Meeting place and time: Biomed D205; Monday and Wednesdays 10:30 p.m. 11:45 p.m.

Transcription

1 PH310: Introduction to Epidemiology, Spring 2018 Meeting place and time: Biomed D205; Monday and Wednesdays 10:30 p.m. 11:45 p.m. Instructor: Thomas Lee, PhD Biomed D104H Office hours: By appointment only Course overview: This is a survey course to introduce students to epidemiologic principles and methods. Topics covered include: measures of morbidity and mortality; vital statistics; incidence and prevalence measurements; adjustment of rates; measurements of risk; biological variability; screening; measurements of error; sampling; statistical significance; surveillance; study design; association and causation; and outbreak investigation. Course format: The course methodology will include a combination of lectures, class discussions, exercises, student presentations, and short quizzes. Textbooks: The one required book is: Saracci R. Epidemiology: A Very Short Introduction. New York: Oxford University Press, Inc., A book of interest is: Pendergrast M. Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service. New York: Houghton Mifflin Harcourt Publishing Company, An optional book is: Porta M (Editor). A Dictionary of Epidemiology, 5 th edition. New York: Oxford University Press, Inc., A book that may be useful for those of you with limited experience with health statistics is: Woloshin S, Schwartz LM, and Welch HG. Know Your Chances: Understanding Health Statistics. Berkeley: University of California Press, I will refer to this book periodically throughout the course. Software: Two free epidemiologic software programs will be used to demonstrate key principles and methods. EpiInfo: Download from the Centers for Disease Control and Prevention website at: OpenEpi: Download from the OpenEpi website at:

2 Tentative schedule and class topics: Date Topic Assignments Due 1/8 Course Introduction & Overview 1/10 5 Major Areas of Epidemiology History of Epidemiology Student interest Epi Questionnaire Learning Styles 1/15 Holiday Martin Luther King Day 1/17 Define a Population of Interest Exercise Set 1 1/22 Conceptualize and create measures of exposures and health indicators What is a health indicator What are the different types of exposures 1/24 Estimate Measures of Disease Frequency between Exposures and Health Indicators of Interest 1/29 Estimate Measures of Disease Frequency between Exposures and Health Indicators of Interest Exercise Set 2 AND Exercise set 3 1/31 Estimate Measures of Disease Frequency between Exposures and Health Indicators of Interest Exercise Set 4 2/5 Review for Midterm 1 2/7 Midterm 1 2/12 Midterm 1 Review Age Adjustment 2/14 Age Adjustment Searching for Causes of Disease 2/19 Holiday Presidents Day 2/21 Establishing Causes of a Disease (Causal Criteria) Koch s Postulates Causal Pies 2/26 Absolute and Relative Measures of Risk Exercise Set 5 2/28 Types of Epidemiologic Studies Exercise set 6 Randomized Clinical Trials 3/5 Bias in Epidemiologic Studies Cohort Studies 3/7 Cohort Studies Exercise set 7 3/12 Introduce Final Project Criteria 3/14 ***Open Class*** 3/19 Midterm 2 3/21 Case Control Mapping Health and Disease 3/26-30 Spring Break No Classes 4/2 Mapping Health and Disease Sensitivity and Specificity 4/4 Review 4/9 ***Open Class*** 4/11 Final Presentations 4/16 Final Presentations

3 4/18 Final Presentations 4/23 Final Presentations 4/25 Final Presentations 4/30 Final Presentations 5/2 Review for Final Exam 5/8 Assigned Final Exam Date/Time Grading: Students will be graded on their performance on exercise sets (10%), presentations (20%), quizzes (10%) and two midterm examinations (30%), and a final quiz (30%). Material for the quizzes and midterms will be taken from the lectures, readings, and exercises. Grades will be assigned based on overall course percentage score: %: A %: C %: A 73-76%: C 90-92%: A %: C %: B %: B 80-82%: B- Course learning objectives Upon completion of the course, the student will be able to: 1. Define epidemiology and identify applications of the epidemiologic method. 2. Identify examples of primary, secondary, and tertiary prevention. 3. Describe the contribution of epidemiology to disease prevention and control. 4. Name several sources of population and disease information and identify the major errors inherent in them. 5. Define and interpret the following terms: validity, reliability, sensitivity, specificity, positive predictive value. 6. Name, apply, calculate and interpret commonly used public health rates. 7. Explain the need for rate adjustment; interpret adjusted rates. 8. Given a summary description of an analytic study: A. Select terms to describe the study design. B. Name and calculate appropriate rates, proportions, and measures of risk. C. Interpret the study results. D. Identify strengths, limitations, and potential sources of bias. 9. Identify three basic epidemiologic study designs and list the strengths and weaknesses in each.

4 10. Define information bias, selection bias, and confounding and give examples of each. 11. Given a causal hypothesis for a described health problem, select the most appropriate analytic study design to test the hypothesis. 12. Given disease frequency data in graphic or tabular form, interpret the findings and identify trends and patterns in disease occurrence. 13. Interpret trends and patterns in disease occurrence in terms of public health implications. 14. Correctly define and apply the basic vocabularies of infectious and chronic disease epidemiology. 15. Given data from a study of disease etiology, select the most plausible interpretation among several alternatives. 16. List and describe the criteria used to assess whether a statistically significant association between an independent and dependent variable is causal. 17. Differentiate causal, indirect, and artifactual associations, and give examples of each.

5 Core Epidemiologic Concepts (recommended for Epidemiology 101 course)* I. History, Philosophy, and Uses of Epidemiology Historical contributions and modern uses of epidemiology Development of epidemiologic thinking and placement of epidemiology in historical and modern perspective. Ethics and philosophy of epidemiology Appreciation of the links between epidemiology and broader ethical and philosophic traditions and concerns. II. Descriptive Epidemiology Condition, frequency, and severity The basic tools of epidemiologic analysis, including case definitions and populations, incidence, prevalence, and case-fatality rates. Data regarding disease or injuries Vital statistics, public health surveillance, and measures of health status, including methods for describing quantitatively the natural history, frequency, and changes in infectious and chronic diseases and injuries. Patterns of disease and injuries Application of the basic tools of epidemiology to generate hypotheses regarding person, place, and time; changes and differences in rates; exposures; incubation periods; and disease spread. III. Association and Causation Estimation Measures of strengths of association, graphical display of data, risk, relative risk/risk ratios, and attributable risk. Inference Concepts of statistical significance and confidence intervals Bias, confounding, and adjustment Identification of bias, confounding, and effect modification/interaction and methods to prevent and take into account their impact. Causation Risk factors and other determinants of diseases and conditions. IV. Analytic Epidemiology Basic epidemiologic study designs and their application to population health including: ecologic or population comparison, cross-sectional, case-control, and retrospective and prospective cohort. Experimental studies Randomized clinical trials and community trials and their applications to the efficacy and effectiveness of disease or injury etiology and the efficacy and effectiveness of interventions. V. Evidence-Based Public Health and Evidence-Based Recommendations Harm, benefit, and cost analyses Evidence-based decision analysis regarding risks, benefits, and cost-effectiveness of interventions. Intervention efficacy and effectiveness Evidence-based analyses of interventions' capacity for producing desired results and measurement of the accuracy or success of prevention and control efforts for diseases or injuries. VI. Applications to Policy and Basic and Clinical Sciences Outbreak investigation, testing, and screening Application of epidemiologic methods and basic and clinical science. Public health policy Application of results from investigations and analyses to influence policymaking. Special epidemiologic applications Molecular and genetic epidemiology, environmental and occupational health and safety, unintentional injury and violence prevention, and behavioral sciences. * Association of Schools of Public Health Undergraduate Public Health Learning Outcomes; July 14, 2011.

6 University Policies for Opportunity and Accommodation Equal Opportunity and Affirmative Policy The University of Hawai i is an equal opportunity/affirmative action institution and is committed to a policy of nondiscrimination on the basis of race, sex, gender identity and expression, age, religion, color, national origin, ancestry, citizenship, disability, genetic information, marital status, breastfeeding, income assignment for child support, arrest and court record (except as permissible under State law), sexual orientation, national guard absence, status as a covered veteran, pregnancy, and domestic or sexual violence victim status. This policy covers admission and access to and participation, treatment, and employment in the University s programs and activities. For more information on equal opportunity and affirmative action policies and complaint procedures for the UH Mānoa Campus, contact: Students: Lori Ideta, Assistant Vice Chancellor & Dean of Students, EEO/AA, Title IX & ADA Coordinator Ph (V/T); ideta@hawaii.edu Employees: Mie Watanabe, EEO/AA Director, Title IX & ADA Coordinator Ph ; -eeo@hawaii.edu Students with Disabilities: Ann Ito, KOKUA Program Director Ph (V/T); kokua@hawaii.edu Accommodations A student who may need an accommodation based on the impact of a disability is invited to contact me privately within the first weeks of the course. I would be happy to work with you and the KOKUA Program (Office for Students with Disabilities) to ensure reasonable accommodations in my course. KOKUA can be reached at or (voice/text) in room 013 of the Queen Liliuokalani Center for Student Services.