Clinical Epidemiology Therapy, Prevention, Chance

CLINICAL EPIDEMIOLOGY :THERAPY, PREVANTION, CHANCE Therapy Therapeutic hypotheses are influenced by disease mechanisms at the cellular and molecular level, observations from clinical experts and epidemiological research aimed at populations that lead to disease prevention. The effect of therapy is sometimes less dramatic so that it is necessary to carry out formal testing of these drugs because of various conditions such as coincidences (coincidences), false comparisons, spontaneous changes in the course of the disease, etc. that affect the real relationship between therapy and effect (consequence)(Colonel et al., 2006). In general, research on therapy is specific research on the course of the disease. Observational research, namely cause control studies, crosssectional studies and cohort studies , is one way to assess therapy. The effects of therapy are: a) Effective therapy (Efficacy) is one that provides more benefits for those who receive the therapy. The effectiveness of a drug is determined by limiting it to only patients who are able to comply with the therapy given b) Successful therapy is (Effective) if the drug provides more good results for those who are offered to use the drug. Effectiveness is determined by offering a therapy program to a patient and allowing the patient to refuse or accept the program. Therapeutic interventions can be divided into four, namely therapy without treatment, which is a comparison carried out with basal conditions, patients who received therapy and those who did not.Observations generally tend to change the behavior patterns of research targets, not the effects of the treatment given. Placebo therapy is a treatment that is intended to be indistinguishable from the active components of physical therapy, color, taste, smell. This therapy does not have a specific mechanism of action. Regular therapy has shown good effects. Prevention Disease prevention currently being developed does not only focus on infectious diseases but also non-communicable diseases by optimizing clean and healthy living behavior (PHBS). a) Primary Prevention First level prevention (primary prevention)is an effort to make sick people healthy and healthy people stay healthy. Primary prevention efforts by providing health counseling or education. First level prevention is divided into two parts.Firstly, Health Promotion is a way of conveying or providing information to individuals or the community in preventing the occurrence of disease such as improving nutrition, the importance of a healthy lifestyle, improving environmental sanitation and so on.Both General and Specific Protection (general and special protection) are specifically for individuals or communities who have a high risk of a diseasecertain. b) Secondary Prevention This is prevention carried out with early diagnosis and treatment as soon as possible to prevent disease or health problems from getting worse by regularly carrying out general check-ups and monitoring illegal drugs. This is caused byLack of public knowledge and awareness regarding the importance of health means that many people do not want to have their health checked early. c) Tertiary Prevention It is an effort to prevent disease from getting worse and to minimize disability due to complications from existing health problems.Tertiary prevention can be done by perfecting treatment and follow-up care, mental, physical and spiritual rehabilitation so that they are able to reintegrate into society and be productive as before. The lack of awareness in society about the importance of health means that many of them no longer want to continue with advanced treatment and therapy. Chance In research and during treatment, patients will face problems of bias and change (opportunity). Chance can influence sample determination (clinical observations) which will cause errors in random measurements. In concluding research or in making decisions, deviations sometimes occur. These deviations are divided into false positives, which means that the treatment carried out has been effective, but the results of the research carried out conclude that the treatment carried out has not been effective. Meanwhile, a false negative means that there are no symptoms, but the examination results are declared positive (sick). If in a study a deviation (p) ÿ > 1 is found in more than five trials then the results are considered insignificant, high risk and unacceptable. Individual improvements can increase the risk of false positive results when a lot of data is compared.Inference statistics is a quantitative research that is based on assumptions about the mathematical characteristics of data, which takes into account the possibilities that research results can occur due to chance factors alone. The statistical test used is One Tailed, used when the assumption is in one direction, which assesses whether an intervention is harmless or can help the sufferer, and Two Tailed, used when the assumption is in two directions. For example, to assess the difference between treatments A and B and assess which treatment is better. Two tailed tests are less able to conclude whether a treatment is useful or not. The patient's adequacy number can be determined by a) Sample size Depends on the number of differences detected, in each sample. To find the differences ‒differences between the intervention group and the comparison group, for example the effect of treatment which only requires a small sample in the study. b) Alpha errors The number of samples is related to the risk of 'alpha error' which concludes that the treatment is working effectively even if the situation is not.The acceptable amount for the risk of alpha deviation, is based on value judgments. c) Beta error Possible deviations/errors obtained are based on considerations that are freely made and changed to suit the wishes of the researcher. d) Data characteristics The greater the incidence rate, the higher the statistical power for a particular risk. The greater the variation that exists between patients, the lower the statistical power