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Prevalence

 

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Prevalence



 
 
In epidemiology
Epidemiology

Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine....
, the prevalence of a disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
 in a statistical population
Statistical population

In statistics, a statistical population is a Set of entities concerning which statistical inferences are to be drawn, often based on a random sample taken from the population....
 is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. It is used as an estimate of how common a condition is within a population over a certain period of time. It helps physician
Physician

A physician, medical practitioner, doctor of medicine, or medical doctor practices medicine, and is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease and injury....
s or other health professionals understand the probability of certain diagnoses
Diagnosis

Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
 and is routinely used by epidemiologists
Epidemiology

Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine....
, health care
Health care

File:Ear surgery on a patient.jpgFile:Monoclonal antibodies3.jpgHealth care, or healthcare, refers to the treatment and management of illness, and the preservation of health through services offered by the Medicine, pharmaceutical, Dentistry, clinical laboratory sciences , nursing, and allied health professions....
 providers, government agencies, and insurance
Insurance

Insurance, in law and economics, is a form of risk management primarily used to Hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed small loss to prevent a large, possibly devastating los...
 companies.

Mathematically prevalence can be defined as follows

let a = the number of individuals in the population with the disease at a given time

let b = the number of individuals in the population at risk of developing the disease at a given time, not including those with the disease, since they are not at risk of developing it.
example, the was estimated by the U.






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In epidemiology
Epidemiology

Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine....
, the prevalence of a disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
 in a statistical population
Statistical population

In statistics, a statistical population is a Set of entities concerning which statistical inferences are to be drawn, often based on a random sample taken from the population....
 is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. It is used as an estimate of how common a condition is within a population over a certain period of time. It helps physician
Physician

A physician, medical practitioner, doctor of medicine, or medical doctor practices medicine, and is concerned with maintaining or restoring human health through the study, diagnosis, and treatment of disease and injury....
s or other health professionals understand the probability of certain diagnoses
Diagnosis

Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
 and is routinely used by epidemiologists
Epidemiology

Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine....
, health care
Health care

File:Ear surgery on a patient.jpgFile:Monoclonal antibodies3.jpgHealth care, or healthcare, refers to the treatment and management of illness, and the preservation of health through services offered by the Medicine, pharmaceutical, Dentistry, clinical laboratory sciences , nursing, and allied health professions....
 providers, government agencies, and insurance
Insurance

Insurance, in law and economics, is a form of risk management primarily used to Hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed small loss to prevent a large, possibly devastating los...
 companies.

Mathematically prevalence can be defined as follows

let a = the number of individuals in the population with the disease at a given time

let b = the number of individuals in the population at risk of developing the disease at a given time, not including those with the disease, since they are not at risk of developing it.

Examples and Utility

For example, the was estimated by the U. S. Centers for Disease Control (CDC)
Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention is an agency of the United States United States Department of Health and Human Services based in Atlanta, Georgia, United States adjacent to the campus of Emory University and northeast of downtown Atlanta....
 at approximately 20.9%. In plain English, "prevalence" simply means "extent", but in scientific English it means "proportion" (typically expressed as a percentage).

Prevalence is distinct from incidence
Incidence (epidemiology)

Incidence is a measure of the risk of developing some new condition within a specified period of time. Although sometimes loosely expressed simply as the number of new cases during some time period, it is better expressed as a proportion or a rate with a denominator....
. Prevalence is a measurement of all individuals affected by the disease within a particular period of time, whereas incidence is a measurement of the number of new individuals who contract a disease during a particular period of time.

To illustrate, a long term disease that was spread widely in a community in 2002 will have a high prevalence at a given point of 2003 (assuming it has a long duration) but it might have a low incidence rate during 2003 (i.e. lots of existing cases, but not many new ones in that year). Conversely, a disease that is easily transmitted but has a short duration might spread widely during 2002 but is likely to have a low prevalence at any given point in 2003 (due to its short duration) but a high incidence during 2003 (as many people develop the disease). As such, prevalence is a useful parameter when talking about long lasting diseases, such as HIV
HIV

Human immunodeficiency virus is a lentivirus that can lead to AIDS , a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections....
, but incidence is more useful when talking about diseases of short duration, such as chickenpox
Chickenpox

Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus . It generally begins with a vesicular skin rash appearing in two or three waves, mainly on the body and head rather than the hands and becoming itchy raw pockmarks, small open sores which heal mostly without scarring....
.

Lifetime prevalence (LTP) is the number of individuals in a statistical population that at some point in their life (up to the time of assessment) have experienced a "case" (e.g., a disorder), compared to the total number of individuals (i.e. it is expressed as a ratio or percentage). Often, a 12-month prevalence (or some other type of "period prevalence") is used in conjunction with lifetime prevalence. There is also point prevalence, the prevalence of disorder at a more specific (a month or less) point in time. There is also a related figure lifetime morbid risk - the theoretical prevalence at any point in life for anyone, regardless of time of assessment. (example: )

Limitations


To simplify, it can be said that a very small error applied over a very large number of individuals (that is, those who are *not affected* by the condition in the general population during their lifetime; for example, over 95%) produces a relevant, non-negligible number of subjects who are incorrectly classified as having the condition or any other condition which is the object of a survey study: these subjects are the so-called false positives; such reasoning applies to the 'false positive' but not the 'false negative' problem where we have an error applied over a relatively very small number of individuals to begin with (that is, those who are *affected* by the condition in the general population; for example, less than 5%). Hence, a very high percentage of subjects who seem to have a history of a disorder at interview are false positives for such a medical condition and apparently never suffered a fully clinical
Clinical

Clinical can refer to:...
 syndrome
Syndrome

In medicine and psychology, the term syndrome refers to the association of several clinically recognizable features, sign , symptoms , phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others....
.

A different but related problem in evaluating the public health significance of psychiatric conditions has been highlighted by Robert Spitzer
Robert Spitzer (psychiatrist)

Dr. Robert L. Spitzer is a Professor of Psychiatry at Columbia University in New York City, United States and is on the research faculty of the Columbia University Center for Psychoanalytic Training and Research....
 of Columbia University
Columbia University

Columbia University in the City of New York , is a private university in the United States and a member of the Ivy League. Columbia's main campus lies in the Morningside Heights, Manhattan neighborhood in the borough of Manhattan, in New York City....
: fulfillment of diagnostic criteria and the resulting diagnosis
Diagnosis

Diagnosis is the identification of the nature of anything, either by process of elimination or other analytical methods. Diagnosis is used in many different disciplines, with slightly different implementations on the application of logic and experience to determine the cause and effect relationships....
 do not necessarily imply need for treatment.

See also

A well-known statistical problem arises when ascertaining rates for disorders and conditions with a relatively low population prevalence or base-rate. Even assuming that lay interview diagnoses are highly accurate in terms of sensitivity and specificity and their corresponding area under the ROC curve (that is, AUC, or area under the receiver operating characteristic
Receiver operating characteristic

In signal detection theory, a receiver operating characteristic , or simply ROC curve, is a graph of a functionical plot of the Sensitivity vs....
 curve), a condition with a relatively low prevalence or base-rate is bound to yield high false positive
Type I and type II errors

In statistics, the terms Type I error and type II error are used to describe possible errors made in a statistical decision process. In 1928, Jerzy Neyman and Egon Pearson , both eminent statisticians, discussed the problems associated with "deciding whether or not a particular sample may be judged as likely to have been randomly dr...
 rates, which exceed false negative
Type I and type II errors

In statistics, the terms Type I error and type II error are used to describe possible errors made in a statistical decision process. In 1928, Jerzy Neyman and Egon Pearson , both eminent statisticians, discussed the problems associated with "deciding whether or not a particular sample may be judged as likely to have been randomly dr...
 rates; in such a circumstance a limited positive predictive value
Positive predictive value

The positive predictive value, or precision rate, or post-test probability of disease, is the proportion of patients with positive test results who are correctly diagnosed....
, PPV, yields high false positive rates even in presence of a specificity which is very close to 100%.

  • Incidence
    Incidence (epidemiology)

    Incidence is a measure of the risk of developing some new condition within a specified period of time. Although sometimes loosely expressed simply as the number of new cases during some time period, it is better expressed as a proportion or a rate with a denominator....
  • Rare disease
    Rare disease

    A rare disease has such a low prevalence in a population that a physician in a busy general practice would not expect to see more than one case a year....


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