Ukuran Penyakit

(Measures of Disease Occurence)

Bony Wiem Lestari
Departemen Epidemiologi & Biostatistik
2015

Pemilihan ukuran penyakit

1. Ditentukan oleh desain studi (cross-sectional,
case-control, cohort)
2. Ditentukan oleh pertanyaan penelitian
(research questions)

Menghitung frekuensi penyakit

Why is a simple count not enough?
Three cases of cancer per year from a city of 1,000 people is
very different than 3 cases per year from a city of 100,000
people

So, in epidemiology we must know:

the size of the population from which the
affected individuals come, and
the time period the information was collected.

Closed Cohort Study

Type of population: fixed (membership is permanent)

Cumulative
incidence in
exposed =
X1/N1

Cumulative
incidence in
unexposed =
X0/N0

Dynamic Cohort Study

Type of population: dynamic (membership is transitory)

Incidence
rate in
exposed =
X1/P1
Incidence
rate in
unexposed =
X0/P0

Menghitung frekuensi penyakit

Types of
calculations
Ratio
Proportion

Rate

Types of Calculations
Characteristics
Division of two unrelated numbers
Division of two related numbers;
numerator is a subset of
denominator

Division of two numbers; time is

always in denominator

Menghitung frekuensi penyakit

Rate =

Number of events in a specified time period

Average population during the time period

***the measure of time is a critical part of a rate!

Such as, the number of newly diagnosed cases of

breast cancer per 100,000 women during 1999.

Incidence Rate
The number of new events (cases) divided by the
amount of person time in the base population. It can be
measured in closed or open populations. It is often
restricted to include a maximum of one event per
person.
= number of new events in a specified period
number of persons exposed to risk during this period
Units = must always include a unit of time, example:
cases per 100.000 person years

Incidence Proportion
or Cumulative Incidence
The average risk for a population
The probability that individuals in the population get the
disease during the specified period
It is measured only in closed population
= number of people who get a disease during a specified period
number of people free of the disease in the population at risk at
the beginning of the period

Prevalence
Point prevalence
The proportion of a population that has disease at
given a specified point on the time scale.
Period Prevalence/ Interval prevalence
The total number of persons known to have had the
disease or attribute at any time during specified
period.
Annual Prevalence

Perbedaan Incidence & Prevalence

Measure

Type of
number

Units

Range

Type of cases

Major uses

Cumulative
Incidence

Proportion

None

0 to 1

New

Research on
causes,
incidence,
prevention,
and treatment
of disease

Incidence
rate

True rate

1/time

0 to infinity

New

Research on
causes,
prevention,
and treatment
of disease

Prevalence

Proportion

None

0 to 1

Existing

Resource
planning

Exercise
Point
Prevalence
at T1 ?
Cumulative
incidence
from T0T1?
Incidence
rate from
T0-T1?

Answer:

1. Point Prevalence at T1 ?
= = 0.5
2. Cumulative incidence from T0-T1?
= 3/5 = 0.6
3. Incidence rate from T0-T1?
= 3/(5+1+4+3+1)=3/14 = 0.21 cases per year

THE INCIDENCE CHARACTERISTICS

1. Indicated for the new events or cases occurred in
the population
2. A fundamental tool in etiological study of disease
3. Act as direct indicator of the risk of getting sick
(the probability of getting sick)
4. The change in incidence rate means the change of
etiological balance
5. The Incidence Rate obtained accurately by cohort
study

THE CHARACTERISTICS OF PREVALENCE

1. The subjects are all cases / events in population
2. Depend on the incidence and duration of the
disease
3. The low Prevalence Rate because of low incidence,
short duration of disease or fast cured of the
disease
4. Therapy to prevent the death but can not omit the
disease might increasing the prevalence of the
disease

THE CHARACTERISTICS OF PREVALENCE

5. In chronic disease the prevalence = I x D
6. It is useful to describe the chronic disease
7. It is an important and useful measure of the burden
of disease in a community
8. Determined by a single survey (cross sectional
study)
9. It is valuable for planning health services.

Prevalence, Incidence and Mean

duration of illness