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PH310: Introduction to Epidemiology, Spring 2016
Meeting place and time: Biomed D207; Mondays 9:30 a.m. – 12:20 p.m.
Instructor:
Eric Hurwitz, DC, PhD
Biomed D201
956-7425
[email protected]
Office hours: By appointment only
Course overview:
This is a survey course to introduce students to epidemiologic principles and methods. Topics covered
include: measures of morbidity and mortality; vital statistics; incidence and prevalence measurements;
adjustment of rates; measurements of risk; biological variability; screening; measurements of error;
sampling; statistical significance; surveillance; study design; association and causation; and outbreak
investigation.
Course format:
The course methodology will include a combination of lectures, class discussions, exercises, student
presentations, and short quizzes.
Textbooks:
The one required book is: Saracci R. Epidemiology: A Very Short Introduction. New York: Oxford
University Press, Inc., 2010. A book of interest is: Pendergrast M. Inside the Outbreaks: The Elite
Medical Detectives of the Epidemic Intelligence Service. New York: Houghton Mifflin Harcourt
Publishing Company, 2010. An optional book is: Porta M (Editor). A Dictionary of Epidemiology, 5th
edition. New York: Oxford University Press, Inc., 2008.
A book that may be useful for those of you with limited experience with health statistics is: Woloshin S,
Schwartz LM, and Welch HG. Know Your Chances: Understanding Health Statistics. Berkeley:
University of California Press, 2008. I will refer to this book periodically throughout the course.
Software:
Two free epidemiologic software programs will be used to demonstrate key principles and methods.
EpiInfo: Download from the Centers for Disease Control and Prevention website at: www.cdc.gov .
OpenEpi: Download from the OpenEpi website at: www.openepi.com .
Tentative schedule and class topics:
January 11
Introduction
January 18
Martin Luther King Jr. holiday (no class)
January 25
Definition of epidemiology;
Quiz 1
February 1
Measuring health and disease;
Quiz 2
February 8
Searching for the causes of disease;
Quiz 3
February 15
Presidents’ Day (no class); Establishing the causes of a disease
February 22
MIDTERM I
March 1
Testing how to control a disease;
Quiz 4
March 8
Following up people’s health;
Quiz 5
March 15
Investigating people’s past experiences;
Quiz 6
March 22
Spring Break (no class); Mapping health and disease
March 29
MIDTERM II
April 5
From epidemiology to medicine, prevention, and public health;
Quiz 7
April 12
Epidemiology between ethics and politics;
Quiz 8
April 19
Student presentations;
Quiz 9
April 26
Review Session - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
May 3
FINAL QUIZ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Tentative reading assignments:
January 11
Saracci (Preface); Pendergrast (Parable and Introduction)
January 18
Martin Luther King Jr. holiday (no class)
January 25
Saracci (Chapter 1); Pendergrast (Chapters 1 and 2)
February 1
Saracci (Chapter 2); Pendergrast (Chapters 3 and 4)
February 8
Saracci (Chapter 3); Pendergrast (Chapters 5 and 6)
February 15
Saracci (Chapter 4); Pendergrast (Chapters 7 and 8)
February 22
MIDTERM I
March 1
Saracci (Chapter 5); Pendergrast (Chapters 9 and 10)
March 8
Saracci (Chapter 6); Pendergrast (Chapters 11 and 12)
March 15
Saracci (Chapter 7); Pendergrast (Chapters 13 and 14)
March 22
Saracci (Chapter 8); Pendergrast (Chapters 15 and 16)
March 29
MIDTERM II
April 5
Saracci (Chapter 9); Pendergrast (Chapters 17 and 18)
April 12
Saracci (Chapter 10); Pendergrast (Chapters 19 and 20)
April 19
Pendergrast (Chapters 21 and 22; Epilogue)
April 28
Review Session - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
May 3
FINAL QUIZ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Grading:
Students will be graded on their performance on exercise sets (20%), presentations (20%), several quizzes
and two midterm examinations (30%), and a final quiz (30%). Material for the quizzes and midterms will
be taken from the lectures, readings, and exercises. Grades will be assigned based on overall course
percentage score:
97 - 100%: A+
93 - 96%: A
90 - 92%: A87 - 89%: B+
83 - 86%: B
80 - 82%: B-
77 - 79%: C+
73 - 76%: C
70 - 72%: C-
Course learning objectives
Upon completion of the course, the student will be able to:
1.
Define epidemiology and identify applications of the epidemiologic method.
2.
Identify examples of primary, secondary, and tertiary prevention.
3.
Describe the contribution of epidemiology to disease prevention and control.
4.
Name several sources of population and disease information and identify the major errors
inherent in them.
5.
Define and interpret the following terms: validity, reliability, sensitivity, specificity, positive
predictive value.
6.
Name, apply, calculate and interpret commonly used public health rates.
7.
Explain the need for rate adjustment; interpret adjusted rates.
8.
Given a summary description of an analytic study:
A.
Select terms to describe the study design.
B.
Name and calculate appropriate rates, proportions, and measures of risk.
C.
Interpret the study results.
D.
Identify strengths, limitations, and potential sources of bias.
9.
Identify three basic epidemiologic study designs and list the strengths and weaknesses in each.
10.
Define information bias, selection bias, and confounding and give examples of each.
11.
Given a causal hypothesis for a described health problem, select the most appropriate analytic
study design to test the hypothesis.
12.
Given disease frequency data in graphic or tabular form, interpret the findings and identify trends
and patterns in disease occurrence.
13.
Interpret trends and patterns in disease occurrence in terms of public health implications.
14.
Correctly define and apply the basic vocabularies of infectious and chronic disease epidemiology.
15.
Given data from a study of disease etiology, select the most plausible interpretation among
several alternatives.
16.
List and describe the criteria used to assess whether a statistically significant association between
an independent and dependent variable is causal.
17.
Differentiate causal, indirect, and artifactual associations, and give examples of each.
Core Epidemiologic Concepts (recommended for “Epidemiology 101” course)*
I. History, Philosophy, and Uses of Epidemiology
• Historical contributions and modern uses of epidemiology — Development of
epidemiologic thinking and placement of epidemiology in historical and modern
perspective.
• Ethics and philosophy of epidemiology — Appreciation of the links between
epidemiology and broader ethical and philosophic traditions and concerns.
II. Descriptive Epidemiology
• Condition, frequency, and severity — The basic tools of epidemiologic analysis,
including case definitions and populations, incidence, prevalence, and case-fatality rates.
• Data regarding disease or injuries — Vital statistics, public health surveillance, and
measures of health status, including methods for describing quantitatively the natural
history, frequency, and changes in infectious and chronic diseases and injuries.
• Patterns of disease and injuries — Application of the basic tools of epidemiology to
generate hypotheses regarding person, place, and time; changes and differences in rates;
exposures; incubation periods; and disease spread.
III. Association and Causation
• Estimation — Measures of strengths of association, graphical display of data, risk,
relative risk/risk ratios, and attributable risk.
• Inference — Concepts of statistical significance and confidence intervals
• Bias, confounding, and adjustment — Identification of bias, confounding, and effect
modification/interaction and methods to prevent and take into account their impact.
• Causation — Risk factors and other determinants of diseases and conditions.
IV. Analytic Epidemiology
• Basic epidemiologic study designs and their application to population health including:
ecologic or population comparison, cross-sectional, case-control, and retrospective and
prospective cohort.
• Experimental studies — Randomized clinical trials and community trials and their
applications to the efficacy and effectiveness of disease or injury etiology and the
efficacy and effectiveness of interventions.
V. Evidence-Based Public Health and Evidence-Based Recommendations
• Harm, benefit, and cost analyses — Evidence-based decision analysis regarding risks,
benefits, and cost-effectiveness of interventions.
• Intervention efficacy and effectiveness — Evidence-based analyses of interventions'
capacity for producing desired results and measurement of the accuracy or success of
prevention and control efforts for diseases or injuries.
VI. Applications to Policy and Basic and Clinical Sciences
• Outbreak investigation, testing, and screening — Application of epidemiologic methods
and basic and clinical science.
• Public health policy — Application of results from investigations and analyses to
influence policymaking.
• Special epidemiologic applications — Molecular and genetic epidemiology,
environmental and occupational health and safety, unintentional injury and violence
prevention, and behavioral sciences.
* Association of Schools of Public Health Undergraduate Public Health Learning Outcomes; July 14,
2011.
University Policies for Opportunity and Accommodation
Equal Opportunity and Affirmative Policy
The University of Hawai‘i is an equal opportunity/affirmative action institution and is committed to a
policy of nondiscrimination on the basis of race, sex, gender identity and expression, age,
religion, color, national origin, ancestry, citizenship, disability, genetic information, marital
status, breastfeeding, income assignment for child support, arrest and court record (except as
permissible under State law), sexual orientation, national guard absence, status as a covered
veteran, pregnancy, and domestic or sexual violence victim status. This policy covers admission
and access to and participation, treatment, and employment in the University’s programs and
activities.
For more information on equal opportunity and affirmative action policies and complaint procedures for
the UH Mānoa Campus, contact:
Students: Lori Ideta, Assistant Vice Chancellor & Dean of Students, EEO/AA, Title IX & ADA
Coordinator Ph.-956-3290 (V/T); Email [email protected]
Employees: Mie Watanabe, EEO/AA Director, Title IX & ADA Coordinator
Ph. 956-7077; Email [email protected]
Students with Disabilities: Ann Ito, KOKUA Program Director
Ph. 956-7511 (V/T); Email [email protected]
Accommodations
A student who may need an accommodation based on the impact of a disability is invited to contact me
privately within the first weeks of the course. I would be happy to work with you and the
KOKUA Program (Office for Students with Disabilities) to ensure reasonable accommodations in
my course. KOKUA can be reached at 808-956-7511 or 808-956-7612 (voice/text) in room 013
of the Queen Liliuokalani Center for Student Services.