Analyzing and Interpreting Data

2019 ◽  
pp. 153-186
Author(s):  
Richard C. Dicker
Keyword(s):  
Public Health ◽  
Statistical Significance ◽  
Epidemiologic Study ◽  
Health Impact ◽  
Field Investigation ◽  
Study Data ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Public Health Decision ◽  
Health Decision

A well-planned and carefully executed analysis is essential for any epidemiologic study, even one conducted during the frenzy of a field investigation. An analysis plan, or at least table shells, should be drafted to guide the analysis. To assess the relationship between an exposure and a health outcome, measures of association should be used that are appropriate for the study design—risk ratios for cohort studies, odds ratios for case–control studies, and prevalence ratios for cross-sectional studies. Measures of public health impact can be calculated to reflect the contribution of an exposure, either harmful or beneficial, on occurrence of the outcome among a population. Although tests of statistical significance address the role of chance in an apparent exposure–outcome association, they largely have been replaced by confidence intervals that reflect the range of values of the association that are consistent with the study data. When two or more exposures seem to be associated with the outcome, or when confounding might be present, stratified analysis and logistic regression can be used to clarify the contributions of each exposure. Before accepting that an apparent association is real, consider whether chance, bias, or investigator error might account for the finding. The strength of the evidence, as well as epidemiologic judgment, should guide public health decision-making and action.

scholarly journals Using informatics to guide public health policy during the COVID-19 pandemic in the USA

2020 ◽  
Vol 42 (4) ◽  
pp. 660-664
Author(s):  
Jay G Ronquillo ◽  
William T Lester ◽  
Diana M Zuckerman
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Washington Dc ◽  
Cross Sectional ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision ◽  
The Usa ◽  
The Impact ◽  
At Home

Abstract Background Current and future pandemics will require informatics solutions to assess the risks, resources and policies to guide better public health decision-making. Methods Cross-sectional study of all COVID-19 cases and deaths in the USA on a population- and resource-adjusted basis (as of 24 April 2020) by applying biomedical informatics and data visualization tools to several public and federal government datasets, including analysis of the impact of statewide stay-at-home orders. Results There were 2753.2 cases and 158.0 deaths per million residents, respectively, in the USA with variable distributions throughout divisions, regions and states. Forty-two states and Washington, DC, (84.3%) had statewide stay-at-home orders, with the remaining states having population-adjusted characteristics in the highest risk quartile. Conclusions Effective national preparedness requires clearly understanding states’ ability to predict, manage and balance public health needs through all stages of a pandemic. This will require leveraging data quickly, correctly and responsibly into sound public health policies.

FACTORS AFFECTING THE UTILIZATION OF SYSTEMATIC REVIEWS

2001 ◽  
Vol 17 (2) ◽  
pp. 203-214 ◽  
Author(s):  
Maureen Dobbins ◽  
Rhonda Cockerill ◽  
Jan Barnsley
Keyword(s):  
Public Health ◽  
Systematic Reviews ◽  
Multiple Logistic Regression Analysis ◽  
Medical Officer ◽  
Decision Makers ◽  
Primary Data ◽  
Cross Sectional ◽  
Public Health Decision ◽  
Health Decision ◽  
Very High

Objective: To determine the extent to which public health decision makers used five systematic reviews to make policy decisions, and to determine which characteristics predict their use.Methods: This cross-sectional follow-up study of public health decision makers in Ontario collected primary data using a telephone survey and a short, self-administered organizational demographics questionnaire completed by the administrative assistant for each Medical Officer of Health. Independent variables included characteristics of the innovation, organization, environment, and individual. Data were entered into a computerized database developed specifically for this study, and multiple logistic regression analysis was conducted.Results: The participation rate was very high, with 85% of public health units and 96% of available decision makers completing the survey. In addition, 63% of respondents stated they had used at least one of the systematic reviews in the previous 2 years to make a decision. The most important predictors of use were one's position, expecting to use a review in the future, and perceptions that the reviews were easy to use and that they overcame the barrier of limited critical appraisal skills.Conclusions: Utilization of the systematic reviews in Ontario was very high. The utilization rates found in this study were significantly higher than those reported in previous utilization studies. One's position was found to be the strongest predictor of use, identifying program managers and directors as the most appropriate audience for systematic reviews.

Persons with Disabilities and Public Health Ethics

2019 ◽  
pp. 218-231
Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Ethical Issues ◽  
The United States ◽  
Policy And Practice ◽  
Persons With Disabilities ◽  
Public Health Decision ◽  
Health Decision ◽  
Health Policy And Practice

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.

scholarly journals The NCCMT’s dynamic model for evidence-informed public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Neil-Sztramko ◽  
M Dobbins
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Research Evidence ◽  
Decision Makers ◽  
Local Data ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Political Preferences ◽  
Health Decision ◽  
Structured Approach

Abstract Issue It is well accepted that public health decision makers should use the best available research evidence in their decision-making process. However, research evidence alone is insufficient to inform public health decision making. Description of the problem As new challenges to public health emerge, there can be a paucity of high quality research evidence to inform decisions on new topics. Public health decision makers must combine various sources of evidence with their public health expertise to make evidence-informed decisions. The National Collaborating Centre for Methods and Tools (NCCMT) has developed a model which combines research evidence with other critical sources of evidence that can help guide decision makers in evidence-informed decision making. Results The NCCMT's model for evidence-informed public health combines findings from research evidence with local data and context, community and political preferences and actions and evidence on available resources. The model has been widely used across Canada and worldwide, and has been integrated into many public health organizations' decision-making processes. The model is also used for teaching an evidence-informed public health approach in Masters of Public Health programs around the globe. The model provides a structured approach to integrating evidence from several critical sources into public health decision making. Use of the model helps ensure that important research, contextual and preference information is sought and incorporated. Lessons Next steps for the model include development of a tool to facilitate synthesis of evidence across all four domains. Although Indigenous knowledges are relevant for public health decision making and should be considered as part of a complete assessment the current model does not capture Indigenous knowledges. Key messages Decision making in public health requires integrating the best available evidence, including research findings, local data and context, community and political preferences and available resources. The NCCMT’s model for evidence-informed public health provides a structured approach to integrating evidence from several critical sources into public health decision making.

scholarly journals Contributions in the field of Public Health for decision-making in health

2017 ◽  
Vol 27 (2) ◽  
pp. 128 ◽  
Author(s):  
Luiz Antônio Tavares Neves
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Motor Development ◽  
Growth And Development ◽  
Human Growth ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Scientific World ◽  
Health Decision ◽  
Human Growth And Development

  Brazil has made a wide development and contribution in the field of Public Health. These contributions have maximized public health decision-making, which is a factor of great importance for the maintenance of health of a given population, either in the prevention of disease, as is the case of immunizations or with actions in Health Promotion, improving the quality of life of the affected population. Thus, the Journal of Human Growth and Development has contributed enormously to the dissemination of knowledge, not only in Brazil but also in the world making a major effort with its publications in English which is the preferred language of the modern scientific world. It was evidenced the importance of research in the investigation of better ways to obtain the public health of a given community, bringing discussion of themes that involve aspects of human growth and development such as nutritional aspects, sexuality, motor development, covering situations and diseases as obesity, cerebral palsy, dyslexia and violence. The Journal of Human Growth and Development has maintained the tradition of approaching the different aspects that involve clinical practice for people and for Public Health. 

PP130 Nudging In Public Health: Accountability For Practical Wisdom

2017 ◽  
Vol 33 (S1) ◽  
pp. 133-134
Author(s):  
Michal Stanak
Keyword(s):  
Public Health ◽  
Decision Maker ◽  
Narrative Analysis ◽  
Practical Wisdom ◽  
Health Gain ◽  
Cost Effective ◽  
Public Health Decision ◽  
Moral Principles ◽  
Health Decision ◽  
Public Scrutiny

INTRODUCTION:Nudging is the application of behavioural sciences aimed at influencing behaviour in a non-prescriptive way. It is a tool of public health decision makers to produce health gain. Just like decisions in the field of Health Technology Assessment (HTA), nudging decisions are inevitably value laden. The current European Network for HTA (EUnetHTA) approach to evaluate ethical aspects encompasses mainly utilitarian and principlistic approaches. The aim of this project is to incorporate the virtue ethics approach in public health decision-making processes based on the example of nudging.METHODS:The narrative analysis of nudging is based on a systematic literature search conducted from 28 October to 13 November 2015 in the following databases: Medline via Ovid, Embase, and TRIP Database. A total of sixty-two articles were listed as relevant as a result of searches and, in addition, twenty-five more articles were found through hand searching.RESULTS:Regardless of the potential issues related to nudging (manipulation or coercion), nudging is considered cost-effective and inevitable because of the malleability of human psychology for example, alcoholic drinks served in smaller glasses nudge people to drink less alcohol.No policy intervention, nudging or HTA, is value neutral and hence it requires an ethical evaluation. It takes traits of character, virtues, to discern which principle to apply in what circumstances and phronesis, practical wisdom, is the key virtue of a decision maker. Phronesis is not a moral judgement deduced from principles, but it is context specific, bottom-up, action orientated, and framed through dialogues. It focuses on the agent, the decision maker, who, via the use public scrutiny, should be held accountable for phronetic decisions made.CONCLUSIONS:Nudging is a cost-effective tool that can improve the populations health in a non-prescriptive way. Transparent reporting open to public scrutiny is necessary for the sake of evaluating whether the decisions made were phronetic for it takes traits of character, virtues, to decide between competing moral principles.

scholarly journals Knowledge in palliative care of nursing professionals at a Spanish hospital

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Elena Chover-Sierra ◽  
Antonio Martínez-Sabater ◽  
Yolanda Lapeña-Moñux
Keyword(s):  
Palliative Care ◽  
Basic Education ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Study Data ◽  
Care Hospital ◽  
Cross Sectional

Resume Objective: to determine the level of knowledge in palliative care of nursing staff at a Spanish tertiary care hospital. Method: descriptive, cross-sectional study. Data were collected about the results of the Spanish version of the Palliative Care Quiz for Nurses (PCQN), sociodemographic aspects, education level and experience in the field of palliative care. Univariate and bivariate descriptive analysis was applied. Statistical significance was set at p < 0.05 in all cases. Results: 159 professionals participated (mean age 39.51 years ± 10.25, with 13.96 years ± 10.79 of professional experience) 54.7% possessed experience in palliative care and 64.2% educational background (mainly basic education). The mean percentage of hits on the quiz was 54%, with statistically significant differences in function of the participants’ education and experience in palliative care. Conclusions: although the participants show sufficient knowledge on palliative care, they would benefit from a specific training program, in function of the mistaken concepts identified through the quiz, which showed to be a useful tool to diagnose professionals’ educational needs in palliative care.

scholarly journals Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246085
Author(s):  
Muhammad Riaz ◽  
Ghazala Shah ◽  
Muhammad Asif ◽  
Asma Shah ◽  
Kaustubh Adhikari ◽  
...  
Keyword(s):  
Public Health ◽  
Urban Areas ◽  
Health Workers ◽  
Health Concern ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Negatively Associated ◽  
Factors Associated ◽  
Health Related

Background High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population. Methods We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies. Results We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30–60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension. Conclusion We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

Sign in / Sign up

Export Citation Format

Share Document