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杨海燕
Yang Haiyan
Epidemiology is a discipline to study
distribution (or occurrence and development)
of diseases and health conditions in human
populations and the determines influencing
the distribution as well as to study the
measures for the prevention and control of
disease and promotion of health.
Population
Distribution
Cause
Prevention
• Definition and Models of Cause of
Disease
• Classification of Cause of Diseases
• Process of Study on Cause of Disease
• Evaluation of Presence of A Valid
Statistical Association
• Criteria in the Judgment of Cause of
Disease
Section 1 Definition and
Models of
Cause of Disease
• Definition of Cause of Disease
Cause of disease is the factors
which can increase the incidence
rate of disease. And if one or
more of these factors don’t exist,
the incidence rate of population
will decrease.
In epidemiology, we can also
describe these factors as risk
factors. That means these factors
can be indirect causes of disease .
For example,
smoking--?--?--?--?---lung cancer
• Models of Cause of Disease
(1) Organism Human Disease
only suitable for infectious diseases.
For example, tubercle germ---
tuberculosis ( TB )
Pathogen Environment
For example:
tubercle + low level of immunity
tuberculosis
(3) The Wheel Model
Social Environment
Biologic
Host
Environment
Physical
Genetic Core Environment
The relative size of the different
components of the wheel depend upon
the specific disease.
For hereditary diseases, the genetic core
would be relatively large.
For a disease like measles, the genetic
core would be smaller, the state of
immunity of the host and biological
sector of environment would be larger.
Section 2
Classification of Cause
of Diseases
Host Factor (Intrinsic)
Genetic Factor
Immunity
Personality
(1) Genetic Factor
Most diseases have relationship
with genetic factor , but the degree
is different.
Some diseases only due to genetic
factors, such as color blinding.
Some diseases partly due to genetic
factors,partly due to environment
factors.
For example, ABO blood type
Type A gastric cancer
Type O duodenal ulcer
(2) Immunity
low immunity---tuberculosis
(3) Personality
Type A: CHD (coronary heart
disease)
Type B: Cancer
Environmental Factors
(Extrinsic)
(1) Biological Environment
such as bacteria, virus
(2) Social Environment
In Japan stomach cancer
(3) Physical Environment
Including heat, light, air, water, radiation,
atmospheric pressure, and so on.
Air pollution chronic respiratory
disease, such as chronic bronchitis and
lung cancer
(4) Chemical Environment
Such as heavy metal, trace element.
Section 3 Process of
Study on
Cause of
Disease
1 Descriptive study to understand
the distribution of disease
formulate etiologic hypotheses
inpatients
Relationship exists
But, We can not estimate cause-
effect relationship.
Why? The direction of this kind study
is retrospective, cause effect.
Non-smoking group
Intervention test
Filed trail
Example of intervention test:
Lung cancer ----- smoking
Experimental group
Smoking people
Control group
B C
Indirect
association
Example: smoking
Stomach Lung
ulcer cancer
Section 5 Criteria
in the Judgment of
Cause of Disease