Universitat Internacional de Catalunya
Introduction to Epidemiology
Teaching staff
Students may ask lecturers questions at the end of each class. For inquiries outside of class time, students must make an appointment by email:
Coordinador: Dr. Carlos Gª Forero (cgarciaf@uic.es)
Jorge Piqueras Marqués (jpiqueras@uic.es)
Introduction
Health and disease are not random phenomena. Their patterns can be identified even before having knowledge of pathophysiological mechanisms. Such knowledge is possible by identifying population patterns and comparisons among groups of people according to hypotheses. The discipline providing the methodology to determine these patterns is Epidemiology.
Epidemiology is a scientific method of reasoning about causes and effects that, unlike clinical medicine, addresses the relationships between causes and health outcomes in groups. Thus, it makes it possible to analyze the natural course of diseases that allows establishing etiological hypotheses. This provides the basis for developing and evaluating promotion and prevention programs in groups.
The main role of the epidemiologist is the design of scientific research and its application in public health. In this course, students will learn basic epidemiological methods and their applications. In this course, we will understand how to apply and interpret epidemiological methods for health promotion, prevention, and clinical practice.
During the course, we will present descriptive and analytical epidemiology, and basic study designs, including randomized trials, case-control studies, and cohort-based studies. We will learn how to measures risk and methods for controlling bias and confusion to ensure causally valid and generalizable interpretations.
The course follows the framework curricula of the Association for Prevention Teaching and Research (APTR). This will enable students to critically appraise epidemiological information and will lay the foundations for Clinical Epidemiology and Public Health.
Pre-course requirements
It is required to have taken the course Biostatistics.
Objectives
1) Describing the identifiable causes of disease using population pattern analysis, group comparisons, and individual monitoring as core epidemiology methods.
2) Understanding health and illness as determined phenomena, with detectable patterns that can be looked for and surveyed.
3) Designing hypotheses to determine the association between exposure and health outcomes, comparing disease frequencies as a function of exposure.
4) Examining the conditions in which the exposures and outcomes are causally associated, and assessing the factors that may offer alternative explanations, such as random error and bias.
5) Selecting which type of study answers a specific question, distinguish when a random trial is needed to prove efficacy and effectiveness.
6) Differentiating between ethics that conditions the use of a clinical assault.
7) Applying indicators in diagnostic decision making, and their applications in the area of patient safety, quality control, and interventions.
8) Assessing how epidemiological reasoning can be applied to identify patterns in the populations and formulating causal hypotheses both cross-sectional and longitudinal comparisons.
Competences/Learning outcomes of the degree programme
- 06 - Develop professional practice with other health professionals, acquiring teamwork skills.
- 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
- 28 - Obtaining and using epidemiological data and assess trends and risks in health related decision-making.
- 36 - Be able to formulate hypotheses, collect and critically evaluate information for problem solving using the scientific method.
- 37 - Acquire basic training for research.
- CB-2 - To know how to apply and incorporate knowledge, an understanding of it and its scientific basis and the ability to solve problems in new and loosely defined environments, including multidisciplinary contexts that include both researchers and highly specialised professionals.
- CB-3 - To know how to evaluate and select the appropriate scientific theories and precise methodologies required by their field of study to make judgements based on incomplete or limited information. Where necessary and appropriate, this includes a reflection on the ethical and social responsibility linked to the solution suggested in each case.
- CB-6 - To have developed sufficient autonomy to participate in research projects and scientific or technological cooperation within the student’s own thematic and interdisciplinary context. This should also include a high degree of knowledge transfer.
- CTP-3 - To develop critical thinking and reasoning as well as self-assessment skills.
- CTS-2 - To demonstrate sensitivity to environmental issues and act accordingly.
Learning outcomes of the subject
By the end of the course, the student must be able to:
1) Define Epidemiology and its use in epidemiological reasoning
2) Explain how ethical principles affect epidemiological research
3) Calculate frequencies and rates to quantify and describe the distribution of health outcomes
4) Explain the basic concepts of epidemiological analysis: exposure, outcome, risk, bias, and confounding
5) Identify and describe basic epidemiological designs
6) Use the principles of causality to health outcomes and to make hypotheses about their mechanisms
7) Use evidence of association to assess whether a relationship is causal
8) Apply the concepts of test performance to diagnostic validity and screening
9) Apply the concepts of benefit, harm, and costs to health decisions
10) Describe the applicability of epidemiological methods in Public Health, clinical and basic research, and health policy
Syllabus
CM1 History and uses of epidemiology
-History of epidemiology
-Ethics in epidemiology
-Applications of epidemiology
Development of epidemiological reasoning and the situation of epidemiology in a historical context. Evaluation of epidemiology and its ethical conditions. Applications of epidemiology in Medicine and other disciplines
CM2 & CM3 Descriptive epidemiology
-Disease, frequency and severity
-Prevalence and incidence.
-Natural history of the disease: exposure and outcome.
- Epidemiological hypotheses: who, where and when.
Analysis tools: definition of cases and populations, measures of incidence, prevalence and morbidity and mortality. Description of the disease: vital statistics, surveillance and measures of health status. Natural history analysis methods. Patterns of the disease: people, places and times. Exposures, latent periods and measures of dispersion
TP 1 Epidemiological hypotheses and indicators
CM 4 & CM 5 Association and causality
-- Association measures: data description, risk and impact measures.
-- Bias, confusion and adjustment. Mediation and interaction.
-- Causality: principles of contributing cause. Cause of cause.
Estimation of risk measures: relative, attributable risk and population fractions. Identification of bias and confounding. Effect modification. Adjustment methods. Bradford-Hill criteria. DAGs.
TP 2 Contingency tables and impact measures
CM 6 & CM7 Analytical Epidemiology and Decision Making
--Internal and external validity.
-- Epidemiological designs observations
Experimental designs: trials without equivalent control and controlled trials.
Control and generalization. Representativeness biases and causality biases. Observational designs. ecological, cross-sectional, case control, prospective and retrospective cohorts. Experimental designs: community trial and controlled trials. Clinical trial: equivalence, superiority and non-inferiority.
TP3 Designing an epidemiological study
Teaching and learning activities
In person
1. Masterclass Lesson (LM)
2. Presentation and Resolution of cases (PRc)
3. Project-based learning (PBL)
4. Individual Academic Mentoring (TAP)
5. Self-study and personal work (ATP)
1. Theoretical-practical classes (LM): Sessions of the complete group. The teaching team will explain the theoretical concepts of each topic and will propose exercises to be solved in class on the theoretical concepts explained in the classroom. The dynamics of the classroom will integrate the theoretical work with practical exercises (+0.5 points).
2. Practical problem-solving classes (PRc): Group classes divided into conventional classroom. In each session there will be review exercises around problems that will be given to students in advance.
Between 4 and 5 exercises will be uploaded to Moodle a week before the problem sessions that will be worked INDIVIDUALLY and worked during divided sessions in the classroom. The sessions will be worked for 40 minutes in groups of 5 people. Subsequently, the exercises will be corrected and all students will upload the corrected exercises as a Moodle task. It will be necessary to upload all the corrections to pass the subject.
Practical classes have an evaluable contention of up to 1.5 points (see evaluation systems and criteria)
3. Epidemiological study project (PBL): Collaboration and defense of the team project. The team project involves the individual delivery of a volunteer group project at the end of the subject, where each member of the group will have to submit the complete project and a dossier with their contributions. The group will conduct individual tutoring with the teacher, where they will present and discuss the project for 20 minutes.
Students who wish to take advantage of the re-implementation of the project will have to communicate it in the first two weeks of the course, where a work topic will be assigned. The ABP assumes an evaluable content rating of 1 point. (see evaluation systems and criteria)
Course Moodle page: The course website will present the available material (syllabus, bibliography, review exercises, forms, data files, etc.) tasks and schedule. In addition, forums will be created for questions on the course.
To achieve the objectives, the constant work of the student is essential.
Presence
The course is done in an in face-to-face format. Lectures will be held in class and practical face-to-face format with divided groups in the classroom. Attendance to the indicated shifts must be respected. Shift changes will only be accepted with prior authorization from the coordinator. Shift demands must be notified at least 48 hours before the session.
The course has two credits, estimating a student work time for the average student of 27, therefore it requires a total of 54 hours of student work (20 in the classroom and 37 outside the classroom).
Evaluation systems and criteria
In person
ORDINARY CALL
Final examination
Theoretical-practical final exam. The exam will consist of two parts:
a) Multiple choice questions: 30 multiple choice questions with a 33% penalty for wrong responses (60%).
b) Practical exercises (40% of the qualification): This part involves choosing, applying, and interpreting practical problems using research designs and measures like those carried out during the case methods.
The format and difficulty level of the Final Exam questions will be like those in the Questionnaires and Case Methods during the semester. The final exam will be conducted on paper in a conventional classroom at the end of the semester. Students must bring a scientific calculator to the exam.
Additional ongoing evaluation activities
None of the activities in the ongoing evaluation will be mandatory. However, they will add up to 2.5 extra points to the final qualification, which will be added exam qualification, provided that it is at least 5 points.
1. Individual Case Method Learning Portfolio (+1.5 points): a compendium of tasks in practical activities of the case method sessions. A week before the case method sessions, the case activities will be uploaded for the students to resolve. To get the extra rating, you must make two deliveries per session:
a) Pre-session: You will upload in a Moodle task a number of individually solved exercises of your choice from the proposed exercises.
b) Post-session: As indicated in the methodology, at the end of the case method session, all students must upload the correction of all exercises. If you delivered the pre-session activity, you will clearly indicate the corrections and self-assessments made to your pre-session task, and upload this correction as the Moodle task.
The extra grade will be based on the number of exercises you delivered AND self-assessed. Thus, you try and assess 10 exercises of the pre-session activities from a total of 20 proposed exercises, a score of +0.75 points will be added to your final qualification; if you try and correct all the 20 exercises, you will get +1.5 points to the exam qualification (this extra will be added as long as the exam has a passing mark)
2. Questions (+0.5 points): During the subject, there will be small multiple-choice questionnaires that will be answered in the classroom on the subject matter, based on previous readings on session contents. Students will respond to each assignment in the classroom.
3. Elaboration and defence of the team project (+1 point): Evaluation of a team project (maximum 5 members). This evaluation involves the individual delivery of a voluntary group project at the end of the subject. Students interested in doing this activity should say so before the second class session. Since each student's participation in the work can be unbalanced, each student will have to submit the complete project and a dossier with their contributions. The group will interview with the teacher, and they will present and discuss the project for 20 minutes. Only students who have submitted this project will be evaluated.
Activities are not mandatory. However, plagiarism behaviors will not be tolerated in any of the evaluation activities. In case of suspicion, the entire activity will be canceled for the entire group and will not count for assessment purposes.
QUALIFICATION OF THE ORDINARY CALL
The qualification of the ordinary call will be calculated in two ways:
a) Exam grade over 9 points (minimum 5.5 points for the pass) + Qualification activity 3
b) Qualification of the exam over 7 points (minimum 3.5 for the pass) + Qualification activities 1 and 2 + Qualification activity 3.
The final grade will be the maximum of these two qualifications. In both modalities, it will be necessary to obtain a minimum 5 in the final grade to achieve the approval of the subject.
SECOND CALL
In case of obtaining under 5 points in the first call, the student must attend the final exam in the second call. The qualification of the second call will be based solely on exam qualification. Passing the course on the second call will require a score of 5 points in the final exam.
Bibliography and resources
Basic reference
Friis, RH. Epidemiology 101. Sudbury, Mass: Jones and Bartlett Publishers, 2010. 220p.
This is a compulsory reference for the course. Students are expected to be up to date in the reading of the book. Materials will be followed rigorously so that readings will be recommended prior to the sessions.
Other sources
- Saracci R. Epidemiology: A Very Short Introduction. Oxford U.K.: Oxford University Press, 2010
- Ward H, Toledano MB, Shaddick G, Davies B, Elliott P. Oxford Handbook of Epidemiology for Clinicians. Oxford, U. K.: Oxford University Press, 2012. 416 p. (Oxford Medical Handbooks).
- Gordis L. Epidemiología. 3ª ed. Madrid: Elsevier España, S.A., 2014.
- Hulley SB, Cummings SR y col. Diseño de las investigaciones clínicas. 3ª ed. Lippincot Williams and Wilkins, 2008.
Evaluation period
- E2 06/07/2022 11:30h