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Department of Epidemiology
Public Health College of Harbin Medical University
1
流行病学绪论Introduction of EpidemiologyIntroduction of Epidemiology
哈尔滨医科大学流行病学教研室
Department of epidemiology , Harbin Medical University
Department of Epidemiology
Public Health College of Harbin Medical University
2
医学 Medicine
Basic medicine Clinical medicine Preventive medicine
Epidemiology has always been a
necessary part of medicine practice.
流行病学一直医学实践必不可少的部分
基础医学 临床医学 预防医学
Department of Epidemiology
Public Health College of Harbin Medical University
3
医学之母 The mother of medicine
Because, the epidemiology is from macro point of view to observe the any question. e.g. from macro point of view to study the disease and health.
因为流行病学是从宏观观察问题, 亦即从宏观研究疾病和健康
Department of Epidemiology
Public Health College of Harbin Medical University
4
CONTENTS 目录History
Definition
Methods
Principle
Application
Features
Prospect
历史定义方法原理应用特点展望
Department of Epidemiology
Public Health College of Harbin Medical University
5
Brief History of Epidemiology 流行病学简史
学科形成前期 -18 世纪
学科形成期 18 世
纪末 -20 世纪初 学科发展期(现代
流行病学时期) 20 世纪 40 、 50年代 -
Before the form of Epidemiology
--1700s Forming of Epidemiology End of 1700s— beginning of 20 century Development of Epidemiology ( Modern Epidemiology ) 40s-50s of 20 century
Department of Epidemiology
Public Health College of Harbin Medical University
6
Earlier stage: ----- 18th century
-Hippocrates (460-377 -Hippocrates (460-377 BC)BC)
A First Epidemiologist 《 Epidemic Ⅰ 》《 Epidemic Ⅲ 》《 On Airs, Waters and Places 》
- 中国:“疫”、“时疫”、“疫疠”
From there is the human history of civilization to the 18th century. During this time ,This discipline( branch) not yet forms, but had its embryonic form.
Department of Epidemiology
Public Health College of Harbin Medical University
7
Hippocrates (460-377 BC)Hippocrates (460-377 BC)
第一个流行病学家主要的流行病学著作:
《 Epidemic Ⅰ》《 Epidemic Ⅲ》《 On Airs, Waters and Places 》
中国:“疫”“时疫”“疫疠”
一、学科形成前期一、学科形成前期 -18 世纪
自从有人类文明到 18 世纪 . 这期间 ,该学科( 分支) 尚未形成,但已形成雏形 .
Department of Epidemiology
Public Health College of Harbin Medical University
8
The Black Death in Europe ca.1300s 欧洲黑死病
Department of Epidemiology
Public Health College of Harbin Medical University
9
1347-13511347-1351 年年 鼠疫导致 鼠疫导致 24002400 万人死亡万人死亡
Department of Epidemiology
Public Health College of Harbin Medical University
10
Italy-- Venice ---- the earliest quarantine 15th Century : The people in order to avoid the infectio
us disease spreading, the request external ships mus
t Away (outside) from the port 40 days .That is (quadr
aginta (latin =40)) →.
1423: set up first
infectious diseases
hospital
中国:隋朝开设“疠人坊” (leprosy hospital) 隔离麻风病人
Department of Epidemiology
Public Health College of Harbin Medical University
11
意大利威尼斯-最早的检疫意大利威尼斯-最早的检疫
14 世纪 外来船只必须在港外停留检疫 40 天 qu
adraginta ( 拉丁语,意思为 40) → quarantine
1423 年成立了首家传染病隔离医院
中国:隋朝开设“疠人坊”以隔
离麻风病人
Department of Epidemiology
Public Health College of Harbin Medical University
12
-John Graunt (1620-1674)-John Graunt (1620-1674)
Use death data to study distribution
of disease
Make first life table calculate
expectation of life
Summarizes death process with
probability of survival and death
Producce control group idea
His contribution is the first time to introduceHis contribution is the first time to introduce
Statistics to Epidemiology Statistics to Epidemiology
《 Natural and Political Observations Made Upon the Bills of Mortality 》
Department of Epidemiology
Public Health College of Harbin Medical University
13
John Graunt (1620-1674)John Graunt (1620-1674)
利用死亡数据进行死亡分布及规律性研究
创制了第一张寿命表,计算期望寿命
用生存概率和死亡概率来概括死亡经历
提出设立比较组的思想
将统计学引入流行病学领域将统计学引入流行病学领域《 Natural and Political Observations Made Upon the Bills of Mortality 》
Department of Epidemiology
Public Health College of Harbin Medical University
14
Graunt’s Observations Excess of males over females
among births but higher mortality in males
High infant mortality rate Seasonal variation in
morbidity Acute versus chronic diseases Urban versus rural mortality Rural migration to the city First attempts at a life table
出生时男性多于女性,但男性死亡高
婴儿死亡率高 发病呈季节变动 比较急性与慢性疾病 城市与农村死亡比较 农村象城市流动 首次尝试寿命表
Department of Epidemiology
Public Health College of Harbin Medical University
15
Lind .James 1716—1795Lind .James 1716—1795
- A surgeon of English navy - By means of Epidemiologic experiment Discovered Orange prevent scurvy
2. Form stage
Start the experimental Start the experimental EpidemiologyEpidemiology
Department of Epidemiology
Public Health College of Harbin Medical University
16
James Lind (1716-1794)James Lind (1716-1794)
VitC 缺乏 – 坏血病 (1747)(1747)
开创了流行病学临床试验的先河开创了流行病学临床试验的先河
二、学科形成期
Department of Epidemiology
Public Health College of Harbin Medical University
17
-Edward Jenner-Edward Jenner (1796) (1796)
He used cowpox immunization in preventing smHe used cowpox immunization in preventing smallpoxallpox. .
Department of Epidemiology
Public Health College of Harbin Medical University
18
Edward JennerEdward Jenner (1749-1823) (1749-1823)
(1796)(1796)
接种牛痘
预防天花
开创了主动免疫的先河开创了主动免疫的先河
施民安 . 琴纳发现牛痘预防天花的经过 . 见 : 钱宇平 , 主编 . 流行病学研究实例 ( 第 1 卷 ). 北京 : 人民卫生出版社, 1984. p38-42.
Department of Epidemiology
Public Health College of Harbin Medical University
19
In 1979 WHO declared that smallpox has been In 1979 WHO declared that smallpox has been eliminated in the whole world.eliminated in the whole world.
Smallpox eradication should be attributed to his Smallpox eradication should be attributed to his research .research .
Department of Epidemiology
Public Health College of Harbin Medical University
20
Sir Percivall Pott: 1775Sir Percivall Pott: 1775 English surgeon in London We all best known for “Pott’s fracture” He is one of earliest accounts of cause a
nd effect linkage for an occupational carcinogen.
He found that the scrotal cancer was particularly in the workers of
Chimney (stovepipe) cleaning
Department of Epidemiology
Public Health College of Harbin Medical University
21
Sir Percivall Pott: 1775Sir Percivall Pott: 1775
英国外科医生以“ Pott’s 骨折著称 他最早将职业致癌物与病因联系起来他发现阴囊癌为烟筒清洁工所特有
Department of Epidemiology
Public Health College of Harbin Medical University
22
William Farr (1807-William Farr (1807-1883)1883)
Statistician (English )
First person who routine collect population and death data in England
Put important words: Standard mortality,
Person year 、 Dose-response relationship 、 P=I×D
Department of Epidemiology
Public Health College of Harbin Medical University
23
William Farr (1807-1883)William Farr (1807-1883)
在英国首创人口和死亡的常规资料收集
提出许多流行病学的重要概念:标化死亡率、人年、剂量反应关系、患病率
患病率=发病率 × 病程
现代流行病学的奠基人之一现代流行病学的奠基人之一
公共卫生运动的领导者之一公共卫生运动的领导者之一
Department of Epidemiology
Public Health College of Harbin Medical University
24
--London Epidemiological Society London Epidemiological Society (1850) (1850) establishedestablished
It is a first one in the world
It is showed that the discipline already formed
Department of Epidemiology
Public Health College of Harbin Medical University
25
London Epidemiological Society (1850)London Epidemiological Society (1850)
全世界第一个流行病学学会
标志着流行病学学科的形成
Department of Epidemiology
Public Health College of Harbin Medical University
26
-John Snow (1848--John Snow (1848-1854)1854)
Department of Epidemiology
Public Health College of Harbin Medical University
27
The great French The great French Bacteriologist Bacteriologist
Louis Pasteur (1822-1895)Louis Pasteur (1822-1895)He established the Germ theory
Manufacture animal vaccine:
-anthrax,
-fowl cholera,
-swine erysipelas
-Rabies---virus---vaccine
Pasteurization– 600C –30’
the new useful disinfection method
Department of Epidemiology
Public Health College of Harbin Medical University
28
伟大的法国微生物学家伟大的法国微生物学家Louis Pasteur (1822-1895)Louis Pasteur (1822-1895)
微生物理论 (germ theory)
开发了鸡霍乱、炭疽、猪丹毒疫苗
减毒的微生物可以用作免疫
提出狂犬病是由一种显微镜看不到的物质传播的(即病毒),并开发疫苗治疗和预防狂犬病
巴斯德杀菌法
Department of Epidemiology
Public Health College of Harbin Medical University
29
3, Development stage (发展阶段) (20th Century 40’s, 50’s ------now)
Features (特点) : (1) Spectrum of disease : The study area extended from communicable diseases--- to Non-communicable /chronic disease --- to health
疾病谱 研究领域从 传染病—非传染病 ---健康
Department of Epidemiology
Public Health College of Harbin Medical University
30
Ten leading causes of death 1900 and 1990
Department of Epidemiology
Public Health College of Harbin Medical University
31
Children of Polio脊髓灰质炎患儿
Department of Epidemiology
Public Health College of Harbin Medical University
32
Features (特点) :( 2 ) Research method from Survey and analysis to qualitative and quantitative combined, and macroscopic and microscopic combined
研究方法从调查分析到定性和定量结合,宏观与微观结合 (3) Social behavior factors is very important 社会行为因素非常重要 (4) There are more other related Branch of epidemiology e
merge 有更多的流行病学相关分支出现
Department of Epidemiology
Public Health College of Harbin Medical University
33
REVIVAL OF EPIDEMIOLOGY: BEGINNING OF MODERN EPIDEMIOLOGY
Main characteristic: From communicable diseases to non-co
mmunicable diseases
Time: Mid 20th Century
First RCTs: streptomycin and respiratory
tuberculosis in 1948Early case-control studies: smoking and
lung cancer in 1950Early cohort studies: Framingham Study
in 1948 British Doctors Study in 1951
Sir Austin B. Hill: Sir Austin B. Hill: The Father of The Father of ModernModern EpidemiologyEpidemiology
Sir Richard Doll: The Godfather of EpidemiologySir Richard Doll: The Godfather of Epidemiology
Department of Epidemiology
Public Health College of Harbin Medical University
34
流行病学复兴:现代流行病学的开始
主要特点 : 从传染病倒非传染病时间 : 20th 世纪中叶
第一个 RCTs: 链霉素与肺结核 1948早期病例对照研究:吸烟和肺癌的关系 1950早期队列研究 : Framingham 研究 1948
英国医生研究 1951 Sir Austin B. Hill: Sir Austin B. Hill: The Father of The Father of ModernModern EpidemiologyEpidemiology
Sir Richard Doll: The Godfather of EpidemiologySir Richard Doll: The Godfather of Epidemiology
Department of Epidemiology
Public Health College of Harbin Medical University
35
Kenneth Rothman: The Philosopher in Epidemiology
现代流行病学中的哲学家 Kenneth Rothman
Department of Epidemiology
Public Health College of Harbin Medical University
36
ROTHMAN AND MODERN ROTHMAN AND MODERN EPIDEMIOLOGYEPIDEMIOLOGY
From Study of distributions to study of causes of diseaseIn humans and observational: case-control & cohort studiesIn order o avoid the Confounding bias he suggested :
By means of the …… * Restriction and matching
*Standardization *Stratified analysis *Adjustment by regression can be control the confounding bias
Department of Epidemiology
Public Health College of Harbin Medical University
37
1992: BIRTH OF EVIDENCE-BASED MEDICINE
1992 年: 循证医学诞生
“A new paradigm for medical practice is emerging in 1992”
出现医学实践进模式-A New Approach to Teaching the Practi
ce of Medicine
医学教育新方法
Department of Epidemiology
Public Health College of Harbin Medical University
38
DAVID SACKETT
Activist in clinical epidemiology 临床流行病学活动家
The pioneer in EBM 循证医学先驱
The first book on EBM 第一本循证医学书
McMaster University Health Science Centre
Chairman of Oxford Centre for EBM
Department of Epidemiology
Public Health College of Harbin Medical University
39
WORLD COCHRANE COLLABORATION
国际 COCHRANE合作 In 1992, the very first
Cochrane centre was established in Oxford.
Mission: Collecting, summarizing and disseminating evidence from organized research.
1992 年第一个 COCHRANE中心在牛津建立
使命:收集、总结和传播研究证据
Department of Epidemiology
Public Health College of Harbin Medical University
40
Today there is a total of 15 national or regional Cochrane centers and over 40 review groups world wide.
Chinese national Cochrane/EBM Centre is in Sichuan University
目前,全球有 15个国家和地区 COCHRANE 中心和 40多个评价组
中国国家循证医学中心在四川大学
WORLD COCHRANE COLLABORATION国际 COCHRANE合作
Department of Epidemiology
Public Health College of Harbin Medical University
41
Definition of Epidemiology流行病学定义
Epidemiology: the study of the distribution and determinants and the occurrence of health-related states or
events in specified and the application of this study to control health problems.
(Last)
Department of Epidemiology
Public Health College of Harbin Medical University
42
the meaning of this definition
Disease Population Distribution –
prevention & control Social medicine
疾病 人群 分布—预防空中 社会医学
Department of Epidemiology
Public Health College of Harbin Medical University
43
The relationship between epidemiology and clinical medicine
Populations Studies/assessments Prevention Evaluation Planning
Individuals Diagnosis Treatment Curing Caring
Department of Epidemiology
Public Health College of Harbin Medical University
44
Study methods 研究方法 -Observation
-Experimental
-Theoretical
Department of Epidemiology
Public Health College of Harbin Medical University
45
STUDY Surveillance Observation Hypothesis testing Analytic research Experiments Theoretical
epidemiology
监测 观察 假设检验 分析研究 实验 理论流行病学
Department of Epidemiology
Public Health College of Harbin Medical University
46
Distribution
Place Time Persons
Department of Epidemiology
Public Health College of Harbin Medical University
47
Determinantsby means of:
Physical Biological Social Cultural Behavioral Factors
Department of Epidemiology
Public Health College of Harbin Medical University
48
Health- related states and events 健康相关状态和事件
Diseases Causes of death Behavior: Tobacco, Alcohol, Drug use Reactions to preventive regimens Provision and use of health services
Department of Epidemiology
Public Health College of Harbin Medical University
49
Epidemiology Population Medicine
群体医学 The Language of Quantification
定量语言
Department of Epidemiology
Public Health College of Harbin Medical University
50
Factors influencing the spread of disease
Socioeconomic conditions
Sanitation Nutrition Lifestyle Age Gender
社会经济状况卫生营养 生活方式 年龄性别
Department of Epidemiology
Public Health College of Harbin Medical University
51
Principle of epidemiology
流行病学原理 Distribution Epidemic process Relationship of human
and environment Causation Causal inference Prevention Theoretical epidemiology
流行 分布 人语自然关系 病因 病因推断 预防 理论流行病学
Department of Epidemiology
Public Health College of Harbin Medical University
52
Application of epidemiology
流行病学应用1. Determine great public
health Problems
2. Response and deal with emergency event
3. Surveillance of disease related
重大公共卫生问题的确定突发事件的应急与处理疾病相关监测
Department of Epidemiology
Public Health College of Harbin Medical University
53
Application of epidemiology
流行病学应用4. Study the cause and risk
factor of disease
5. To study the natural history and prognosis of disease.
6. Evaluate the prevent effect
疾病病因和危险因素研究疾病的自然史研究疾病防治的效果评价
Department of Epidemiology
Public Health College of Harbin Medical University
54
一、重大公共卫生问题的确定Determine great public health Problems
图图 1-11-1 中国中国 1954-19981954-1998 年死亡率变化趋势年死亡率变化趋势
0
100
200
300
400
500
600
700
800
900
1954 1957 1963 1975 1980 1985 1990 1995 1998
CD
R (1
/10
0,0
00 )
OthersOthers Injuries & Injuries & poisoningpoisoning
Non-communicable Non-communicable diseasesdiseases
CommunicablCommunicable,e,
maternal and maternal and child diseaseschild diseases
Department of Epidemiology
Public Health College of Harbin Medical University
55(2006 中国卫生统计提要 )
表 1-1 2005 年中国部分市县前十位疾病死亡专率及死亡原因构成
Department of Epidemiology
Public Health College of Harbin Medical University
56
顺位城市 农村疾病 患病率 构成 疾病 患病率 构成
1 高血压高血压 54.722.
8高血压高血压 16.4
13.6
2 糖尿病糖尿病 16.3 6.8 胃肠炎 10.5 8.7
3 脑血管病脑血管病 13 5.4 类风湿性关节炎 8.7 7.2
4 缺血性心脏病缺血性心脏病 12.4 5.2 慢性阻塞性肺病慢性阻塞性肺病 7.3 6
5 胃肠炎 9.8 4.1 胆结石胆囊炎 4.7 3.9
6 胆结石胆囊炎 8.5 3.5 脑血管病脑血管病 4.4 3.7
7 类风湿性关节炎 8.4 3.5 锥间盘疾病 4 3.3
8 慢性阻塞性肺病慢性阻塞性肺病 8.2 3.4 消化性溃疡 3.8 3.2
9 锥间盘疾病 8.1 3.4 缺血性心脏病缺血性心脏病 2 1.6
10 消化性溃疡 3.4 1.4 糖尿病糖尿病 1.9 1.6
表 1-2 2003年中国居民慢性病患病率 (‰)及疾病构成(%)
( 第三次国家卫生服务调查结果 )
Department of Epidemiology
Public Health College of Harbin Medical University
57
二、突发事件的应急与处理Response and deal with emergency event
SARS
人感染猪链球菌病
Meningitis Caused by Streptococcus Suis
Department of Epidemiology
Public Health College of Harbin Medical University
58
0
20
40
60
80
100
120
140
160
180
First stage 1.2—2.28
Second stage3.8—4.23
Third stage4.24—5.31
Fourth6.1—6.24
图 1-2 Time distribution of SARS
Department of Epidemiology
Public Health College of Harbin Medical University
59
图 1-3
Department of Epidemiology
Public Health College of Harbin Medical University
60
6 10 SARS截止 月 日北京市 病例发病时间分布情况
0
20
40
60
80
100
120
140
3-53-63-73-83-93-103-113-123-133-143-153-163-173-183-193-203-213-223-233-243-253-263-273-283-293-303-314-14-24-34-44-54-64-74-84-94-104-114-124-134-144-154-164-174-184-194-204-214-224-234-244-254-264-274-284-294-305-15-25-35-45-55-65-75-85-95-105-115-125-135-145-155-165-175-185-195-205-215-225-235-245-255-265-275-285-295-305-316-16-26-36-46-56-66-76-86-96-10
发病时间
病例数
确诊 疑似
发热门诊
强化疫情报告
密切接触者隔离
病人管理
疫点消毒与隔离
输入期 扩散期 高峰期高峰期 缓降期平稳期
重点人群管理
集中医院收治
爆发点处理
新发病例分析与排查
6 10 SARS截止 月 日北京市 病例发病时间分布情况
0
20
40
60
80
100
120
140
3-53-63-73-83-93-103-113-123-133-143-153-163-173-183-193-203-213-223-233-243-253-263-273-283-293-303-314-14-24-34-44-54-64-74-84-94-104-114-124-134-144-154-164-174-184-194-204-214-224-234-244-254-264-274-284-294-305-15-25-35-45-55-65-75-85-95-105-115-125-135-145-155-165-175-185-195-205-215-225-235-245-255-265-275-285-295-305-316-16-26-36-46-56-66-76-86-96-10
发病时间
病例数
确诊 疑似
发热门诊
强化疫情报告
密切接触者隔离
病人管理
疫点消毒与隔离
输入期 扩散期 高峰期高峰期 缓降期平稳期
重点人群管理
集中医院收治
爆发点处理
新发病例分析与排查
图 1-4
Department of Epidemiology
Public Health College of Harbin Medical University
61
Cause of isolationNO. of isolated
NO. of incidence
Attack rate(%)
Contacted SARS patient 630 24 3.8
Contacted SARS patient but excluded 140 0 0
Contacted person contacted SARS patient 130 0 0
Diagnosed as SARS , but excluded and disparage of hospital
45 0 0
Patient with Fever or contact with Patient with Fever
31 0 0
No contact with SARS or close contact person
26 0 0
Isolated SARS patient after discharge 8 0 0
No answer 18 0 0
Total 1028 24 2.3
Proportion of person contacted SARS to all isolated 61%( 630/1028)
Table 1-5 Incidence of isolated medical observers of 1028
Department of Epidemiology
Public Health College of Harbin Medical University
62
Table 1-6 Incidence situation of 630 person close contacted with SARS
Contacted period No. of isolated
No. ofpatients
Attack rate %)
Symptom period 383 24
6.3
Incubation period 167 0 0.0
unclear 50 0 0.0
Not Answer 30 0 0.0
Total 630 24 3.8
Proportion of person contacted with Symptom period SARS to total is
olated 37% (383/1028)
Department of Epidemiology
Public Health College of Harbin Medical University
63
监测目的
描 述 现 状
应 急 反 应
决 策 依 据
干 预 评 价
三、疾病相关监测 Disease related surveillance
Purpose of surveillance
Describe the situation
Emergency response
Basis for decision mak
ing
Evaluation for interven
tion
Department of Epidemiology
Public Health College of Harbin Medical University
64
疾病监测(发病、死亡)
生物学监测(全血、血浆、血清、唾液及液……)
行为监测(吸烟、饮酒、锻炼、性行为、毒……)
环境监测(自然环境、社会环境)
虫媒监测(鼠、蚊……)
Disease surveillance (incidence, death)
Biology surveillance (blood, serum, plasma, saliva …)
Behavior surveillance (smoking, alcohol drinking, drug..)
Environmental surveillance natural ,
social , Environment
Vector surveillance ( mouse mosquito……)
监测类型 Type of surveillance
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Public Health College of Harbin Medical University
65
第一阶段( 20 世纪 50 年代-) 全国法定传染病疫情报告系统 (1950 年 )
First stage (50s of 20 century-- )
The notifiable infection disease system
in China (1950)
我国的监测系统Surveillance system in China
Department of Epidemiology
Public Health College of Harbin Medical University
66
第二阶段( 20 世纪 70 年代后期-) 传染病监测(单病监测系统) 出生、死亡监测 综合疾病监测系统( 1980 年) Second stage (70s of 20 century--)
infectious disease surveillance (single disease
surveillance system)
birth, death surveillance
comprehensive surveillance system (1980-)
Department of Epidemiology
Public Health College of Harbin Medical University
67
第三阶段( 20 世纪 80 年代后期-) 传染病监测、出生、死亡监测 慢性非传染性疾病监测 行为监测 The third stage ( 80s 20 century--) infectious disease surveillance; birth, death surveillance
Chronic non-communicated disease 、 behavior surveillance
第四阶段( 21 世纪初-) 整合:国家公共卫生监测体系 The fourth stage ( beginning of 20 centur
y--) integrate : National public health surveillance system
Department of Epidemiology
Public Health College of Harbin Medical University
68
Risk factor and disease– smoking and lung cancer
图图 66 --11
图图 66 --22
图图 66 --33
图图 66 --44
Department of Epidemiology
Public Health College of Harbin Medical University
69
五、疾病自然史研究
图图 1-1-77
Department of Epidemiology
Public Health College of Harbin Medical University
70
The Natural History of Disease
A- Stage of susceptibility (易感期)B-Stage of pre-symptomatic disease (症状前期)C-Stage of clinical disease (临床病人)D-Stage of disability or recovery or death (残疾、恢复或死亡)
A B C D
Department of Epidemiology
Public Health College of Harbin Medical University
71
0 1 2 3 4 5 6 7 8 9 10 11 12 13Week
Re
sp
on
se
Clinical illness
ALT
IgM IgG
HAV in stool
Infection
Viremia
EVENTS IN HEPATITIS A VIRUS INFECTION
Department of Epidemiology
Public Health College of Harbin Medical University
72
RANDOMIZED CONTROLLED TRIAL, RCT随机对照试验
EVIDENCE BASED MEDICINE循证医学
流行病学循证医学“生产”证据的科学方法
决策过程中利用证据所必需的知识技能
六、疾病防治效果的评价 Evaluate the effect of prevent and treatment
Department of Epidemiology
Public Health College of Harbin Medical University
73
Features 特点Population medicine
Compare
Probability theory and statistics
Social medicine
Prevention
Development
群体的特征 对比的特征 概率论和数理统计学的
特征 社会心理的特征 预防为主的特征 发展的特征
Department of Epidemiology
Public Health College of Harbin Medical University
74
Prospect 展望Macroscopic+Mirocosmic
Communicable +non-communicable
Population health
Emergency events and EID
Ethic
Evidence-based medicine
宏观与微观并举 传染病和非传染病并重 重视人群健康和生活质量研究 发展应急和现场流行病学 重视流行病学研究中的伦理学
问题 强化流行病学在循证实践中的
作用
Department of Epidemiology
Public Health College of Harbin Medical University
75
Question
1. What is Epidemiology?
2. What is the meaning of this definition?
3. What is the study method of epidemiology?
4. what is the use of epidemiology?
Department of Epidemiology
Public Health College of Harbin Medical University
76