Course Syllabus, Spring 2012

E-mail: Please c ontact me via my Blackboard email ONLY.

This is a web-assisted course, and you may also send messages via Moodle.
This course is an introduction to the study of the distribution, determinants, and measurement of health and disease in populations, including design methods and their application to specific diseases and conditions.
The students will:
1. Develop a population-based perspective of the distribution and determinants of disease or health condition.
2. Define and use epidemiologic terminology appropriately.
3. Use appropriate sources of epidemiologic data and understand limitations of existing databases.
4. Appraise epidemiologic study designs.
5. Recognize the roles of chance, bias, confounding, and interactions in the interpretation of observational studies.
6. Distinguish between association and causation, and use criteria for judgment of a cause- effect relationship.
7. Calculate and interpret measures of disease frequency and association in observational studies.
8. Use a systematic approach to read and evaluate epidemiologic literature and understand its relevant terms and methodologies.
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

9. Recognize how epidemiology contributes to public health.
10. Understand basic concepts, principles, and issues related to protection of human participants.
11. Report on descriptive epidemiology of a health phenomenon.
M
M
This course will assist students in developing the following MPH core competencies:
COMPETENCY COURSE OBJECTIVE
Use epidemiologic measures to describe public health conditions in a population in terms of magnitude, person, place, and time
1,2, 7, & 11
Use information technology to interpret and communicate public health data to lay and professional audiences. 11
The following PhD competencies will be primarily met in this course:
COMPETENCY COURSE OBJECTIVE
EPI I – Descriptive Epidemiology 1, 2, 7, & 11
10 EPI VIII – Ethics
Epidemiology for Public Health Practice (REQUIRED),
Friis, RH, & Sellers, TA ,
Jones and Bartlett Publishers, Inc., 2009, 4th Edition.
ISBN: 0-7637-3170-6
Suggested additional reading:
Principles of Epidemiology ,
Centers for Disease Control and Prevention,
US Department of Health and Human Services, 2009, 3RD Edition.
You can download this from the Internet at no charge: http://www.cdc.gov/training/products/ss1000/ss1000-ol.pdf
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Web Resources:
The publishers of your text have student resources such as study flash cards that are available at their web site: http://publichealth.jbpub.com/friis/Studentresources.cfm
. http://www.census.gov
(home page of the U.S. Census Bureau) http://www.cdc.gov
(Centers for Disease Control and Prevention) http://www.nlm.nih.gov
(National Library of Medicine’s on-line databases including Medline) http://www.cdc.gov/nchs (National Center for Health Statistics) http://www.doh.state.fl.us
(Florida Department of Health) http://www.who.int
(World Health Organization home page) http://www.dadehealth.org
(Miami-Dade County Health Department) http://www.geocities.com/HotSprings/3468/gloss96.html
(Dictionary of Epidemiology) http://www.epimonitor.net
(links to many resources including journals and training programs) http://owl.english.purdue.edu/owl/ (extensive materials to help with writing and proper citation)
Journals that commonly publish epidemiologic studies
American Journal of Epidemiology
American Journal of Public Health
Annals of Epidemiology
Epidemiology
Epidemiological Bulletin
Epidemiologic Reviews
International Journal of Epidemiology
Journal of Epidemiology and Community Health
Morbidity and Mortality Weekly Report
Public Health Reports
Books to read/reference to expand your knowledge of epidemiology
Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health.
Sudbury, MA: Jones and
Bartlett, 2003. (more advanced than your text)
Gordis L. 3rd Ed. Epidemiology . Philadelphia, PA: Elsevier Saunders, 2004. (a good introductory text)
Gregg MB. Ed. Field Epidemiology.
2nd Ed. New York: NY, 2002. (for those interested in outbreak investigations)
Haynes RB, Sackett DL, Guyatt GH, Tugwell P. Clinical Epidemiology: How to do Clinical Practice
Research.
3rd Ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2006. (For those interested in epidemiology in clinical settings).
Last JM, Ed. A Dictionary of Epidemiology . New York, NY: Oxford University Press, 2001. (good reference)
Rothman KJ. Epidemiology An Introduction . New York, NY: Oxford University Press, 2002. (more advanced than your text)
Rothman KJ, Greenland S. Modern Epidemiology . 2nd Ed. Philadelphia, PA: Lippincott Williams &
Wilkins, 1998. (very advanced text, good reference)
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Susser M. Causal Thinking in the Health Sciences . Oxford University Press, 1973. (landmark book by world-renowned epidemiologist, on ways to look theoretically at causal connections; on reserve at
Library).
Teustch SM, Churchill RE. Principles and Practice of Public Health Surveillance . 2nd Ed. New York,
NY: Oxford University Press, 2000. (extensive text about surveillance
CLASS POLICIES AND PROCEDURES
Course structure : The class will meet once per week for two hours, 40 minutes with a 10-minute break in the middle of the session. The class sessions will consist of lectures, discussions, and case studies. Students will be responsible for reading all assignments prior to class and for being prepared to discuss the readings. Homework is due on the syllabus lecture date where it is indicated. This is a web-assisted class. The lecture notes will be available on the web site several days prior to a given session. The web address for this course will be announced in class once it is available.
Participation : Participation will be evaluated based on classroom attendance and participation in class
(student participating fully in discussions, demonstrating that he or she has read the assigned materials).
Two absences are granted for each student (excused or unexcused). For each additional absence the participation grade will decrease by 5 points (e.g. 1 additional absence will decrease a participation grade of 100 to 95, 2 from 100 to 90, etc.).
Participation in class will be demonstrated by active participation in discussions and completion of assigned exercises. Students who clearly have not read the assigned readings or are unable to discuss the assigned exercises will have 5 points deducted from their participation grade for each time instructor notes lack of preparation.
Standardization and ethics assignments : There will be two assignments that must be turned in. One is the direct and indirect standardization exercise. The other is the Human Participant Protections
Education self-study certificate. You will receive 100 points for each of these assignments as long as they are turned in on time. 10 points will be deducted per day late.
Figure/table assignment
During the first set of lectures, you will each be assigned a disease for which there are surveillance data in Miami-Dade County. Your will create tables and figures that you will have several weeks to work on. More information will be distributed at the appropriate time in the class schedule. Figure/table a ssignments received late will be subject to the same deductions as the standardization and ethics assignments .
Exams: Exams will be a multiple-choice exam. Exams assess how well students have met the course objectives. Contact the instructor by e-mail or phone if you are sick or have another emergency preventing you from taking the exam. You must have a doctor's note if you are sick enough not to take your exam.
Important : Bring a calculator to each class and all tests.
Disability
Exams may be timed. If you have any disability that may prevent you from completing the exam on time, please let the instructor know by the second week of class by email. If you have disability and/or need special assistance, please make arrangements through the Office of Disability Services (305-348-
4131).
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Course Requirements
Midterm exam I
Midterm exam II
Figures/tables Exercise (Competency assessment)*
Standardization /ethics assignments
Classroom participation
Final exam
Weights
20%
20%
20%
5%
10%
25%
Total 100%
Letter
*Competency Assessment: Exercise will require that you describe a health phenomenon (e.g., a reportable disease or condition) in terms of magnitude, person, time and place. You will be communicating these epidemiologic data to your peer audience. The core competencies will be assessed using the rubric attached at the end of this syllabus. This assessment will constitute one-fifth (20%) of the total grade.
Range Letter Range Letter Range
Grade Grade Grade
A 92.6 - 100 B- 79.6 - 82.5 D+ 66.6 - 69.5
A-
B+
B
89.6 - 92.5 C+
86.6 - 89.5 C
82.6 - 86.5 C-
76.6 - 79.5 D
72.6 - 76.5 D-
69.6 - 72.5 F
62.6 - 66.5
59.6 - 62.5
< 59.5
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Incomplete grade: The university policy on incomplete grades is as follows: "An incomplete grade is a temporary symbol given at the discretion of the instructor for work not completed because of serious interruption not caused by the student's own negligence."
Florida International University is a community dedicated to generating and imparting knowledge through excellent teaching and research, the rigorous and respectful exchange of ideas and community service. All students should respect the right of others to have an equitable opportunity to learn and honestly to demonstrate the quality of their learning. Therefore, all students are expected to adhere to a standard of academic conduct, which demonstrates respect for themselves, their fellow students, and the educational mission of the University. All students are deemed by the
University to understand that if they are found responsible for academic misconduct, they will be subject to the Academic Misconduct procedures and sanctions, as outlined in the Student Handbook.
Misconduct includes: Cheating – The unauthorized use of books, notes, aids, electronic sources; or assistance from another person with respect to examinations, course assignments, field service reports, class recitations; or the unauthorized possession of examination papers or course materials, whether originally authorized or not. Plagiarism – The use and appropriation of another’s work without any indication of the source and the representation of such work as the student’s own. Any student, who fails to give credit for ideas, expressions or materials taken from another source, including internet sources, is responsible for plagiarism. All students are expected to abide by the Florida International University Honor Code. Any violation will be reported.
DATE TOPIC ASSIGNMENT
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Introduction and History
Objectives:
The student will be able to
 Describe instructor’s expectations of students during course
 Define the term “epidemiology”

List common determinants

Describe several uses of epidemiology in medicine and public health
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Compare and contrast descriptive and analytic epidemiology

Recall the history of epidemiology
Practical Applications and Measures
Objectives:
The student will be able to

Describe uses of epidemiology

Compare and contrast Koch and Hill causation criteria
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Construct an epidemiologic triangle

Identify which measures are proportions, percentages, and rates

Calculate common measures used in public health

Compare and contrast prevalence, cumulative incidence and incidence rate

Calculate crude and specific rates

Calculate adjusted rates using direct and indirect standardization

Define and calculate YPLL
- Friis: Chapter 1 (History and
Scope of Epidemiology)
- CDC: Ch 1 pages 1-13
-
- Friis: Chapter 2 (Practical
Applications of Epidemiology)
- CDC ch 1: pages 52-55;
CDC ch 2 pgs 1-9
- Friis: Chapter 3 (Measures of
Morbidity and Mortality)
- CDC ch 3: pages 1-19
- Figure/table topics to be assigned
- Indirect and Direct standardization exercise sheet posted
Measures (Cont.)
Objectives:
Same as prior lecture
- CDC ch 3: pages 20-38
Exercises due: Friis Chapter 3
(#2, #3, #5, #6),
- CDC ch 3 Exercise 3.1-3.5
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Person, Place and Time
Objectives:
The student will be able to

Give an example of a health problem, - Friis: Chapter 4 (Descriptive
Describe roles of descriptive and analytic Epidemiology) epidemiology -

Given a research question, compose a null
CDC ch 4: pages 1-39
- Exercises due: Friis Chapter 3 hypothesis

List several possible explanations for secular
-
(#4, #7)
Direct and indirect changes

Compare and contrast cohort and secular
- standardization exercises due analyses
MIDTERM EXAM
Sources of Data, Surveillance, and Organizing
Data
Objectives:
The student will be able to

List advantages and disadvantages of primary and secondary data

Recall criteria to assess if you can use secondary data

Relate examples of secondary data used in epidemiology

Define surveillance

Describe a case definition

Describe notifiable disease surveillance system

Construct tables and figures using epidemiologic data
Study Designs
Objectives:
The student will be able to

Compare and contrast observational and experimental trials

Describe characteristics, advantages and disadvantages of following design types:
-Ecologic,
-Cross-sectional,
-Case-control, Cohort,
-Experimental

Give a study description and classify the study into a design type

Calculate and interpret odds ratio and relative risk
- Friis: Chapter 5 (Sources of
-
-
Data)
- CDC: ch 4: 1-53 and CDC chapter 5: 1-34
Do exercises 4.1, 4.3, 4.5, and
4.6 (This material will be on exam 2. If you have any problems with these exercises, make an appointment with the instructor.)
Friis: Chapters 6 and 7 (Study
Designs)
Page 8 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Study Designs
Objectives:

Same as for previous lecture
- Friis: Chapter 8 (Experimental
Study Designs)
- Exercises due: Friis Chapter 6
(#3, #7, #8, #9) and Chapter 7
(#5,#7), CDC 1.7
- Figure/table assignment due
Measure of Effect
Objectives:
The student will be able to

Compare and contrast absolute and relative effects

Calculate and interpret risk difference, population risk difference, etiologic fraction and population etiologic fraction

Compare and contrast type I and type II errors
SPRING BREAK – NO LECTURE
- Friis: Chapter 9 (Measures of
Effect)
- CDC Ch3: pages 38-50
- Exercises due: Friis Chapter 8
(#8, #9)
SECOND MIDTERM EXAM
Objectives (For Human Participants assignment):

Discuss importance of informed consent

Describe key ethical principles guiding human research
Bias, Confounding, Error and Interactions
Objectives:
The student will be able to

Compare and contrast internal and external validity

Identify random and systematic errors

Describe main sources of bias

Identify techniques to reduce bias at design and analysis phases

Discuss concept of confounding

Describe methods to control confounding

- Assignment : Students will complete the Human Participant
Protections Education for
Research Teams self-study at the NCI web site: http://phrp.nihtraining.com/user s/login.php
. The certification of completion is due on 4/3. The certificate is required to pass this course. The material will be on the final.
- Friis: Chapter 10 (Data
Interpretation Issues)
- Exercises due: Friis Chapter 9
(#3-10)
-
Page 9 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Screening
Objectives:
The student will be able to

List principles for a successful screening program

Identify length time and lead time biases

Calculate sensitivity, specificity, positive predictive value and negative predictive value

Describe effect of prevalence on positive predictive value

Discuss potential harms of a screening program
Infectious Disease Epidemiology; ethical issues;
MOCK DEBATE
Objectives:
The student will be able to

Calculate attack rate, secondary attack rate and case fatality rate

Describe how an outbreak investigation is conducted

Describe ethical issues associated with epidemiologic studies
- Friis: Chapter 11 (Screening for
Disease)
- Exercises due: Friis Chapter 10
(#6-10)
- Human Participant Protections
Education certificate due
-
-
-
Friis: Chapters 12
Exercises due: Friis Chapter 11
(#5-10)
- Parker LS , Alvarez HK.
Legacy of the Tuskegee
Syphilis Study Module. Ethics and Public Health Model
Curriculum. Association of
Schools of Public Health.
Available at: http://www.asph.org/UserFiles/
Module2.pdf
. Be prepared to discuss the lead case study
Infectious Disease Epidemiology; ethical issues;
MOCK DEBATE
(Objectives: same as prior lecture)
FINAL EXAM
- TBA
** The schedule and reading assignments are subject to change, but you will be given at least 1 week notice. Please download and read them out prior to class.
Suggestions for students to be successful in course:
1) Be prepared (e.g. complete readings and prepare case studies) for each discussion session and participate fully. Address and resolve your questions as they come up.
Page 10 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

2) Work through all the questions in the assigned chapters of the CDC Principles of
Epidemiology self-study work.
3) Organize study time around objectives listed in syllabus as well as those presented for each class session.
4) Your text has a web site with some review questions. You will find them helpful for studying: http://publichealth.jbpub.com/friis/Friisstudyguide.doc
.
Epidemiology
Use epidemiologic measures to describe public health conditions in a population in terms of magnitude, person, place, and time.
Epidemiology
Use information technology to interpret and communicate public health data to lie and professional audiences.
Biostatistics
Use biostatistical measures of distribution shape, central tendency, and variability, and apply statistical analysis software to describe population health and demographic data.
Access and evaluate public health data, using information technology.
Biostatistics
Health Promotion and
Disease Prevention
Identify and assess the underlying social, cultural, and behavioral determinants of health and how they impact the health status of the population.
Health Promotion and
Disease Prevention
Propose public health policies and programs that are collaborative, culturally appropriate, and address the causes of health problems.
Environmental and
Occupational Health
Identify environmental and occupational determinants of health and illness in a population.
Environmental and
Occupational Health
Health Policy and
Management
Health Policy and
Management
Differentiate applications of environmental health science tools in public health core functions.
Apply principles of public health budgeting.
Use policy information (health, fiscal, administrative, legal, ethical, social, and political) to inform public health decisions.
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PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Student Name:______________________________________________
Topic:___________________________________
Evaluator:_____________________________________ Date________________
Introduction to Epidemiology Exercise
1
2
Category Undeveloped
0
Developing
1
Adequate
2
Obtains numerator 0-did not obtain 1-obtained and denominator data correct numerator or numerator and
(competency #2 denominator data denominator data but for incorrect populations or years
2-obtained correct numerator and denominator data, but minor errors in transposing data
Calculations of epidemiologic measures
(prevalence,
0-did not demonstrate knowledge of how to set up incidence, mortality, etc.) (competency #1) calculations
1-multiple errors throughout assignment, but demonstrated understanding of how to set up calculations
2-correct calculations for assignment except for one to two minor errors
Proficient
3
3-obtained correct numerator and denominator data and no errors
Total points and how to improve
3-correct calculations for entire exercise, no errors identified
3
4
5
Formatting of graph
(competency #2)
0-data depicted incorrectly and more than 2 errors in graph formatting
1-data depicted incorrectly or more than 2 errors in graph formatting
2-correct depiction of data on graph with mostly correct formatting. No more
3-correct depiction of data on graph with correct formatting of graph with complete title (person, than 1-2 errors in labels place, time), footnote with of axes, title or footnote source of data, labeled axes, citing source of data clearly labeled legend.
Description of graph results using epidemiologic terms
(competency #1,2)
Description of graph results using lay terms (competency
#2)
0-description of data in the graph moderately unclear
1-description of data in the graph moderately and incorrect use of more than one unclear or incorrect use of epidemiologic terms more than one epidemiologic terms
0-description of data in the graph moderately unclear and inaccurate
1-description of data in the graph moderately unclear or moderately inaccurate
2-either description of data in the graph slightly unclear or incorrect use of one epidemiologic term
2-either description of data in the graph slightly unclear or slightly inaccurate
3-description of data in the graph correct, clear (would be clear to other public health professionals including standard grammar and correct spelling and punctuation). Correct use of epidemiologic terms.
3-description of data in the graph accurate and would be clear to a lay audience
(no jargon). Standard grammar and correct spelling and punctuation.
6 Formatting of pie chart (competency
#2)
0-data depicted incorrectly and more than 2 errors in pie chart formatting
1-data depicted incorrectly or
2-correct depiction of data in pie chart with
3-correct depiction of data in pie chart with correct more than 2 formatting mostly correct errors in pie chart formatting. No more than 1-2 errors in labels formatting of pie chart with complete title (person, place, time), footnote with of legend, title, or footnote source of data, labeled legend.
Page 12 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

7
8
Description of pie chart results using epidemiologic terms
(competency #1,2)
0-description of data in the pie chart moderately unclear and incorrect use of
1-description of data in the pie chart moderately unclear or more than one incorrect use of epidemiologic terms more than one epidemiologic terms
2-either description of data in the pie chart slightly unclear or incorrect use of one epidemiologic term
3-description of data in the pie chart correct, clear
(would be clear to other public health professionals including standard grammar and correct spelling and punctuation). Correct use of epidemiologic terms.
Description of pie 0-description of chart results using lay data in the pie chart terms (competency
#2) moderately unclear and inaccurate
1-description of data in the pie chart moderately unclear or moderately inaccurate
2-either description of data in the pie chart slightly unclear or slightly inaccurate
3-description of data in the pie chart accurate and would be clear to a lay audience (no jargon).
Standard grammar and correct spelling and punctuation.
9 Formatting of table
(competency #2)
0-data depicted incorrectly and more than 2 errors in table
1-data depicted incorrectly or more than 2 errors in table formatting
2-correct depiction of data in table with mostly correct formatting. No more formatting of pie chart with complete title (person, than 1-2 errors in labels place, time), footnote with of columns and rows, title, or footnote
3-correct depiction of data in pie chart with correct source of data, labeled rows and columns with units
10 Description of table results using epidemiologic terms
(competency #1, #2)
0-description of data in the table moderately unclear and incorrect use of
1-description of data in the table moderately unclear or more than one incorrect use of epidemiologic terms more than one epidemiologic terms
2-either description of 3-description of data in the data in the table slightly table correct, clear (would unclear or incorrect use of one epidemiologic term be clear to other public health professionals including standard grammar and correct spelling and punctuation). Correct use of epidemiologic terms.
Description of table results using lay terms (competency
#2)
0-description of data in the table moderately unclear and inaccurate
1-description of data in the table moderately unclear or moderately inaccurate
2-either description of 3-description of data in the data in the table slightly table accurate and would be unclear or slightly inaccurate clear to a lay audience (no jargon). Standard grammar and correct spelling and punctuation.
11
Total score for grade (maximum possible 33) and comments
Page 13 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.

Core competency #1: Use epidemiologic measures to describe a public health problem in terms of magnitude, person, place and time (Rows 1, 2, 4, 7, 10, maximum possible points 15).
MEAN SCORE _____A mean score of >2 (for rows 1, 2, 4, 7, and 10) is required to attain this competency.
Core competency #2: Use information technology to interpret and communicate public health data to lay and professional audiences (Rows 1 and 3-11, maximum possible points 30).
MEAN SCORE_____ : A mean score of >2 (for rows 1 and 3-11) required to attain this competency.
Page 14 of 14
PHC 6000 – Introduction to Public Health Epidemiology
Changes or Modifications: The Instructor reserves the right to change, alter, add, or delete from the content of this course as deemed appropriate by the Instructor based upon students’ needs.