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Dermatology
Public Health and Dermatology
Built from Dermatology, 5th Edition
What’s inside
10 sections · 88 slides
Overview
- Scope of this topic
Epidemiology in Diagnosis
How knowing the pattern of a disease in a population helps identify it in one patient
- Definition and scope of epidemiology
- Epidemiology as a diagnostic tool
- Eczema herpeticum in a patient with atopic dermatitis
- Epidemiologic reasoning in this case
- Uses for epidemiology in dermatology.
Public Health Burden of Skin Disease
How common, how disabling, and how fast-changing skin conditions are
- Global burden of skin disease
- Disability-adjusted life year (DALY) rates for all skin conditions combined (2013).
- Dermatology visits in US healthcare
- Common outpatient dermatologic diagnoses
- Melanoma incidence and mortality trends
- Keratinocyte carcinoma and indoor tanning trends
LGBT Health in Dermatology
Specific infection risks, cancer risks, and care needs for LGBT patients
- Sexually transmitted infections and skin signs
- Skin cancer risk in sexual minority men
- Dermatologic care for transgender patients
- Approaches to care for Lesbian, Gay, Bisexual and Transgender (LGBT) patients 19 .
Types of Epidemiologic Studies
From simple case descriptions to studies that can prove cause and effect
- Families of epidemiologic study design
- Case reports and case series
- Case series example: scalp disease in dermatomyositis
- Studying exposure and disease together
- Categorization of study participants, based on their disease and exposure.
- Confounding: a hidden shared cause
- Confounding between an exposure and a disease
- Case-control study design
- Case-control study strengths and limitations
- Case-control example: psoriasis and coronary artery disease
- Confidence interval around a point estimate
- Cohort study design
- Cohort study strengths and limitations
- Cohort example: tanning beds and skin cancer risk
- Effect modification across subgroups
- Effect modification by an interacting variable
- Cross-sectional study design
- Cross-sectional study strengths and limitations
- Cross-sectional example: psoriasis and metabolic syndrome
- Case series
- Case–control
- Cohort
- Cross-sectional
- Randomized controlled trials (RCTs)
Clinical Trials and Evidence Synthesis
Testing an intervention directly, and combining many studies into one answer
- What a randomized controlled trial adds
- Four phases of new drug testing
- The four phases of testing a new drug 2 , 23 .
- Intention-to-treat analysis
- Measuring prognosis and survival
- Five ways of expressing prognosis and survival data.
- Randomized controlled trial strengths and limitations
- RCT example: etanercept for pediatric plaque psoriasis
- Systematic reviews and meta-analysis
- Systematic review strengths and limitations
- Systematic review example: indoor tanning and skin cancer
- Factors that strengthen causal inference
- Factors that strengthen causal inference.
Genetic Epidemiology and Health Services Research
From DNA variants to how care is actually delivered and followed
- Genome-wide association studies
- GWAS example: alopecia areata
- Efficacy, effectiveness, and efficiency
- Barriers to treatment adherence
- Adherence in dermatologic care: obstacles and potential solutions.
- Adherence in dermatologic care: obstacles and potential solutions. (continued)
Health Policy and Quality of Life
Turning research findings into better care decisions and better-measured outcomes
- Evidence-based healthcare policy
- Overdiagnosis near the end of life
- Quality of life as an outcome measure
- Quality-of-life instruments in dermatology
Designing and Appraising a Study
What to check before trusting a study's methods, results, and conclusions
- Matching study design to the research question
- Important considerations when reviewing a study.
- Random error versus systematic error
- Types of errors and bias. There are two types of errors: random (due to chance) and systematic. UV, ultraviolet.
- Four categories of systematic bias
- Precision versus validity
- Precision and validity compared
- Sensitivity, specificity, and predictive values
- Sensitivity, specificity, and predictive value formulas
- Statistical significance and confidence intervals
- Statistical power and sample size
- Type I and type II errors
- Generalizability and conflicts of interest
- STROBE reporting checklist
- CONSORT reporting statement
The Future of Dermato-Epidemiology
Where the field is heading, and how dermatologists can get involved
- Opportunities for epidemiologic research
- Psoriasis and cardiovascular comorbidity research
- Building a career in dermato-epidemiology
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)