Public'Health'-'Formula'Sheet.

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1. Ratio!=!!
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!

!
!

!!=!!

2. Proportion!=!
!
!

!"#$

!"#$%!&

!
!!!

!'=!!

3. Odds!Ratio!=!

!!
!"#$

!"!#$!!"#$%&!!"!!"!#$%&'"(

!"
!"

OR!=!1!!No!association!
OR!!>!1!!Risk!factor!
OR!!<!1!!Protective!factor!

!
4. Odds!ratio!for!matched!pair!
!

''''!

OR!=! !

3. Rate!=!!

!
!!!

'x!time%

5. Risk!ratio!=!

!
1. Prevalance!
At!a!point!of!time!
Period!of!time!
!

Prevalance!=!

!"#$%&!!"!!"#$%#$!

!"#$%!!"!#$%&'"(!!"#$%&

!!!!

2. Incidence!!
In!a!period!of!elasped!time!
!

Incidence!=!

!"#$%&!!"!!"#!$"!!"#"$%&"!!!!!!!"#$%#$

!"#$%!!"#!$"!!"!!"#$!!"!!"#"$%&'()!!!!!!"#$%#$

3. Relationship!between!prevalence!&!incidence!
Prevalence!=!Incidence!x!Duration!

4. Condition!of!a!Disease!
Acute!Illness!
!
P,!I!
!
Chronic!&!Common!Illness!
!
P,!I!
!
Chronic!&!Uncommon!Illness!
!
P!>!I!
!
!
1. Crude!Death!Rate!
!
=!!

!"#$%&!!"!!"#$!!!"!!!!"#$%!!"#$

!"#$%&!!"!!"#!$"!!"!!"!#$!!"!#$%&'"(

!
!
2. Infant!Mortality!Rate!
!
!"#$%&!!"!!"#$!!"!!!"#$%&!!"#$!!"##!!!"!1!!"!!!!"#$%!!!"#
!
!"#$%&!!"!!"#$!!"#$!!"!!!!!"#$!!"#$
!
!
3. Perinatal!Mortality!
!
!"#$$%#&"! > 28!!""#$ !!"#$ + !"#!$%$&! < 1!!""# !!"#$
!
!"#$$%#&"! > 28!!""#$ !!"#$ + !"#$%&!!"!!"!"!!"#$!
!
!
!
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1. Common!2!x!2!Table!
!
!
Disease!
No!Disease!
Total!
Exposed!
a!
b!
!
Non!Exposed!
c!
d!
!
Total!
!
!
!
!
2. Odds!=!
!

!"#$%&

!"#!!"#$%&

!!=!

!"#$%&'(

!!!"#$%&'(

!"#$%#$!!"#!$%"#%!!"!!"#$%!&
!"#$%#$!!"#!$%"#%!!"!!"#$%&'#(

!
!
6. Attributal!Risk!=!Incidence%in%Exposed%%Incidence%in%Unexposed!
!
!
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Randomized'Control'Trial'
!
!
!
Disease!
No!Disease!
Total!
Exposed!
Intervention!
a!
b!
!
!
Comparison!
!
!
!
Non!Exposed!
or!Original!
c!
d!
Treatment!
Total!
!
!
!
!
!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!Direction!of!Study!
!
!
!
Cohort'Studies!!No!one!is!diseased!at!the!beginning!of!study.!
!
Status!of!exposed!or!nonSexposed!is!chosen!first!
Then!the!cohort!is!followed!in!time!for!the!outcome!
!
!
Disease!
No!Disease!
Total!
Exposed!
a!
b!
!
Non!Exposed!
c!
d!
!
Total!
!
!
!
!
Direction!of!Study!
!
'
Case'Control'Studies'
!
Cases!(Disease)!&!Control!(NonS!Disease)!is!chosen!first!
Then!past!exposed!or!not!exposed!is!measured!
!
!
!
[Cases]!
[Control]!
Total!
Disease!
No!Disease!
[Yes]!
a!
b!
!
Exposed!
[No]!
c!
d!
!
Non!Exposed!
Total!
!
!
!
!
Direction!of!Study!
!
!
Cross''Sectional'Studies'
!
Determine!exposure!status!&!disease!at!the!same!time!
!
!
Disease!
No!Disease!
Total!
Exposed!
a!
b!
!
Non!Exposed!
c!
d!
!
Total!
!
!
!
!
!

1. Confounders!
Example!:!Is!gender!a!confounder!
!
Without!gender!factor!:!OR!=!3.00!
!
With!gender!factor!:S!
!!!!!!!!!!!Male!:!OR!=!2.00!
!!!!!!!!!!!Female!:!OR!=!2.00!
!
!since!OR!of!male!=!OR!of!female,!hence!gender!is!a!confounder!
!
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1. Hypothesis!Testing!
!
H0!:!Not!associated!
H1!:!Associated!
!
!
2. PSValues!
!
P!!value!<!0.05!!
!
H0!is!rejected!
!
It!is!statistically!significant!
!
P!!value!>!0.05!!
!
H1!is!rejected!
!
It!is!not!statistically!significant.!
!
!
3. Confidence!interval!!for!relative!risk!or!risk!ratio.!
!
If!CI!contains!1!!
!
It!is!not!statistically!significant!
!
If!CI!does!not!contain!1!
!
It!is!statistically!significant!
!
!
1. Testing!association!between!2!categorical!variable!
!
X2!Test!!Chi!Squared!Test!
PSvalue!<!0.005!!it!is!statistically!significant!
!
!
1. Standardized!Mortality!Ratio!
!

!"#$%&$'!!"#$%&!!"!!"#$!!!"!!!!!!"#$%!!"!#$%&'"(

!"#$%&$'!!"#$%&!!"!!"#$!!!"#$%!!"!!!!!!"#$%#&%!!"!#!!"#!!"#$%&%$!!"#$

!
!
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Measures'of'Effect'
!
Given!the!2!x!2!table,!
!
!
Disease!
Exposed!
a!
Non!Exposed!
c!
Total!
!
!
1. Relative!Risk!(RR)!
!

!/(!!!)
!/(!!!)

No!Disease!
b!
d!
!

Total!
!
!
!

Hence,!the!risk!of!having!the!disease!when!having!the!
intervention!in!is!0.69!of!the!placeb!

!
!
!
!
!
!

!!!

(!!!)

Eg.!ARR!=!0.015!

Hence,!15%!were!spared!from!the!outcome!of!having!the!
disease!because!they!received!the!intervention!rather!than!
the!placebo!over!the!time!period.!!

!
!
4.!Number!Needed!to!Treat!(NNT)!
!

!""

Eg.!NNT!=!66.67!
!
!

Hence,!we!need!to!treat!67!people!with!the!intervention!to!
prevent!one!bad!outcome.!!

Statistically'Significant'Results'
!
1.!Relative!Risk!
Confidence!interval!without!1!
!
!
2.!R.!R.!Reduction!or!R.!R.!Increase!!
Confidence!interval!without!0!
!
!
3.!A.!R.!Reduction!or!A.!R.!Increase!
Confidence!interval!without!0!
!
!
4.!NN!Treat!or!NN!Harm!
Confidence!interval!does!not!include!Infinity!()!

!
!

Eg.!RR!=!0.96!

2. Relative!Risk!Reduction!(RRR)!
!
1!!Relative!Risk!
!
Eg.!RRR!=!0.3!
Hence,!compared!to!the!placebo!the!intervention!reduces!the!
risk!of!having!the!disease!by!30%!over!the!time!period.!!
!
!
3. Absolute!Risk!Reduction!(ARR)!!
!
Incidence!of!Comparison!!Incidence!of!Intervention!
!

Identifying'Heterogeneity'
!
1. Visually!!effect!estimate!of!forest!plot!is!not!uniform!
!
2. Statistically!!
X2!Test!:!P<0.1!!
Heterogeneity!is!present!
!
I2!>!50%!!
Heterogeneity!is!present!
!
Consideration!!I2!is!the!biggest!determiner!and!only!then!is!
compared!to!the!X2!Test!
!
!
Publication'Bias'
!
1. Visually:!Funnel!plot!is!asymetrical!
!
2. Statistically:!Eggers!Test:!S!P<0.1!!statistically!significant.!
!

True'Diagnosis''True'Standard'
!
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Disease!
Positive!Test!
A!
Result!
True!+ve!
Negative!Test!
C!
Result!
False!ve!
Total!
A+C!
!
1.

Sensitivity!=!!

!
!

(!!!)

No!Disease!
B!
False!+ve!
D!
True!Sve!
B+D!

Total!
A!+!B!

PPV!&!NPV!!both!depends!on!!
Prevalence!
Accuracy!of!the!test!

Therefore!if!sensitivity!&!specificity!is!the!same!

C!+!D!
!
A+B+C+D!

hence!the!following!
!
P,!PPV!!!
!
P,!NPV!!

!
!

6.

Positive!Likelihood!Ratio!(+LR)!

2.
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Specificity!=!

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(!!!)

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3.

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Positive!Predictive!Value!=!

!
(!!!)

7.

!"#$%&%'%&(

!!!"#$%&%$%'(

+LR!>!10!:!It!has!high!diagnostic!value!

Negative!Likelyhood!Ratio!(SLR)!

!!!"#$%&%'%&(
!"#$%&%$%'(

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4.

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5.

Negative!Predictive!Value!=!

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(!!!)

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8.

SLR!<!0.1!:!It!has!high!diagnostic!value!

Calculating!PostSTest!Probability!

Pretest!Probability!(Usually!given)!

Use!both![+LR]!&![SLR]!

Get!postStest!probability!from!Bayes!Nomogram!