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Syllabus

Graduate Programs in Public Health

GPH 712 Principles of Epidemiology – Fall 2015

Credits - 3

Description

Course Description:

This course is designed to introduce students to the basic principles of epidemiology as they apply to public health practice. Content will include: a historical perspective on epidemiology, descriptive epidemiology, effect measures, study designs, bias, surveillance, and screening for disease. Emphasis will be placed on investigative techniques, epidemiological methodology, and critical thinking about epidemiological studies and data. By the end of the course, students should have a strong background in the fundamentals of this field, particularly the basics of the various study designs. They should be able to critique and understand current literature in epidemiology and public health and be able to use the tools in their practice.

Course Format:

This course is facilitated through Blackboard, UNE’s online learning management system. The course will be delivered in 8 weekly online modules, with each module beginning on Wednesday at 12:01 am ET and ending the following Wednesday at 11:59 pm ET, except for the last week (Week 8), which will begin on Wednesday and end on Sunday. Note all times are Eastern Time. Students will watch online lectures produced by the course instructor and field experts, engage in readings and other media provided by instructors, and will learn from one another through the discussion board and written assignments. Each section of this course will be facilitated by an instructor with significant professional and academic expertise in the area of study. Individual meetings with the course instructor will be up to the student to schedule.

Materials

Friis RH, Sellers TA. Epidemiology for Public Health Practice, 5th ed. Burlington, MA: Jones and Bartlett Publishers: 2013. ISBN-13: 978-1449665494

We will be working with the newest version (5th edition) of this textbook, but it is also possible to use the 4th or even the 3rd edition. Assigned readings might start on different pages in some cases, but the general content is the same. Please note that if you do not use the newest version you will be responsible for determining where the lessons start and end. If you are not comfortable with doing this extra step, it would be better to buy the new book.

Tools to Prepare for the Course:

Learning Objectives and Outcomes

The following are the Association of Schools and Programs of Public Health (ASPPH) competencies that this course addresses:

  • C.1. Identify key sources of data for epidemiologic purposes.
  • C.2. Identify the principles and limitations of public health screening programs.
  • C.3. Describe a public health problem in terms of magnitude, person, time, and place.
  • C.4. Explain the importance of epidemiology for informing scientific, ethical, economic, and political discussion of health issues.
  • C.6. Apply the basic terminology and definitions of epidemiology.
  • C.7. Calculate basic epidemiology measures.
  • C.9. Draw appropriate inferences from epidemiologic data.
  • C.10. Evaluate the strengths and limitations of epidemiologic reports.

Course Learning Objectives:

  • Discuss the history and role of epidemiology as the fundamental science of public health.
  • Discuss what a population-based perspective of disease entails.
  • Calculate and interpret epidemiological measures of disease occurrence and the measures of effect used to compare the risk of disease between populations.
  • Distinguish between association and causation, and understand the criteria to evaluate causal associations.
  • Describe the role of surveillance in epidemiology.
  • Describe the primary features of each type of study design, including its strengths and limitations.
  • Describe the roles of chance, bias, confounding, and effect modification in epidemiological research.
  • Describe the role of screening in epidemiology.
  • Learn how aspects of person, place, and time contribute to disease occurrence.

Assignments

Forum Discussions: Each student is expected to post at least twice each week in response to forum questions on that week’s topic. First posts are due by midnight on Sunday. All posts must be completed by midnight Wednesday for credit. Because this is an online course, the online discussion portion is an important way to exchange ideas with your classmates. Students will be graded on their participation and effort of their posts. These posts will take time to complete but they are an essential part of this on-line course and a great way to get to know your colleagues. Please be familiar with the course material (readings/lectures) before posting each week. Full marks will be given to those who ask questions, bringing in new data from the literature or other resources, and demonstrate a thorough understanding of the topics for the week.

Tutorials/Practice Problems: Within many of the weekly modules, there will be suggested additional problems listed for practice and/or links to other web-based tutorials. In addition, though they are not listed here, many of the questions at the end of each chapter in your book are good for practice and have answers listed in the back of the book. Some of the tutorials come from Epiville, a web-based learning tool developed at Columbia University (See http://epiville.ccnmtl.columbia.edu/). The practice problems for each module tend to be similar to the problems on the final exam, so completion of practice exercises is encouraged for your success, but is not required.

Workshops: The workshops will require you to apply the knowledge you’ve gained in the lectures, reading, and tutorials/practice problems to a case study. Each workshop will focus on one concept (e.g. cohort studies, calculating adjusted rates). Five of the workshops will require you to work with data in Excel and/or another spreadsheet application (e.g. Google Docs, FreeOffice, Open Office). The others will require you to look critically at a study. The assignments are available for printing, but please report your answers in the Blackboard form to make it easier for the instructor to grade in a consistent and timely manner. Workshop assignments are due by Wednesday at 11:59 pm ET the week they are due. Workshops may be challenging, especially for those less familiar with Excel. Because of this, there will be a workshop thread on the discussion board where you can ask your professor questions and collaborate with your peers. Think of this as a student lounge in the public health program where you might go between classes to work on your assignments and discuss your courses. Answers should not be posted in this area.

Final Exam: The final exam will be open-book and will cover all of the material from the lectures and the readings. The final exam will test your knowledge and understanding of many of the topics covered in the course and your ability to apply that knowledge to public health problems. For your convenience, the exam will begin on Monday of Week 7 to give you a full week to complete it. Please allocate a good amount of time during the last week of class to spend on the exam. (Note that the final exam is due by 11:59 pm ET, on Sunday of Week 8, while the other assignments are due on Wednesday). You may ask questions on the course material before the exam begins. After you begin the exam, you may only ask questions on logistics. You may not discuss the final exam with your peers.

Grading Policy

Your grade in this course will be determined by the following criteria:

Grade Breakdown

Discussion Forum 21 points
Workshops49 points
Final Exam30 points
Total:100 points

Grade Scale

Grade Points Grade Point Average (GPA)
A 94 – 100% 4.00
A- 90 – 93% 3.75
B+ 87 – 89% 3.50
B 84 – 86% 3.00
B- 80 – 83% 2.75
C+ 77 – 79% 2.50
C 74 – 76% 2.00
C- 70 – 73% 1.75
D 64 – 69% 1.00
F 00 – 63% 0.00

Schedule

Course Schedule:

Each week opens on Wednesday at 12:01 AM Eastern Time. Each week closes on Wednesday at 11:59 pm ET, with the exception of Week 8, which ends on Sunday. 

Week 1: Sept. 2 – Sept. 9
Week 2: Sept. 9 – Sept. 16
Week 3: Sept. 16 – Sept. 23
Week 4: Sept. 23 – Sept. 30
Week 5: Sept. 30 – Oct. 7
Week 6: Oct. 7 – Oct. 14
Week 7: Oct. 14 – Oct. 21
Week 8: Oct. 21 – Oct. 25 (Sunday)

Weekly Schedule:

Week 1: Sept 2 – Sept 9

Lectures and Reading:

  • Module 1 – Introduction to Epidemiology
  • Epidemiology in the Context of Public Health
  • Profile of the Practice of Epidemiology

Reading:

Optional Reading:

Lectures:

  • Module 1 part 1
  • Module 1 part 2

Module 2 – The Epidemiologist’s Toolbox

Reading:

Lectures:

  • Module 2 part 1
  • Module 2 part 2

Do:

Optional:

 

Module 3 – Measures I (Counts, Proportions, Ratios, Rates)

Reading:

Lecture:

  • Module 3

Practice:

  • Module 1 Practice Questions
  • Module 3 Practice Questions

Assignments:

  • Discussion Forum 1: Introductions & Envision an Epidemiological Study (3 points)
    • First Post: Since we are just getting to know each other, tell us a little more about you. Choose a place where you currently live, work, or play, or a place where you have lived in the past (e.g. spent a semester in India, grew up in Brooklyn, or did a residency in rural Maine). Tell us about a health concern related to that place or to an activity you do there. What do you know about that concern (you could use PubMed literature to increase your knowledge)? What gaps in knowledge remain?
    • Response: Envision a study that could shed light on a gap in knowledge in one of your colleagues’ hometowns. What is the health effect? What are the suspected determinants? Pose a focused research question. (You do not need to develop a study at this time, just pose a research question).
  • Workshop 1: Basic Measures (7 points)

 

Week 2: Sept 9 – Sept 16

Module 4 – Measures II (Prevalence, Incidence, Mortality)

Reading:

Lecture:

  • Module 4: Measures II (Incidence, Prevalence, Mortality)

Watch:

Optional:

Module 5 – Causation and Causal Inference

Reading:

  • Chapter 2, pages 84-97
  • Chapter 9, pages 420-430
  • Article: Kenneth J. Rothman and Sander Greenland. Causation and Causal Inference in Epidemiology. American Journal of Public Health: July 2005, Vol. 95, No. S1, pp. S144-S150.
  • Causal Inference Tutorial: http://epiville.ccnmtl.columbia.edu/causal_inference/

Lecture:

  • Module 5: Causation and Causal Inference

Optional:

Module 6 – Surveillance

Reading:

Lecture:

  • Module 6: Public Health Surveillance

Watch:

  • Tutorial on CDC Train: Introduction to Public Health Surveillance

Optional:

Practice:

  • Module 4 Practice Questions
  • Module 5 Practice Questions
  • Self Assessment Surveillance from CDC’s Self Study Course

Assignments:

  • Discussion Forum 2: Global Health Priorities (3 points). For this week’s discussion, become familiar with data from the WHO’s Global Burden of Disease project- http://www.who.int/healthinfo/global_burden_disease/en/index.html. You might peruse the Global Health Risks Report (2009), statistics from the Global Health Observatory, or other statistics on disease and injury, risk factors, and/or projections. You have been invited by a newly formed international NGO to attend a small meeting with some of the brightest epidemiologists in the world. The goal of the meeting is to determine the top GLOBAL health priorities for funding by this NGO in the next five years. Funding can be spent to address risk factors, treatment, or other issues. Millions of dollars are on the line.
    • First Post: You are asked to go around the room and advocate for one priority. Write a persuasive argument for one health issue and back your argument up from data from the WHO and/or other sources. Take into consideration the measures we’ve learned this week. (You can advocate for the same issue as other students who have already posted if you would like, but also it would be good to have some variety). Use measures like prevalence, incidence, counts, DALYs, etc.
    • Response: After all of the epidemiologists contribute, there is time to ask questions and debate the top issues. How would you go about setting priorities for funding and why?
  • Workshop 2: Measures Part II (7 points)

 

Week 3: Sept 16- Sept 23

Lectures and Reading:

Module 7- Adjusted Rates

Reading:

Lecture:

  • Module 7: Adjusted Rates
  • Diener-West and Kanchanaraksa: Direct and Indirect Methods of Adjustment (PDF)

Watch:

Module 8- Descriptive Epidemiology

Reading:

Lecture:

  • Module 8: Descriptive Epidemiology

Optional:

Module 9- Data Sources for Use in Epidemiology

Reading:

  • Chapter 5

Lecture:

  • Module 9: Data Sources

Watch:

  • Tutorial on CDC Train: Data Available for Public Health Professionals

Do:

Practice:

  • Module 7 Practice Questions
  • Module 8 Practice Questions
  • Module 9 Practice Questions

Assignments:

  • Discussion Forum 3: Describe the Epidemiology of Lyme Disease (3 points)
    • First Post: Mention some interesting aspects of person, place, and time for Lyme disease. You may cite a recent study or present some surveillance data collected over time. Evaluate existing data sources in the US and beyond. What existing data sources, if any, might be available to study this topic? You do not have to complete the entire descriptive epidemiology of the disease (leave some work for your colleagues), but present some data in a succinct manner and mention some research gaps. You may try to tailor your response to a specific region or subpopulation, for example.
    • Response: Imagine that you are going to apply for a grant to do an analytic study of Lyme disease. Using what has been mentioned in the descriptive research by your colleagues, formulate a clear research question/hypothesis that would address some research gaps.
  • Workshop 3: Descriptive Epidemiology and Adjusted Rates (7 points)

 

Week 4: Sept 23 – Sept 30

Module 10 – Analytic Epidemiology

Reading:

Optional:

  • Tutorial on CDC Train: Study Types in Epidemiology

Lecture:

  • Analytic Studies

Module 11 – Ecological Studies

Reading:

  • Chapter 6, pages 287-294

Lecture:

  • Ecological Studies

Module 12 – Cross Sectional Studies

Reading:

  • Chapter 6, pages 294-303

Lecture:

  • Cross-Sectional Studies

Practice:

  • Module 10: Practice Questions
  • Module 11: Epiville Tutorial, Ecological Studies
  • Module 12: Practice Questions

Assignments:

  • Discussion Forum 4: Journal Article Review (3 points). Read the Ogden article posted in Week 4 readings. At least two posts are required in response to the article. Respond critically to the study design and/or how it was portrayed in the media. Studies tend to suggest as many new research questions as they answer. What new research questions are raised by this study?
  • Workshop 4: Ecological and Cross Sectional Studies (7 points)

 

Week 5: Sept 30 – Oct 7

Lectures and Reading:

  • Module 13 – Case Control Studies

Reading:

Optional:

Module 14- Screening

Reading:

  • Chapter 11

Optional:

  • Tutorial on CDC Train: Screening In Public Health Practice

Practice:

  • Module 13: Epiville, Case Control Studies
  • Module 14: Epiville, Screening

Assignments:

  • Discussion Forum 5: Town Hall Meeting – PSA Screening. In 2012, the US Preventive Services Task Force (USPSTF) recommended against PS screening for prostate cancer. This recommendation was based on the following Evidence Report: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostateart.htm Choose one of the following roles in a town hall meeting:
    • Insurance Company – Argues that they should not have to pay for screenings.
    • Medical Provider – Wants to determine whether their practice will continue to offer screenings.
    • Patient – Concerned about health, knows somebody who has died of prostate cancer.
    • Independent Expert – Attempting to translate results of PSA studies to the public in nonbiased manner.
    • Representative of American Society of Clinical Oncology – Argues that there is value to the PSA test for some men and the tests should not be discarded.
  • Present your position and ask questions. Support and challenge each other. Two posts are required. Additional posts are welcome.
  • Workshop 5: Case Control Studies
  • Prepare for Week 6 & 7 Forum Discussion. In weeks 6 & 7 you will develop a study for a research question submitted in Week 3 Forum. Begin thinking about which research question you will explore and how you will explore it using all you have learned.

 

Week 6: Oct 7 – Oct 14

Lectures and Reading:

Module 15- Cohort Studies

Reading:

Lecture:

  • Cohort Studies

Module 16- Confounding and Effect Modification

Reading:

Lecture:

  • Confounding and Effect Modification

Module 17- Error and Bias

Reading:

Optional:

  • Tutorial on CDC Train: Cohort Study Analysis and Interpretation

Lecture:

  • Error and Bias

Practice:

  • Module 15: Epiville, Cohort Studies
  • Module 16: Epiville, Confounding
  • Module 17: Epiville, Bias

Assignments:

  • Discussion Forum 6: Develop a Study (4.5 points – spans two weeks. Final study must be posted on the main discussion board by 11:59pm ET on Wednesday) In this discussion, you will develop a study based on the research question you chose.
  • 1. Start by thinking about the following aspects of your study.
    • What is the time available for study?
    • What are the resources available for the study?
    • Is it a common/rare disease?
    • Quality of data from various sources (is there data already available or would you need to collect primary data?)
  • Select a study design that seems most relevant. Often there are multiple approaches which will all work, but the questions above should help you pick a design. The first step should be to pick a study design for each hypothesis and have solid reasons for picking it.
  • 2. Work to fill in some details of your study, such as-
    • Who will be your study population?
    • If necessary, how will you conduct sampling?
    • How will you determine exposure, if applicable? (Biological samples? Questionnaire?)
    • If developing a questionnaire, what types of questions will you ask?
    • How often will you sample?
    • What information can you expect to get out of the study?
    • What issues might arise during our study and how will we address them, if at all? (Drop outs? Difficulties in recruitment? Issues with control selection?)
  • Be critical as you develop these studies and in your responses to classmates. What about the proposed study “works”? What other aspects have you not considered?
  • Start by assessing options for a study design type in your first post. Once you get that nailed down, move onto the details. It may require more than two posts to get this done.
  • First posts and responses and refinements of the study design can take place over Weeks 6 & 7. Please review the Week 6 & 7 forum discussion rubric below to understand expectations for your posts. Your final study design needs to posted to the main discussion board (in the Week 6 & 7 Forum) by 11:59 pm Wednesday.
  • Workshop 6: Cohort Studies (7 points)

 

Week 7: Oct 14 – Oct 21

Lectures and Reading:

  • Module 18- Experimental Studies

Reading:

  • Chapter 8
  • Epiville, Randomized Trials

Practice:

  • Module 18: Practice Questions
  • Additional Study Design Practice Questions

Assignments:

  • Discussion Forum 6 (Week 6 & 7): Develop a Study: Post your study to the main discussion board by 11:59 pm on Wednesday
  • Workshop 7: Clinical Trials (7 points)

 

Week 8: Oct 21 – Oct 25 (Sunday)

Assignments:

  • Week 8 Discussion Forum: Critique Studies (1.5 points, only one post required)
    Review the studies posted in the Week 6 & 7 Discussion Forum. These designs were nominated as finalists to our funding agency for consideration.
    • Critique one of the other studies. Identify strengths and weaknesses. Describe source of biases/confounding that may not have been considered, and make suggestions to improve the proposal.
  • Final Exam (30 points)

Student Resources

Online Student Support

Your Student Support Specialist is a resource for you. Please don't hesitate to contact them for assistance, including, but not limited to course planning, current problems or issues in a course, technology concerns, or personal emergencies.

Questions? Visit the Student Support Public Health page

UNE Libraries:

UNE Student Academic Success Center

UNE's Student Academic Success Center (SASC) offers a range of free online services to support your academic achievement. Writing support, ESOL support, study strategy and learning style consultations, as well as downloadable resources, are available to all matriculating students. The SASC also offers tutoring for GPH 712 Epidemiology, GPH 716 Biostatistics, GPH 717 Applied Epidemiology, GPH 718 Biostatistics II, and GPH 719 Research Methods. To make an appointment for any of these services, go to une.tutortrac.com. For more information and to view and download writing and studying resources, please visit:

Information Technology Services (ITS)

  • ITS Contact: Toll Free Help Desk 24 hours/7 days per week at 1-877-518-4673

Accommodations

Any student who would like to request, or ask any questions regarding, academic adjustments or accommodations must contact the Student Access Center at (207) 221-4438 or pcstudentaccess@une.edu. Student Access Center staff will evaluate the student's documentation and determine eligibility of accommodation(s) through the Student Access Center registration procedure.

Policies

AMA Writing Style Statement

The American Medical Association Manual (AMA) of Style, 11th edition is the required writing format for this course. Additional support for academic writing and AMA format is provided throughout the coursework as well as at the UNE Portal for Online Students.

Online resources: AMA Style Guide

Turnitin Originality Check and Plagiarism Detection Tool

The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.

Make sure to cite your sources appropriately as well as use your own words in synthesizing information from published literature. Webinars and workshops, included early in your coursework, will help guide best practices in APA citation and academic writing.

You can learn more about Turnitin in the Turnitin Student quick start guide.

Technology Requirements

Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements

Course Evaluation Policy

Course surveys are one of the most important tools that University of New England uses for evaluating the quality of your education, and for providing meaningful feedback to instructors on their teaching. In order to assure that the feedback is both comprehensive and precise, we need to receive it from each student for each course. Evaluation access is distributed via UNE email at the beginning of the last week of the course.

Late Policy

Students are responsible for submitting work by the date indicated in Brightspace.

Quizzes and Tests: Quizzes and tests must be completed by the due date. They will not be accepted after the due date.

Assignments: Unless otherwise specified, assignments will be accepted up to 3 days late; however, there is a 10% grade reduction (from the total points) for the late submission. After three days the assignment will not be accepted.

Discussion posts: If the initial post is submitted late, but still within the discussion board week, there will be a 10% grade reduction from the total discussion grade (e.g., a 3 point discussion will be reduced by 0.3 points). Any posts submitted after the end of the Discussion Board week will not be graded.

Please make every effort ahead of time to contact your instructor and your student support specialist if you are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.

Student Handbook Online - Policies and Procedures

The policies contained within this document apply to all students in the College of Graduate and Professional Studies. It is each student's responsibility to know the contents of this handbook.

Student Handbook

UNE Course Withdrawal

Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.

Academic Integrity

The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit https://www.une.edu/studentlife/plagiarism.

Academic dishonesty includes, but is not limited to the following:

  1. Cheating, copying, or the offering or receiving of unauthorized assistance or information.
  2. Fabrication or falsification of data, results, or sources for papers or reports.
  3. Action which destroys or alters the work of another student.
  4. Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
  5. Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.

Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations.  Appeal of a decision may be made to the Dean whose decision will be final.  Student appeals will take place through the grievance process outlined in the student handbook.

Attendance Policy

Online students are required to submit a graded assignment/discussion prior to Sunday evening at 11:59 pm ET of the first week of the term. If a student does not submit a posting to the graded assignment/discussion prior to Sunday evening at 11:59 pm ET, the student will be automatically dropped from the course for non-participation. Review the full attendance policy.

Late Policy

Assignments: Late assignments will be accepted up to 3 days late; however, there is a 10% grade reduction (from the total points) for the late submission. After three days the assignment will not be accepted.

Discussion posts: If the initial post is submitted late, but still within the discussion board week, there will be a 10% grade reduction from the total discussion grade (e.g., a 3 point discussion will be reduced by 0.3 points). Any posts submitted after the end of the Discussion Board week will not be graded.

Please make every effort ahead of time to contact your instructor and your student support specialist if you are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.

Student Handbook Online - Policies and Procedures

The policies contained within this document apply to all students in the College of Graduate and Professional Studies. It is each student's responsibility to know the contents of this handbook.

UNE Online Student Handbook

UNE Course Withdrawal

Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.

Academic Integrity

The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.

Academic dishonesty includes, but is not limited to the following:

  1. Cheating, copying, or the offering or receiving of unauthorized assistance or information.
  2. Fabrication or falsification of data, results, or sources for papers or reports.
  3. Action which destroys or alters the work of another student.
  4. Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
  5. Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.

Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations.  Appeal of a decision may be made to the Dean whose decision will be final.  Student appeals will take place through the grievance process outlined in the student handbook.