Ecologic study

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Ecologic study

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Diagnoses

Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Coronary artery disease: Pathology review
Anticoagulants: Direct factor inhibitors
Anticoagulants: Heparin
Antiplatelet medications
Thrombolytics
Renal failure: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
Anatomy of the lungs and tracheobronchial tree
Anatomy clinical correlates: Pleura and lungs
Alveolar surface tension and surfactant
Breathing cycle and regulation
Gas exchange in the lungs, blood and tissues
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Obstructive lung diseases: Pathology review
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy clinical correlates: Other abdominal organs
Bile secretion and enterohepatic circulation
Liver anatomy and physiology
Cirrhosis: Pathology review
Anatomy of the heart
Anatomy of the coronary circulation
Anatomy of the inferior mediastinum
Anatomy of the superior mediastinum
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Cardiac afterload
Cardiac contractility
Cardiac cycle
Cardiac preload
Cardiac work
Cardiovascular system anatomy and physiology
Changes in pressure-volume loops
Frank-Starling relationship
Measuring cardiac output (Fick principle)
Microcirculation and Starling forces
Pressure-volume loops
Stroke volume, ejection fraction, and cardiac output
Heart failure: Pathology review
Anatomy of the coronary circulation
Anatomy clinical correlates: Heart
Cardiovascular system anatomy and physiology
Atherosclerosis and arteriosclerosis: Pathology review
Coronary artery disease: Pathology review
Anatomy of the cerebral cortex
Anatomy of the limbic system
Anatomy clinical correlates: Cerebral hemispheres
Dementia: Pathology review
Mood disorders: Pathology review
Selective serotonin reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors
Tricyclic antidepressants
Monoamine oxidase inhibitors
Atypical antidepressants
Pancreas histology
Diabetes mellitus: Pathology review
Dyslipidemias: Pathology review
Lipid-lowering medications: Fibrates
Lipid-lowering medications: Statins
Miscellaneous lipid-lowering medications
Enteric nervous system
Esophageal motility
Gastrointestinal system anatomy and physiology
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Hypertension: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
Adrenergic antagonists: Beta blockers
Calcium channel blockers
Thiazide and thiazide-like diuretics
Anatomy of the thyroid and parathyroid glands
Thyroid and parathyroid gland histology
Endocrine system anatomy and physiology
Thyroid hormones
Hyperthyroidism: Pathology review
Anatomy of the thyroid and parathyroid glands
Thyroid and parathyroid gland histology
Endocrine system anatomy and physiology
Thyroid hormones
Hypothyroidism: Pathology review
Introduction to the skeletal system
Bone remodeling and repair
Bone disorders: Pathology review
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy clinical correlates: Other abdominal organs
Pancreas histology
Pancreatic secretion
Pancreatitis: Pathology review
Anatomy of the diaphragm
Anatomy of the larynx and trachea
Anatomy of the lungs and tracheobronchial tree
Anatomy of the nose and paranasal sinuses
Anatomy of the pleura
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Alveolar surface tension and surfactant
Anatomic and physiologic dead space
Breathing cycle and regulation
Gas exchange in the lungs, blood and tissues
Lung volumes and capacities
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Pneumonia: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Atypical antidepressants
Nasal, oral and pharyngeal diseases: Pathology review
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Anatomy of the female urogenital triangle
Anatomy of the male urogenital triangle
Anatomy of the perineum
Anatomy of the urinary organs of the pelvis
Anatomy clinical correlates: Female pelvis and perineum
Anatomy clinical correlates: Male pelvis and perineum
Renal system anatomy and physiology
Urinary tract infections: Pathology review
Anatomy of the lungs and tracheobronchial tree
Fascia, vessels and nerves of the upper limb
Vessels and nerves of the forearm
Vessels and nerves of the gluteal region and posterior thigh
Anatomy clinical correlates: Pleura and lungs
Clot retraction and fibrinolysis
Coagulation (secondary hemostasis)
Platelet plug formation (primary hemostasis)
Deep vein thrombosis and pulmonary embolism: Pathology review
Anticoagulants: Direct factor inhibitors
Anticoagulants: Heparin
Anticoagulants: Warfarin

Clinical conditions

Abdominal quadrants, regions and planes
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Innervation of the abdominal viscera
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy of the abdominal viscera: Small intestine
Anatomy of the anterolateral abdominal wall
Anatomy of the diaphragm
Anatomy of the gastrointestinal organs of the pelvis and perineum
Anatomy of the inguinal region
Anatomy of the muscles and nerves of the posterior abdominal wall
Anatomy of the peritoneum and peritoneal cavity
Anatomy of the vessels of the posterior abdominal wall
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Inguinal region
Anatomy clinical correlates: Other abdominal organs
Anatomy clinical correlates: Peritoneum and diaphragm
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Appendicitis: Pathology review
Diverticular disease: Pathology review
Gallbladder disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Pancreatitis: Pathology review
Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
Acid-base disturbances: Pathology review
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Kidney histology
Renal system anatomy and physiology
Renal failure: Pathology review
Anatomy of the basal ganglia
Anatomy of the blood supply to the brain
Anatomy of the brainstem
Anatomy of the cerebellum
Anatomy of the cerebral cortex
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the diencephalon
Anatomy of the limbic system
Anatomy of the ventricular system
Anatomy of the white matter tracts
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Posterior blood supply to the brain
Nervous system anatomy and physiology
Amnesia, dissociative disorders and delirium: Pathology review
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Dementia: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Drug misuse, intoxication and withdrawal: Other depressants: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Mood disorders: Pathology review
Schizophrenia spectrum disorders: Pathology review
Seizures: Pathology review
Traumatic brain injury: Pathology review
Anticonvulsants and anxiolytics: Benzodiazepines
Atypical antipsychotics
Typical antipsychotics
Blood histology
Blood components
Erythropoietin
Extrinsic hemolytic normocytic anemia: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Introduction to the central and peripheral nervous systems
Introduction to the muscular system
Introduction to the skeletal system
Introduction to the somatic and autonomic nervous systems
Anatomy of the ascending spinal cord pathways
Anatomy of the descending spinal cord pathways
Anatomy of the muscles and nerves of the posterior abdominal wall
Anatomy of the vertebral canal
Anatomy of the vessels of the posterior abdominal wall
Bones of the vertebral column
Joints of the vertebral column
Muscles of the back
Vessels and nerves of the vertebral column
Anatomy clinical correlates: Anterior and posterior abdominal wall
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Vertebral canal
Back pain: Pathology review
Positive and negative predictive value
Sensitivity and specificity
Test precision and accuracy
Type I and type II errors
Anatomy of the breast
Anatomy of the coronary circulation
Anatomy of the heart
Anatomy of the inferior mediastinum
Anatomy of the lungs and tracheobronchial tree
Anatomy of the pleura
Anatomy of the superior mediastinum
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Breast
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Cardiovascular system anatomy and physiology
Respiratory system anatomy and physiology
Aortic dissections and aneurysms: Pathology review
Coronary artery disease: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Gastrointestinal system anatomy and physiology
Enteric nervous system
Colorectal polyps and cancer: Pathology review
Diverticular disease: Pathology review
Laxatives and cathartics
Anatomy of the diaphragm
Anatomy of the larynx and trachea
Anatomy of the lungs and tracheobronchial tree
Anatomy of the nose and paranasal sinuses
Anatomy of the pleura
Bones and joints of the thoracic wall
Muscles of the thoracic wall
Vessels and nerves of the thoracic wall
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Lung cancer and mesothelioma: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Obstructive lung diseases: Pathology review
Pneumonia: Pathology review
Restrictive lung diseases: Pathology review
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Bile secretion and enterohepatic circulation
Enteric nervous system
Gastrointestinal system anatomy and physiology
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Bacillus cereus (Food poisoning)
Campylobacter jejuni
Clostridium difficile (Pseudomembranous colitis)
Clostridium perfringens
Escherichia coli
Norovirus
Salmonella (non-typhoidal)
Shigella
Staphylococcus aureus
Vibrio cholerae (Cholera)
Yersinia enterocolitica
Anatomy of the heart
Anatomy of the lungs and tracheobronchial tree
Anatomy of the pleura
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Mediastinum
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Alveolar surface tension and surfactant
Anatomic and physiologic dead space
Breathing cycle and regulation
Diffusion-limited and perfusion-limited gas exchange
Gas exchange in the lungs, blood and tissues
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Cardiac afterload
Cardiac contractility
Cardiac cycle
Cardiac preload
Cardiac work
Frank-Starling relationship
Measuring cardiac output (Fick principle)
Pressure-volume loops
Stroke volume, ejection fraction, and cardiac output
Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
Lung cancer and mesothelioma: Pathology review
Obstructive lung diseases: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Pneumonia: Pathology review
Restrictive lung diseases: Pathology review
Tuberculosis: Pathology review
Introduction to the cardiovascular system
Introduction to the lymphatic system
Microcirculation and Starling forces
Cirrhosis: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
Hypothyroidism: Pathology review
Nephrotic syndromes: Pathology review
Renal failure: Pathology review
Antidiuretic hormone
Phosphate, calcium and magnesium homeostasis
Potassium homeostasis
Renin-angiotensin-aldosterone system
Sodium homeostasis
Diabetes insipidus and SIADH: Pathology review
Electrolyte disturbances: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Mood disorders: Pathology review
Psychological sleep disorders: Pathology review
Adrenergic antagonists: Beta blockers
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Antihistamines for allergies
Nonbenzodiazepine anticonvulsants
Opioid agonists, mixed agonist-antagonists and partial agonists
Tricyclic antidepressants
Cytokines
Inflammation
Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
Anatomy of the abdominal viscera: Esophagus and stomach
Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
Anatomy of the vessels of the posterior abdominal wall
Anatomy clinical correlates: Viscera of the gastrointestinal tract
Gastrointestinal bleeding: Pathology review
Anatomy of the blood supply to the brain
Anatomy of the cranial base
Anatomy of the cranial meninges and dural venous sinuses
Anatomy of the nose and paranasal sinuses
Anatomy of the suboccipital region
Anatomy of the temporomandibular joint and muscles of mastication
Anatomy of the trigeminal nerve (CN V)
Bones of the cranium
Bones of the neck
Deep structures of the neck: Prevertebral muscles
Muscles of the face and scalp
Nerves and vessels of the face and scalp
Superficial structures of the neck: Cervical plexus
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Headaches: Pathology review
Anatomy of the abdominal viscera: Liver, biliary ducts and gallbladder
Anatomy of the abdominal viscera: Pancreas and spleen
Anatomy clinical correlates: Other abdominal organs
Gallbladder histology
Liver histology
Bile secretion and enterohepatic circulation
Liver anatomy and physiology
Pancreatic secretion
Jaundice: Pathology review
Anatomy of the elbow joint
Anatomy of the glenohumeral joint
Anatomy of the hip joint
Anatomy of the knee joint
Anatomy of the radioulnar joints
Anatomy of the sternoclavicular and acromioclavicular joints
Anatomy of the tibiofibular joints
Joints of the ankle and foot
Joints of the wrist and hand
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Wrist and hand
Gout and pseudogout: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Anatomy of the knee joint
Anatomy clinical correlates: Knee
Rheumatoid arthritis and osteoarthritis: Pathology review
Seronegative and septic arthritis: Pathology review
Candida
Clostridium difficile (Pseudomembranous colitis)
Enterobacter
Enterococcus
Escherichia coli
Proteus mirabilis
Pseudomonas aeruginosa
Staphylococcus aureus
Bacterial and viral skin infections: Pathology review
Skin histology
Skin anatomy and physiology
Acneiform skin disorders: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Pigmentation skin disorders: Pathology review
Skin cancer: Pathology review
Vesiculobullous and desquamating skin disorders: Pathology review
Anatomy of the heart
Anatomy of the vagus nerve (CN X)
Aortic dissections and aneurysms: Pathology review
Cardiomyopathies: Pathology review
Coronary artery disease: Pathology review
Heart blocks: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Ventricular arrhythmias: Pathology review
Hunger and satiety
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Breast cancer: Pathology review
Colorectal polyps and cancer: Pathology review
Dementia: Pathology review
Diabetes mellitus: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Heart failure: Pathology review
HIV and AIDS: Pathology review
Hyperthyroidism: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Lung cancer and mesothelioma: Pathology review
Malabsorption syndromes: Pathology review
Mood disorders: Pathology review
Tuberculosis: Pathology review

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Ecologic study

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A researcher is attempting to study the prevalence of type II diabetes mellitus amongst different countries. He finds that Western countries (e.g. the United States, Canada, Europe) tend to have higher rates of type II diabetes when compared to countries in Asia or Africa. Which of the following best describes this type of study design?  

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An ecological study is a study design that uses group-level or aggregate-level data to figure out if there is a potential association between two variables.

For example, let’s say you want to figure out if women that eat more fat have a higher risk of breast cancer.

Perhaps you have information about the average dietary fat intake per capita as well as breast cancer rates in 10 different countries.

You could plot this information on a graph with dietary fat intake on the x-axis and yearly incidence of breast cancer - which is the number of new cases of breast cancer in a year, per 100,000 women - on the y-axis.

In Japan, the dietary fat intake per capita is around 650 calories, and the incidence of breast cancer is 50 cases per 100,000 women.

On the flip side, in the United States the dietary fat intake per capita is around 1400 calories, and the incidence of breast cancer is 235 cases per 100,000 women.

The rest of the countries - Switzerland, Denmark, France, Norway, Australia, Spain, Hong Kong, and Romania - have an average fat intake and breast cancer rates somewhere between Japan and the U.S.

Generally, we can see that the more fat a country consumes, the higher the rate of breast cancer is for that country, and at this point we might conclude that eating more fat leads to breast cancer.

The problem with this conclusion is that we only have information from the whole country, and we don’t have information about each individual within that country.

In fact, we might get very different results from a study that uses individual-level data!

For example, let’s say you conduct a cohort study using individual-level data from all 10 countries.

Cohort studies look at individuals in a group who have a certain exposure, as well as individuals in a cohort who have not had that exposure, to compare their rates of a certain outcome in the future.

So, you could follow 500,000 individuals that have a high fat diet, the exposed group, and 500,000 individuals that have a low fat diet, the non-exposed group, for ten years.

Summary

An ecologic study is an observational study that examines the relationships between environmental exposures and health outcomes at the population level. This type of study can be used to identify potential risk factors for disease, but it cannot determine whether or not these risk factors actually cause disease. Ecologic studies are also limited by the fact that they cannot account for individual differences in exposure and susceptibility.