EPIDEMIOLOGY, PUBLIC HEALTH AND APPLIED BIOSTATISTICS. SUBJECT MATTER GUIDE Edition for the course

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1 EPIDEMIOLOGY, PUBLIC HEALTH AND APPLIED BIOSTATISTICS. SUBJECT MATTER GUIDE Edition for the course Descriptive facts Subject s Contents and Competences Contextualization Specific Competences General Competences Contents Formative activities Teaching methodologies Evaluation procedures Teaching schedule Resources

2 1. Descriptive facts Subject name: Epidemiology, Public Health and Applied Biostatistics Code: Degree: Dentistry Year when is taught: First ECTS number of credits: 6 Modality: Presential Normative prerequisites: N/A Recommended prerequisites: None Name of the teacher: Elena Pérez Izquierdo Mentorship slot: Monday 11:30 to 12:30 (by appointment) 2. Subject s Contents and Competences Contextualization. This subject is included in the first year of the studies plan and is a mandatory branch subject. Its general objective is teaching Epidemiology and Public Health as the scientific method to study the frequency and distribution of diseases in the population and the factors that motivate or condition their presentation, with a particular focus on oral health. 3. Specific Competences. Know the essential elements of the dental profession, including the ethical principles and the legal responsibilities. Develop an interest in research in health sciences and create the habit of using scientific publications and the critical awareness needed to understand and assess published epidemiological studies. 2

3 Know the design and utility of the main descriptive, analytical and experimental epidemiologic studies as well as the different basic statistical techniques available to carry them out. Relate the influence of the environment and the lifestyle to the populations health level. Understand the epidemiology of communicable diseases and the methods to prevent them, especially in the dental office. Know the epidemiology of chronic diseases of high prevalence and mortality and of the most frequent oral diseases. Become aware of the role of health professionals in the health education of the population. Know how to identify the patient s worries and expectations, as well as communicate in an effective and clear way with the patients, their relatives, the media and other professionals, orally and in writing. Know how to share information with other health professionals and how to work as a team. Identify, critically assess and know how to use clinical and biomedical information sources to obtain, organize, interpret and communicate scientific and health information. Know the scientific method and have critical awareness to assess the established knowledge and novel information. Be able to formulate hypothesis, collect and critically assess information for problem solving, following the scientific method. 3

4 4. General Competences. Responsibility and planning: the student must get involved and commit himself to the development of organized activities, managing his time adequately, because therefore he will achieve an important part of the learning objectives. Oral and in writing skills, both for a non-specialized and specialized audience: it is worked on in the class room from carrying out different individual and team practical work. Team work: The capacity of working cooperatively with others is developed, developing assertive skills in interpersonal relations, identifying oneself in a common project and committing to the objectives established by the group. Professionality in the application of his knowledge, elaboration and defense of arguments and solving of problems of the study area, by gathering and interpreting relevant data that will allow a critical reflection to make assessments. Autonomous learning by acquiring learning skills. Analysis and synthesis capacity, the first one understood as the reasoning method that allows to decompose complex situations in their constituting parts and also to assess other alternatives and perspectives to find optimal solutions, and the second one as the capacity of reducing complexity with the aim of understand it better and solve problems. Capacity to apply knowledge to practice. 4

5 5. Contents. PART I: FOUNDATIONS OF GENERAL EPIDEMIOLOGY Topic 1. Concept and determinants of health. Concepts of public health and community health. The Spanish health system. Topic 2. Health Demography Concept of demography and its use in public health Static and dynamic demography Birth, fertility and mortality rates and life expectancy Demography and populations health indicators. Topic 3. Epidemiology. Basic concepts Concept of epidemiology Utility of Epidemiology The epidemiologic method Descriptive and analytical (inferential) epidemiology Basic concepts in epidemiology: Concept of population and sample Concept of estimation. Confidence interval Concept of variable and types of variables. Topic 4. Disease frequency measures Most frequently used frequency measures Absolute values and relative to the size of the population values. 5

6 4.3. Incidence and prevalence Tabulation and graphical representation. Topic 5. Compared frequency of disease measures Central tendency measures: mean, median and mode Dispersion measures: range, mean deviation, variance, standard deviation and coefficient of variation Position measures: percentiles, quartiles and deciles Utility in epidemiology of each of the frequency measures. Topic 6. Probability applications. Sensitivity and specificity Concept of probability Random event Operations with events Conditional probability. Union and intersection of events probability. 6.5 Sensitivity and specificity. Their implications in the estimation of prevalence and screening. Topic 7. Risk factors and causality in Epidemiology Risk factors, markers and indicators Association and independence in epidemiology Types of association. Statistical significance Causality and causal models. Topic 8. Probability distributions Inferential epidemiology: 6

7 Probability distributions: normal distribution: characteristics, standard normal distribution, central limit theorem. Binomial distribution Parameters estimations: point estimates, properties of point estimates Distributions derived from the normal: Student s t, Fisher s F y Pearson s X 2. Topic 9. Hypothesis test. Compliance, homogeneity and independence tests. Topic 10. Types of epidemiological studies Cross-sectional or transversal studies. Utility, advantages and disadvantages Cohort studies. Utility, advantages and disadvantages Case-control studies. Utility, advantages and disadvantages Experimental studies. Clinical trials. Topic 11. Quality of epidemiological studies Validity and reliability of epidemiological studies Types of errors. 7

8 PART II. PUBLIC HEALTH, HEALTH PROTECTION AND HEALTH PROMOTION. Topic 12. Communicable diseases epidemiology and prevention Communicable diseases general epidemiology Communicable diseases prevention Sanitation methods. Disinfection and sterilization in the dental office Active and passive immunization. Vaccination programs. Topic 13. Epidemiology and prevention of diseases of high prevalence and mortality General characteristics of chronic diseases Cardiovascular diseases epidemiology and prevention Cancer epidemiology and prevention Chronic respiratory diseases epidemiology and prevention. Topic 14. Most frequent oral diseases epidemiology and prevention Tooth decay epidemiology Periodontal disease epidemiology. Topic 15. Life style and health Food and health Physical activity and health Tobacco and health Alcohol and health Drug dependency. 8

9 6. Formative activities. Methodology: MASTERCLASS: -Formative activities: Class presentations by the teacher that foster debate and students participation; bibliographic orientation. Methodology: PRACTICAL ACTIVITIES: -Formative activities: development of practical exercises that allow the application of theoretical concepts to different situations similar to those that will be encountered in the professional field, such as for example, analysis of scientific papers. Methodology: CASE STUDIES: -Formative activities: Team work on a public health case designed to study specifically the relationship between lifestyles and disease at a population level. 7. Teaching methodologies. Included as teaching methodologies are masterclasses, where students participation is fostered, and active methodologies, where problembased-learning and case-methods are developed. These last two techniques allow in addition to put into practice collaborative learning. Bibliographic support, actualized web resources and online tools are provided through the Blackboard platform (virtual campus) to carry out these activities. 8. Evaluation procedures. The evaluation will be carried out through the following procedures: 9

10 1. Knowledge objective tests: 40% of the final score. Two partial exams will be carried out: first partial exam (includes units 1 to 11 and makes a 25% of the final score) and second partial exam (units 12 to 14; it makes the remaining 15% of the score). All students will take the first and second partial exams. Those students who did not get a score of 5 or more in the first partial exam may take it again the day of the second partial exam. 2. Problems exercise: it will make 20% of the final score. 3. Active methodologies: (40% of the final score) a. Critical analysis of a paper. (20%) b. Case solving: (20%) The student must get a score of 5 or more in each of the five assessed parts of the subject (first partial exam, second partial exam, problems exercise, critical analysis of a paper and case solving). There is no compensation between the scores of the different parts. Both partial exams independent tests, in both of them the student must get a score of 5 or more. Plagiarism is not tolerated in this University. The student who has not passed a part (mark lower than 5) will have to retake it in an extraordinary call. In this case, the mark in the ordinary student s achievement record will be 4 or the corresponding mark if it is less than 4. If a student does not carry out an activity, does not hand out an assignment or does not take any objective tests or active methodologies sessions of compulsory attendance, he/she will be able to retake it in a period established by the teacher only if the cause of the absence is 10

11 justified and the teacher has been duly informed. Any student that does not present the corresponding written note for an absence will get an score of 0 in that test or activity. 9. Materials and other considerations Bibliography: Part I: Robert Nordness. Epidemiology and Biostatistics Secrets. Mosby, 2005 (copies available in the library). Bluman, Allan G. Elementary statistics : A Step By Step Approach. McGraw-Hill Higher, Ron Larson, Betsy Farber. Elementary statistics : picturing the world. Pearson, Fisher, Lloyd D Biostatistics : a methodology for the health sciences. John Wiley & Sons, Part II: Patrick L. Remington, Ross C. Brownson, Mark V. Wegner. Chronic disease epidemiology and control 3 rd ed. American Public Health Association, 2010 [electronic book in the library] Pubmed 11

12 10. Teaching schedule Approximate chronogram (subject to possible changes) September, October and November Units 1 to 11 will be explained at class. Week from the 14 th to the 18 th of November: Activity of critical reading of an article. 28 th of November: First partial exam and problems exercise. December The units of prevention of communicable diseases will be explained. Students will work in class on the public health case from the topics of prevention of chronic diseases. January Presentations of the solving of the public health case between the 10 th and the 13 th of January. 16 th of January: Second partial exam and retake of the first partial exam. 11. Resources. Needed resources to carry out and assess the different subject matter s activities will be published in the virtual campus (Blackboard), during the duration of the course. 12