LA SIERRA UNIVERSITY Department of Health and Exercise Science Winter 2016 Course: HLSC 467 Principles of Epidemiology (3 units) Instructor: Khaled Bahjri, MD, DrPH, MPH (Assistant Professor) Office: 2016 Nichol Hall Loma Linda University Loma Linda, CA 92354 Phone: (909)558-4268 Ext 3 (909)435-9723 (Cell) E-mail: kbahjri@llu.edu Office Hours: Office hours by appointment Time: Tuesdays 6:30 9:20p.m. Location: HES Office Annex Room #1 Course Description: Distribution and determinants of health events in human populations. Assessments of environmental conditions, lifestyles, and other circumstances influencing disease. Measures of disease occurrence and frequency, and use of these measures in health care. Major types of epidemiological investigations. Interpretation of statistical associations. Study of how to read and critically evaluate scientific literature. Presentation of own literature study. Textbook (Recommended): An Introduction to Epidemiology (7 th ed), by Ray M. Merrill GRADING: Quizzes/labs: 20% Mid-term exam: 30% Oral presentation: 20% Final Exam: 30% Grades A-F will be assigned as follows: 93-100 = A 90-92.9 = A- 87-89.9 = B+ 83-86.9 = B 80-82.9 = B- 77-79.9 = C+ 70-76.9 = C 67-69.9 = C- 63-66.9 = D+ 60-62.9 = D 59.9 and Less = F 1
Quizzes and tests CANNOT be made up at a later time, unless a physicians statement is presented certifying illness at the time of the test. Failure to take a quiz, will automatically give a score of zero on that quiz. Failure to take the mid-term or final exam will jeopardize the student s chance of having the course approved. The University provides reasonable accommodations for students with documented physical or learning disabilities. Contact the Office of Disability Services for evaluation and guidance on such matters at (951) 785-2453. The office is located in La Sierra Hall, Suite 100. Students with such documented disabilities that require reasonable accommodations in order to participate in course activities or meet course requirements should contact the instructor during posted office hours or by appointment during the first two weeks of the quarter. COURSE LEARNING OUTCOMES Introduction to Epidemiology (HLSC 467) is a 3-unit course designed to provide a general introduction to the basic concepts and methods of epidemiology. After completing the course, students will be able to: 1. Explain the basic vocabulary, concepts and methods of epidemiology. 2. Discuss the development of epidemiology and the contribution of several historical examples of epidemiologic research to public health. 3. Describe the applications of epidemiology to the investigation of current public health problems and in clinical settings. 4. Calculate and interpret basic measures of disease occurrence in populations such as incidence, prevalence and other crude and specific measures of mortality and morbidity. 5. Calculate and interpret absolute and relative measures of effect including risk difference and relative risk. 6. Describe the basic methods for investigating and controlling an outbreak of a health problem in a community. 7. Describe the contribution of person, place, and time factors to the current understanding of disease causation. 8. Describe models of causation and the criteria for causal association. 9. Discuss the major types of study designs and their strengths and limitations. 10. Describe confounding and other common sources of bias and the methods used to control these biases. 11. Discuss the general principles and problems of mass screening for chronic diseases. 12. Define and calculate sensitivity, specificity, and predictive value positive and predictive value negative. 13. Critically read and interpret results of population research published in professional journals. 2
HLSC 467 Course Schedule Date Title Recommended Textbook Reading Jan 12 Orientation Introduction to Epidemiology Levels of Prevention Statistical Methods in Descriptive Epidemiology Merrill Ch. 1 Merrill Ch. 4 Jan 19 Quiz 1 Descriptive Epidemiology Population Health and Disease Indicators Jan 26 Quiz 2 Screening for Disease Review for Mid-term Exam Feb 02 Midterm Exam List and copies of Journal Articles Due Merrill Ch. 5 Merrill Ch. 6 Merrill Ch. 12 Feb 09 Quiz 3 Go over Midterm Overview of Study Designs Descriptive Study Designs Merrill Ch. 4 Feb 16 Quiz 4 Case-Control and Cohort Studies Merrill Ch. 7 Feb 23 Quiz 5 Experimental Studies Causation in Epidemiology Merrill Ch. 8 Merrill Ch. 9 Mar 01 Quiz 6 Data Interpretation, Bias and Confounding Merrill Ch. 7 Mar 08 Quiz 7 - Group Presentations Review for Final Exam Mar 15 Final Exam - 3
Instructions Research Project Presentations HLSC 467 1. Select your group members, group leader and research topic (email to the lecturer by January 19) a. There will be a maximum of 4 groups with 5 members per group at the most. b. Start to think now about your topic. See suggested topics below from which you can choose. c. Selection of topic will be on a first come first serve basis d. Each group will research a topic and critique 3 relevant and appropriate journal articles and give an oral presentation. 2. Research should be on human beings 3. Select 3 journal articles dated between 2010 and 2016 for critical review 4. A list and copies of journal articles (for approval by lecturer) are due on February 02 5. Journal articles should be complete studies NOT just REVIEWS 6. Choose a variety of study designs. Types of study designs include: a. Cross sectional studies b. Ecologic studies c. Case-control d. Cohort e. Randomized Trial 7. Each member of the group should participate in the presentation. 8. Presentations will be for 20 minutes per group with an additional 5 minutes for Q & A. 9. Information from presentations will be on the final. Suggested Topics 1. Ozone exposure and Parkinson s disease 2. Second-hand smoking and lung cancer 3. Dietary fat and breast cancer 4. Exercise and hypertension 5. Folate (Folic acid) and colon cancer 6. Ionizing radiation and leukemia among radiologists 7. Oral contraceptives and cervical cancer 8. Oral contraceptives and Hypertension 9. Alcohol and breast cancer 10. Cell phones and brain tumors 4
Oral Journal Presentation Format 1. Title 2. Background a. What is known about the topic at hand and what remains to be answered? b. Why is the research important and its influence on clinical and public health policies? c. Biological mechanism (pathophysiology) as to how the exposure is related to the 3. Study Aim(s) 4. Methods disease outcome. a. Type of study design b. Inclusion/Exclusion criteria c. Sample size d. Process of subjects selection e. Exposure assessment f. Follow up strategies g. Outcome assessment h. Other variables included in the study 5. Results a. Measures of effect b. Findings 6. Discussion a. Strengths and weaknesses b. Recommendation(s) 5
Group #: Group Members: Research Topic: Beginning Time: End Time: Introduction Evaluation Form for Oral Presentations Scale Scaled Score Background (3 Points) 1 2 3 4 5 6 7 8 9 10 Study Aim(s) (3 Points) 1 2 3 4 5 6 7 8 9 10 Methods Type of study design (5 Points) 1 2 3 4 5 6 7 8 9 10 Inclusion/Exclusion criteria (3 Points) 1 2 3 4 5 6 7 8 9 10 Sample size (3 Points) 1 2 3 4 5 6 7 8 9 10 Exposure assessment (3 Points) 1 2 3 4 5 6 7 8 9 10 Subjects selection/follow up strategies (3 Points) 1 2 3 4 5 6 7 8 9 10 Outcome assessment (3 Points) 1 2 3 4 5 6 7 8 9 10 Other variables included in the study (3 Points) 1 2 3 4 5 6 7 8 9 10 Results Measures of effect used by study (3 Points) 1 2 3 4 5 6 7 8 9 10 Findings using tables and graphs (10 Points) 1 2 3 4 5 6 7 8 9 10 Discussion Strengths and weaknesses (10 Points) 1 2 3 4 5 6 7 8 9 10 Recommendation(s) (3 Points) 1 2 3 4 5 6 7 8 9 10 Overall Presentation Audio Visual (powerpoint/video etc) (5 Points) 1 2 3 4 5 6 7 8 9 10 Time Frame (20 to 25 minutes) (5 Points) 1 2 3 4 5 6 7 8 9 10 Q & A (10 Points) 1 2 3 4 5 6 7 8 9 10 Total / 75 6