion

b. Reason to choose this measure: The proportion of people found to be affected with heart disease is much higher than those affected with AIDS. This means heart disease is more prevalent than AIDS. So heart disease should get more funding than AIDS.

7. To demonstrate that a new screening program for breast cancer is effective.

a. Best supportive measure: I = Incidence rate

b. Reason to choose this measure: Incidents of breast cancer occurrence was high and breast cancer death incidents were low for a specified time period. This happened because the new screening program effectively found out more breast cancer occurrences earlier and got treatment and the number of breast cancer deaths were reduced.