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Incidence (epidemiology) Wiki2Web Clarity Challenge

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Study Guide: Epidemiological Measures: Incidence and Prevalence

Cheat Sheet:
Epidemiological Measures: Incidence and Prevalence Study Guide

Core Concepts: Incidence and Prevalence

In epidemiological studies, incidence is defined as a measure that quantifies the occurrence of *new* cases of a medical condition within a defined population over a specific period, rather than the total number of existing cases at a single point in time.

Answer: False

Explanation: Incidence measures the rate at which new cases of a condition arise in a population over a specified time interval. The measure that quantifies existing cases at a particular point in time is known as prevalence.

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Prevalence measures the rate at which new cases occur, while incidence measures the proportion of existing cases.

Answer: False

Explanation: This statement incorrectly defines both terms. Incidence measures the rate of *new* cases over time, reflecting risk. Prevalence measures the proportion of *existing* cases at a specific point in time, reflecting disease burden.

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Incidence measures the 'stock' of existing cases in a population, while prevalence measures the 'flow' of new cases.

Answer: False

Explanation: This statement reverses the definitions. Incidence measures the 'flow' of new cases over time, reflecting risk. Prevalence measures the 'stock' of existing cases at a specific point in time, reflecting burden.

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Incidence measures the ongoing risk of disease, while prevalence reflects the current disease burden.

Answer: True

Explanation: This statement accurately distinguishes the two measures: incidence quantifies the rate of new occurrences (risk), while prevalence quantifies the total existing cases at a point in time (burden).

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Incidence measures the proportion of the population that has a disease at a single point in time.

Answer: False

Explanation: This definition describes prevalence, not incidence. Incidence measures the rate of *new* cases occurring over a period, reflecting risk, while prevalence measures existing cases at a specific point in time, reflecting burden.

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What fundamental difference distinguishes incidence from prevalence?

Answer: Incidence measures risk over time; prevalence measures burden at a point in time.

Explanation: Incidence quantifies the rate of new cases (risk) over a period, while prevalence quantifies the total existing cases at a specific moment (burden).

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Which of the following best describes the relationship between incidence and prevalence?

Answer: Incidence measures the rate of new cases (risk), while prevalence measures existing cases (burden).

Explanation: Incidence quantifies the rate at which new cases occur over time (risk), whereas prevalence quantifies the total number of existing cases at a specific point in time (burden).

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Incidence: Quantifying New Disease Occurrence

An increase in incidence suggests that factors contributing to the disease's occurrence are becoming less common.

Answer: False

Explanation: An increase in incidence typically indicates that factors promoting the disease's occurrence, such as exposure to risk factors or changes in susceptibility, are becoming more prevalent or active within the population.

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The phrase 'chance over time of a medical condition' refers to the concept of prevalence.

Answer: False

Explanation: The phrase 'chance over time of a medical condition' accurately describes incidence, as it quantifies the probability (chance) of a new case arising within a population over a specified duration (time).

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In incidence calculations, individuals already possessing the condition at the study's start are included as new cases.

Answer: False

Explanation: Incidence specifically measures *new* cases that develop during the study period. Individuals who already have the condition at the beginning of the study are excluded from the numerator for incidence calculations.

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Public health utilizes incidence calculations primarily to track historical disease patterns rather than current risks.

Answer: False

Explanation: Public health utilizes incidence calculations not only for historical tracking but critically for monitoring current disease risks, identifying outbreaks, and evaluating the effectiveness of interventions in real-time.

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The term 'medical condition' in incidence definitions is restricted to infectious diseases.

Answer: False

Explanation: The term 'medical condition' in the context of incidence is broad and encompasses any disease, illness, injury, or health-related event being studied, not exclusively infectious diseases.

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Incidence helps understand the risk of contracting a disease.

Answer: True

Explanation: Incidence, particularly incidence proportion, directly estimates the probability or risk of an individual developing a disease within a specified period, thus providing crucial insight into disease risk.

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Which epidemiological measure quantifies the occurrence of *new* cases of a disease within a specific population and timeframe?

Answer: Incidence

Explanation: Incidence is the epidemiological measure specifically designed to quantify the rate at which new cases of a disease emerge within a population over a defined period.

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If the number of new cases of a disease increases in a population, what does this primarily suggest?

Answer: Factors promoting the disease's occurrence are likely increasing.

Explanation: An increase in incidence signifies a rise in the rate of new cases, which typically suggests an increase in the prevalence or impact of factors contributing to the disease's occurrence.

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Incidence Proportion (Cumulative Incidence)

Incidence proportion, also referred to as cumulative incidence, serves as an estimate of the probability that an individual within a population will develop a specific disease or experience a particular health event during a defined time period.

Answer: True

Explanation: Incidence proportion (cumulative incidence) is calculated as the number of new cases over a period divided by the total population at risk during that period, thereby representing the probability of developing the disease within that timeframe.

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The formula for incidence proportion is (Number of subjects developing the disease) / (Total person-time at risk).

Answer: False

Explanation: The formula for incidence proportion is the number of subjects developing the disease divided by the total number of subjects followed over the period. The formula provided, using 'Total person-time at risk,' is characteristic of incidence rate.

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In the provided example, if 28 out of 1,000 individuals develop a condition over two years, the incidence proportion is 2.8% for that period.

Answer: True

Explanation: The calculation for incidence proportion is (28 new cases / 1,000 individuals) = 0.028, which equates to 2.8% over the two-year period.

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Incidence proportion requires tracking the exact time each individual leaves the study, whereas incidence rate does not.

Answer: False

Explanation: Incidence proportion requires that all individuals are observed for the entire study period. Incidence rate, conversely, utilizes 'person-time' and can accommodate varying lengths of follow-up, thus not requiring exact exit times for all participants.

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Cumulative incidence is another term for incidence rate.

Answer: False

Explanation: Cumulative incidence is synonymous with incidence proportion, not incidence rate. Incidence proportion estimates the probability of developing a disease over a period, while incidence rate measures the speed of new cases per unit of person-time.

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Incidence proportion is also known as cumulative incidence.

Answer: True

Explanation: The terms 'incidence proportion' and 'cumulative incidence' are used interchangeably in epidemiology to refer to the probability of developing a disease within a specified period.

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Incidence proportion is calculated by dividing new cases by the total population at the beginning of the period.

Answer: True

Explanation: Incidence proportion (cumulative incidence) is calculated as the number of new cases occurring during a period divided by the total number of individuals at risk at the start of that period.

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What does incidence proportion, or cumulative incidence, estimate?

Answer: The probability that an individual will develop a disease within a specified period.

Explanation: Incidence proportion (cumulative incidence) estimates the probability of an individual developing a disease within a defined time frame, representing the proportion of the population affected over that period.

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Which term refers to the probability of an event occurring within a specified period?

Answer: Incidence Proportion

Explanation: Incidence proportion, also known as cumulative incidence, directly estimates the probability or risk of an event, such as disease occurrence, within a specified time frame.

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What is the main difference in data requirements between incidence proportion and incidence rate?

Answer: Incidence proportion requires complete follow-up for all subjects.

Explanation: Incidence proportion necessitates that all individuals in the cohort are observed for the entire specified period. Incidence rate, utilizing person-time, can accommodate varying follow-up durations.

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Incidence Rate and Person-Time Methodology

Incidence rate measures new cases relative to the total time individuals in the population were at risk.

Answer: True

Explanation: Incidence rate is calculated by dividing the number of new cases by the total person-time contributed by the population at risk, thereby accounting for the duration of observation for each individual.

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A key limitation of incidence rate is that it requires all subjects to be observed for the entire study duration.

Answer: False

Explanation: Conversely to the statement, a primary advantage of incidence rate is its ability to accommodate varying lengths of follow-up time for individuals, unlike incidence proportion which requires complete observation for all subjects.

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The 'person-years' concept is used to calculate prevalence, accounting for varying observation times.

Answer: False

Explanation: The 'person-years' concept is integral to the calculation of incidence *rate*, as it accounts for the total time individuals were observed while at risk. Prevalence calculations typically use the total population size at a specific point in time.

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In the HIV example, new cases identified at the 10-year mark were assumed to have contracted the disease at year 7.5 for person-years calculation.

Answer: True

Explanation: The methodology employed in the HIV example assumed that new cases identified at the 10-year follow-up (who were disease-free at the 5-year mark) contracted the disease approximately halfway between the 5- and 10-year marks, i.e., at 7.5 years, for the purpose of calculating person-years.

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The final incidence rate in the HIV example was 28 cases per 1,000 population per year, indicating the annual risk.

Answer: True

Explanation: The calculated incidence rate for HIV in the example was indeed 28 cases per 1,000 population per year, which accurately represents the annual risk of developing the disease within that population cohort.

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The 'total time at risk' in incidence rate calculations sums the duration each individual was susceptible to the disease.

Answer: True

Explanation: The 'total time at risk,' often expressed in person-years, represents the cumulative duration that individuals in the study population were observed and susceptible to the disease being measured. This forms the denominator for incidence rate.

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The term 'person-years' represents the total number of individuals in a study population.

Answer: False

Explanation: 'Person-years' is not simply the count of individuals. It represents the sum of the time periods (in years) that each individual in the study population was observed and remained at risk for the condition.

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The actuarial method assumes new cases occur at the midpoint between follow-up times if the exact time is unknown.

Answer: True

Explanation: The actuarial method, used in incidence rate calculations, simplifies the estimation of person-time by assuming that if a case occurs between two observation points, the event occurred at the midpoint of that interval.

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The 'total time at risk' normalizes the number of new cases by the total exposure time across the population.

Answer: True

Explanation: The 'total time at risk' serves as the denominator in incidence rate calculations, effectively normalizing the count of new cases by the cumulative time individuals were susceptible and observed, thus providing a standardized measure of risk.

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Incidence rate calculation requires that all individuals in the population are followed for the exact same duration.

Answer: False

Explanation: This requirement applies to incidence proportion. Incidence rate, by utilizing person-time, is designed to accommodate varying lengths of follow-up for individuals within the study population.

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The 'person-years' concept allows incidence rates to be calculated even when participants enter or leave the study at different times.

Answer: True

Explanation: The 'person-years' metric is specifically designed to aggregate the total time individuals were observed while at risk, enabling the calculation of incidence rates even in studies with staggered entry or exit of participants.

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The 'total time at risk' is the sum of the time each individual was disease-free and potentially exposed.

Answer: True

Explanation: The 'total time at risk' in incidence rate calculations aggregates the duration each individual was observed and susceptible to the disease, forming the denominator for the rate.

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How is incidence rate calculated?

Answer: Number of new cases divided by the total person-time at risk.

Explanation: Incidence rate is calculated by dividing the number of new cases of a disease by the total person-time at risk accumulated by the population under study.

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Which of the following is a key advantage of incidence rate over incidence proportion?

Answer: It can be used even when participants have varying lengths of follow-up time.

Explanation: A significant advantage of incidence rate is its ability to accommodate varying follow-up times for participants, unlike incidence proportion which requires complete observation for all individuals.

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What does the 'person-years' metric represent in epidemiological calculations?

Answer: The total time individuals were observed while at risk for a condition.

Explanation: Person-years is a measure representing the sum of the time periods (in years) that each individual in a study population was observed and remained at risk for developing the condition of interest.

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In the HIV example, how was the time of infection estimated for new cases identified between follow-ups?

Answer: Assumed to be at the midpoint between follow-up times.

Explanation: For new cases identified between scheduled follow-ups in the HIV example, the time of infection was estimated to be at the midpoint between those follow-up intervals to facilitate person-years calculation.

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The calculation of incidence rate uses 'total time at risk', which is:

Answer: The sum of time each individual was observed and susceptible.

Explanation: The 'total time at risk' in incidence rate calculations is the aggregate of the time each individual was observed and remained susceptible to the disease, often referred to as person-time.

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The actuarial method for calculating incidence rate simplifies calculations by:

Answer: Using the midpoint time between observations for interval cases.

Explanation: The actuarial method simplifies the calculation of person-time by assuming that individuals who develop the disease between two follow-up points contracted it at the midpoint of that interval, thereby estimating their contribution to total person-time.

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Prevalence: Assessing Disease Burden

Prevalence provides insight into the overall disease burden on society at a given moment.

Answer: True

Explanation: Prevalence measures the proportion of existing cases in a population at a specific point in time, thus directly reflecting the current disease burden and its impact on healthcare systems and society.

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In the HIV example, prevalence was calculated by summing all cases (new and old) and dividing by the total population studied at the end of the period.

Answer: True

Explanation: The HIV example illustrates that prevalence is determined by summing all identified cases (initial cases plus new ones) and dividing by the total population size at the conclusion of the study period.

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Prevalence measures the rate at which new cases occur in a population over a specific period.

Answer: False

Explanation: This statement describes incidence, not prevalence. Prevalence measures the proportion of existing cases (both new and old) within a population at a specific point in time.

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Which measure indicates how widespread a disease is within a population at a specific moment?

Answer: Prevalence

Explanation: Prevalence is the epidemiological measure used to determine how widespread a disease is within a population at a particular point in time, reflecting the total existing cases.

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The HIV example calculated prevalence by summing all identified cases and dividing by:

Answer: The total population sample size.

Explanation: In the HIV example, prevalence was calculated by dividing the total number of identified cases (both initial and newly diagnosed) by the total population size studied at the end of the observation period.

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Epidemiological Applications and Etiology

The relationship 'prevalence = incidence × duration' is always accurate, regardless of disease characteristics.

Answer: False

Explanation: This relationship is an approximation that holds most accurately under specific conditions, such as stable incidence and constant disease duration. It is less reliable when these factors vary significantly, particularly in age-specific dynamics.

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A disease with a short duration is likely to have a low prevalence, even if its incidence is high.

Answer: True

Explanation: If a disease resolves quickly (short duration), the number of existing cases at any given time will be limited, leading to a lower prevalence, even if new cases are occurring frequently (high incidence).

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Changes in prevalence are more direct indicators of disease etiology than changes in incidence.

Answer: False

Explanation: Incidence is generally considered a more direct indicator of disease etiology. Changes in incidence rates can more readily reflect the impact of specific risk factors or environmental changes that influence the occurrence of new cases.

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Incidence is less relevant for studying disease etiology compared to prevalence.

Answer: False

Explanation: Incidence is generally considered more relevant for studying disease etiology. Changes in incidence rates can more directly signal the impact of specific risk factors or environmental changes that influence the occurrence of new cases.

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The relationship 'prevalence = incidence × duration' implies that prevalence is independent of disease duration if incidence is constant.

Answer: False

Explanation: The relationship 'prevalence = incidence × duration' implies that prevalence is directly proportional to disease duration when incidence is constant. A longer duration leads to higher prevalence, assuming stable incidence.

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The relationship 'prevalence = incidence × duration' is generally reliable for age-specific disease dynamics.

Answer: False

Explanation: The approximation 'prevalence = incidence × duration' is less reliable for age-specific disease dynamics, as incidence and duration often vary considerably across different age groups, complicating the direct relationship.

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A disease with a long duration typically contributes less to prevalence than a disease with a short duration, assuming similar incidence.

Answer: False

Explanation: Conversely, a disease with a long duration typically contributes *more* to prevalence than a disease with a short duration, assuming similar incidence rates. This is because cases persist longer in the population.

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A disease with high incidence and short duration will likely have a high prevalence.

Answer: False

Explanation: A disease with a short duration, even if incidence is high, tends to have a low prevalence because cases resolve quickly and do not accumulate in the population over time.

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The relationship 'prevalence = incidence × duration' is most accurate when disease duration varies greatly among individuals.

Answer: False

Explanation: This approximation is most accurate when disease duration is relatively constant among individuals. Significant variation in duration complicates the relationship and reduces its accuracy.

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Under which condition is the relationship 'prevalence ≈ incidence × duration' most likely to hold true?

Answer: When the disease has a relatively constant incidence and average duration.

Explanation: The approximation 'prevalence = incidence × duration' is most accurate when the incidence rate remains stable and the average duration of the disease is consistent across the population.

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A disease characterized by a long duration, even with low incidence, can lead to:

Answer: High prevalence

Explanation: A disease with a long duration means that individuals remain affected for extended periods. This accumulation of cases, even with a low rate of new occurrences (incidence), can result in a high overall prevalence.

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For studying the causes of a disease (etiology), which measure is generally more informative?

Answer: Incidence

Explanation: Incidence is generally more informative for studying disease etiology because changes in the rate of new cases can more directly reflect the influence of specific risk factors or environmental changes affecting disease occurrence.

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The relationship 'prevalence = incidence × duration' is less reliable for:

Answer: Age-specific prevalence and incidence.

Explanation: The approximation 'prevalence = incidence × duration' is less reliable for age-specific calculations because incidence and duration often vary significantly across different age groups, violating the assumption of constancy.

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Why is incidence particularly useful for studying disease etiology?

Answer: Changes in incidence can directly signal the impact of specific risk factors.

Explanation: Incidence is highly valuable for etiological studies because changes in the rate of new cases can directly indicate shifts in the influence of specific risk factors or environmental exposures within a population.

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If a disease has a high incidence but resolves quickly (short duration), what is its likely prevalence?

Answer: Low, because cases do not persist long.

Explanation: A disease with a short duration means that individuals recover or are no longer affected quickly. Consequently, even with a high rate of new cases (incidence), the number of existing cases at any given time (prevalence) will likely remain low.

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Ancillary Data and Case Studies

The video caption mentioned in the source describes trends in Dengue fever incidence rates in Thailand from 2002 to 2008.

Answer: False

Explanation: The source material indicates that the video caption pertains to Dengue fever incidence rates in Cambodia, not Thailand, covering the period from 2002 to 2008.

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The 'References' section contains links to external websites offering practical tools for epidemiological analysis.

Answer: False

Explanation: The 'References' section lists the sources cited within the article. Practical tools for epidemiological analysis are typically found in the 'External links' section.

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The 'More citations needed' template suggests that parts of the article lack verification from reliable sources.

Answer: True

Explanation: The 'More citations needed' template is a standard marker indicating that specific claims or sections within an article require additional sourcing from verifiable, reliable references to ensure accuracy and credibility.

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The 'Authority control' section provides standardized identifiers to help uniquely identify the article's subject.

Answer: True

Explanation: The 'Authority control' section typically contains standardized identifiers (like GND, LCCN, etc.) that help uniquely identify the subject of the article across various databases and catalogs, ensuring consistency in information management.

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The 'GND' identifier in the Authority control section refers to a global disease surveillance network.

Answer: False

Explanation: GND stands for 'Gemeinsame Normdatei' (Common Normdatei), which is a standardized authority file used for cataloging entities, not a disease surveillance network.

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The HIV example showed a prevalence of 33% and an incidence rate of 28 per 1,000 population per year.

Answer: True

Explanation: The HIV case study presented reported a prevalence of 33% and an incidence rate of 28 cases per 1,000 population per year, illustrating the application of these epidemiological measures.

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The Dengue fever example illustrates changes in prevalence over time.

Answer: False

Explanation: The Dengue fever example, as described by the video caption, illustrates changes in *incidence rates* over time, not prevalence.

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The template 'More citations needed' indicates:

Answer: Additional sources are required to verify the content.

Explanation: The 'More citations needed' template serves as a notification that specific information within the article requires verification through the addition of citations from reliable sources.

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