Universitat Internacional de Catalunya

Introduction to Epidemiology

Introduction to Epidemiology
2
12063
2
Second semester
OB
Main language of instruction: Spanish

Teaching staff


Students may ask lecturers questions at the end of each class. 

For inquiries outside of class time, students must make an appointment using the tutorial timetable 

Coordinator: Dr. Carlos Gª Forero (cgarciaf@uic.es

Dra Ivet Bayés (ibayes@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.

Competencies

  • 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

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

Session

Block

Topics

Contents

CM1

History and uses of epidemiology

  1. History of epidemiology
  2. Ethics in epidemiology
  3. Applications of epidemiology

Development of epidemiological reasoning and situation of epidemiology in a historical context. Assessment of epidemiology and its ethical conditions. Applications of epidemiology in Medicine and other disciplines

CM2

CM3

Descriptive epidemiology

  1. Disease, frequency and severity
  2. Prevalence and incidence.
  3. Natural history of the disease: exposure and result
  4. 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 health status measures. Methods analysis of natural history.

Patterns of the disease: people, places and times Exposures, latent periods and dispersion measures

TP 1

Epidemiological hypotheses and indicators

 

CM 4

CM 5

Association and causality

  1. Partnership measures: data description, risk and impact measures.
  2. Bias, confusion and adjustment. Mediation and interaction.
  3. Causality: principles of contributing cause. Cause of the cause.

Estimation of risk measures: relative risk, attributable risk and population fractions.

Identification of bias and confusion. Modification of the effect. Adjustment methods.

Bradford-Hill criteria. DAGs.

TP 2

Contingency tables and impact measures

 

CM 6

CM7

Analytical epidemiology and decision making

  1. Internal and external validity.
  2. Epidemiological designs observations
  3. Experimental Designs: Uncontrolled Equivalent Trials 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): Full group sessions. 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 classroom dynamics will integrate the theoretical work with short practical exercises for extra grading in the classroom (+0.5 points).

Due to the lack of content, some of the topics will not be developed extensively in the classroom and students will be asked to prepare them on their own, with the recommended materials and the help of forums and tutorials.

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 the students in advance.

The exercises will be designed to offer opportunities for INDIVIDUAL practice  with basic concepts before the quizzes and the final exam. Homework is intended to be a learning opportunity. Between 4 and 5 exercises will be uploaded to Moodle a week before the problem sessions that will be worked on in the classroom.

The exercises will be corrected and the students will upload the corrected exercises as a Moodle task. The practical classes have an evaluable content of up to 1.5 points (see systems and evaluation criteria)

3. Epidemiological study project (PBL): Collaboration and voluntary defense of the team project. The team project involves the individual delivery of a voluntary group project at the end of the subject, where each member of the group will have to deliver the complete project and a dossier with their individual contributions. The teachers may demand individual tutoring, where they will present and comment on the project. 

Students who wish to take advantage of the realization of the project will have to choose a topic in the first two weeks of the course, where a work design will be assigned. PBL assumes an evaluable content rating of 1 point. (see evaluation systems and criteria) . In case of not presenting the PBL, the maximum grade to be obtained will be 8.5 points.

Moodle page of the course: The website of the subject will present the available material (program, bibliography, review exercises, forms, data files, etc.), tasks, and schedule. In addition, consultation forums will be created for the doubts of the subject. 

To achieve the objectives, the constant work of the student is essential. Continuous practice of the subject material is essential.

 Clasroom presence

The course is done in person format. The master classes will be held in face-to-face format and the shift classes divided into face-to-face format with half of the group in the classroom. No activity is mandatory, but students should know that the evaluable activities will be face-to-face.

In split shift classes, attendance at the indicated shift must be respected. Shift changes will only be made with the authorization of the coordinator and by prior notification at least 48 hours before the session.  Non-attendances will not be recovered.

The subject has two credits, estimating an individual student work time for the average student of 37 hours, therefore requires a total of 57 hours of student work (20 in the classroom and 37 outside the classroom).

The estimated number of hours per activity is:

 

Activity

Classroom prescence

Place

Type

Hours

Master Lesson - Expository Method (LM)

In person

Classroom

Individual

14

Approach and Resolution of cases (PRc)

In person

Classroom

Individual

6

 

 

 

 

 

Tutorial

Non-face-to-face

Seminar

Individual

2

Personal work

Non-face-to-face

--

Individual

22

Project-based learning (ABp)

In person

--

Group

10

Evaluation

In person

online/auditorium

Individual

2

 

 

 

Total face-to-face

20

 

 

 

Total Non-face-to-face

(27 Hours/Credit)

34

 

GRADE REVIEWS:

Revisions to the final grade will be made in a final grade review after the final exam. Continuous assessment tasks will not be reviewed and re-evaluated globally. Grades received on assignments are final unless a grading error has been made. Students are encouraged to contact for tutoring before deadlines to discuss assignments.

Questions about the task will be asked in the forums, where all students are encouraged to participate in the forums to clarify doubts. No assignment inquiries will be made by email, and forum inquiries may not be answered by the teacher unless they require only a brief and clarifying response.

TUTORING AND ATTENTION OUTSIDE THE CLASSROOM

We encourage you to co-tutor with the teacher about any concerns about the course evolution. To do this, you can ask for a tutorial in a shared calendar schedule where you can choose a face-to-face appointment to discuss aspects with the teaching staff. We encourage you to deal with problems as soon as you have concerns about the subject.

 

COURSE REGULATIONS

Communication:

The subject's communication channels will be the topic forums.

The subject will have two forums:

FORUM OF NOTICES: Unidirectional forum where the teaching staff will communicate with the students regarding the appearances of the subject on procedural aspects or contents that are of general interest.  This forum requires reading, and it is the student's responsibility to keep up with the messages.  

CONSULTATION FORUM: Forum for communicating questions and queries from students, of shared participation. In the forum, you can participate in any registered thread. The forums will be moderated by the teaching staff and will be voluntary reading, they will be able to communicate with students.  Messages to the forum addressed directly to teachers will be addressed to the forum within 48 hours.

The email will be reserved for communications of strictly personal aspects. There is no obligation for teachers to attend email.

Delivery dates:

All delivery dates are closed. No extensions or exceptions will be opened on these dates. The student is responsible for the material's content as it has been delivered, which must be done in the accepted formats. If there are errors of any kind in the documents delivered or these are not in the appropriate format, no amendments or exceptions will be accepted.

Plagiarism:

Plagiarism is the use of ideas or phrases of others in the work itself, presenting it as original without clarifying the origin of the copied material.  Plagiarism is a very serious offense according to Law 3/2022, of February 24, on University Coexistence, punishable with expulsion and permanent notification in the student's personal academic record.

The use of plagiarized content from any source, from another student, from the same or from another academic year, will be considered plagiarism, the work will be canceled and the fact automatically notified to the student's advisor and the University Coexistence Commission so that the appropriate disciplinary measures are taken.

Audiovisual recording of sessions or photography in the classroom

The explanations of the teaching staff are "explanations of the chair" and objects of intellectual property. Your presence in the classroom is subject to image rights. Unless express consent of the teacher, it is forbidden to record the sessions or take photographs and share them.  The same criterion refers to the recordings of interventions or contents of the companions.

The notes are versions of the professor's speech record and are also subject to copyright. Distribution among students is authorized to what they are originally intended for, but their public distribution outside the course duration is not authorized without the express authorization of the teacher.

According to Law 3/2022, of February 24, on university coexistence (art. 12e it is a serious offense to misuse content or means of reproduction and recording university activities subject to intellectual property rights. If detected, it will be communicated to the coexistence commission so that the sanctions applicable to these offenses are established.

Punctuality

Students will not be allowed to enter class or exam sessions once they have begun.

It will be considered serious misconduct in this course:

(a) Consult other persons during a questionnaire or examination or consult through technology. Students who are suspected of these behaviors will be expelled from the classroom and will receive a rating of suspense

(b) Access a phone, tablet, or other online devices during a quiz or exam

(c) Represent one's own tasks when they are the work of others without recognition

(d) Presenting an assignment of other people as their own (although there is no problem in working with other students to check their own errors/calculations, the presentations must be individual)

(e) Perform individual group activities when it is not indicated that it is possible to do so.

(f) Plagiarism of content in any course activity

(g) Present a group work without having participated in its realization.

Any student who commits a fault will be reported to their advisor.

The use of phones or tablets will not be allowed in the sessions for uses not directly related to the subject. Students committing misuse will be expelled from the classroom.

The use of telephones or computers in the exam is not allowed. These should be kept out of reach. They will not be kept in the pocket or open bags

Students will not be allowed to enter class or exam sessions once they have begun.

 

 

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 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, non-programmable calculator to the exam as well as all printed materials (NOT computer, tablets or phones)

Ongoing evaluation activities

None of the activities in the ongoing evaluation will be mandatory. However, they will add up to 3 extra points to the final qualification, which will be added exam qualification, provided that it is a passing qualification.

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, all students must upload the correction of all exercises at the end of the case method session. 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.

Continuous assessment 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 +1.5 points will be added to your final qualification; if you try and correct all the 20 exercises, you will get +0.5 points of continuous assessment to the exam qualification (this will be added as long as the exam has a passing mark)

2. Elaboration and defense of the team project (+1,5 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. Depending o the concordance, a group interview with the teacher might be appointed to and individually discuss the project. Only students who have submitted this project will be evaluated.

 Continuous assessment is 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 qualification over 8.5 points (minimum 5.1 points for the pass) + Qualification activity 2

b) Exam qualification over 7 points (minimum 3.5 for the pass) + Qualification activities 1 and 2.

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 pass the course. 

Activities for extra grading: (fins to 0.5 points) During the course, you can do small activities based on previous lecture readings and classroom explanations. Students who answer these activities can earn up to 0.5 extra points to be added to their final grade.  

 

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 5 points in the final exam.

Bibliography and resources

  1. The associated readings that correspond to each class period will be listed from the beginning of the course. The contents of the readings are basic and cover all those of the course. Students are responsible for knowing the content of any assigned readings, regardless of whether this is explicitly covered during a class session.

    It is recommended to read the assigned sections before attending class, as the quizzes deal with that reading, and to prepare a list of reading questions that can then be brought to class for clarification. Classroom presentations are considered supporting material and are not guaranteed to be error-free.

    Students are responsible for taking their own notes during class unless they have a compelling reason for someone else to do so. No student is required to share their notes if they do not wish to do so.

    Basic reference

         Friis, RH. Epidemiology 101 Sudbury, Mass: Jones and Bartlett Publishers, 2010.  220p.   

    This is a mandatory reference of the course and students are expected to be up to date in the scheduled reading of the book for the correct use of the subject. The material will be followed rigorously, so that the readings will be recommended prior to the sessions. In these, work will be done on the readings.

    Reference bibliography

    1. Saracci R.  Epidemiology: A Very Short Introduction. Oxford U.K.: Oxford  University Press, 2010
    2. 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).
    3. Gordis L. Epidemiology. 3rd ed. Madrid: Elsevier España, S.A., 2014.
    4. Hulley SB, Cummings SR et al. Design of clinical investigations.  3rd ed.  Lippincot Williams and Wilkins, 2008.
    s, 2008.