Universitat Internacional de Catalunya
Introduction to Epidemiology
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Coordinador: Dr. Carlos Gª Forero (cgarciaf@uic.es)
Dr. Albert Sánchez Niubó (asanchezn@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
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 07/07/2021 09:00h