Bienvenidos!

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The Joys of Population Perspective

Health Economics
Utilitarian vs Efficiency
utilitarian = the greatest good for the greatest number
Efficiency = the greatest outcome for a fixed resource = cost minimisation/cost effectiveness/cost-benefit/cost utility. Also means balancing inputs and outputs - inputs include direct costs (eg those for the service provided), indirect costs (eg travel), intangible costs (eg inconvenience). Outputs include 'natural units' (ie cases seen/diagnosed/treated), utility measures (eg QALYs), monetary terms.

Confounding
A variable related to both exposure and outcome and may affect results. A common confounder is age ==> are case mixes equal for both groups studied?
standardisation aims to adjust for this --> direct/indirect.
Direct - compare with rate in 'standard' population
Indirect - ratio of observed:expected (eg Standardised Mortality Rate, SMR)

Interpretation of findings
Observations may be true or false - if they are false is it by chance (random variation) or due to bias?
Bias is a systematic difference or error. May occur during selection/recruitment (eg if non-random), during information-gathering, or due to confounders (among others) Study design can reduce bias.

Study Design
Interpreting evidence
Descriptive (weakest-->strongest): Case Report--> Case Series--> Population Study -->Ecological/correlational Study
Analytical (testing a hypothesis): Observational: Case-control study--> Cross-sectional--> Cohort Study; Interventional: Randomised Controlled Trial (RCT) <-- the gold standard for gathering raw data

Risk
Absolute risk: the risk for everyone. Roughly equals incidence. Can be expressed as a fraction (eg 1/9), a percentage

12:57 p.m. - 2007-06-08

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