UNI373H1: Epidemiology
Winter 2015
Co-Instructors:
Jennifer Bethell, MSc, PhD
Dalla Lana School of Public Health, University of Toronto
jennifer.bethell@utoronto.ca
Nancy Kreiger, M.P.H., PhD
Dalla Lana School of Public Health, University of Toronto
nancy.kreiger@utoronto.ca
416-978-7523
Teaching Assistant:
Laura Bogaert, MSc, PhD student
Dalla Lana School of Public Health, University of Toronto
laura.bogaert@mail.utoronto.ca
Day/Time:
Thursdays 1-4pm
Location:
Room 175, University College
Course Description:
This course is designed to provide students with an introductory overview of the
principles, concepts, and methods of epidemiology. Students are not expected to have
prior background in epidemiology.
Prerequisites:
UNI209H1 (Introduction to Health: Determinants of Health & Health Care)
STA221H1 (The Practice of Statistics II) or equivalent
Exclusions:
HMB342H1 (Epidemiology of health and disease)
Objectives:
At the end of this course, students should be able to:
 Define epidemiology
 Distinguish between different epidemiologic measures and recognize when each can be applied
 Distinguish between common epidemiologic study designs and the types of findings that each
generates
 Critically appraise epidemiologic studies reported in the academic literature and media
 Design an epidemiologic study
Required Text:
Webb P, Bain C. Essential Epidemiology: An Introduction for Students and Health Professionals (2nd ed.).
Cambridge, UK: Cambridge University Press, 2011
Course Format:
Weekly sessions include a 2-hour lecture followed by a 1-hour tutorial. Attendance at both the lecture and
tutorial is required. The lectures will include a mix of presentation and discussion on a new topic each week.
Students are expected to come to class prepared to ask questions and discuss the assigned readings. The
tutorials are designed to provide students with opportunities for further clarification and application of the
material covered in the lectures, as well as opportunities to meet for group work (written assignment #1).
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Office Hours:
There will be no formal office hours. Students are encouraged to contact the instructors by email or phone to
make an appointment. Students are also welcome to approach the instructors before or after the class session
to ask questions or make an appointment.
Course Resources:
Additional course resources and materials are available online through Blackboard, accessible via the
University of Toronto’s Learning Portal (https://portal.utoronto.ca/). Students are expected to check the
course site on Blackboard on a regular basis.
Students must have a valid UTORid account to access the Learning Portal/Blackboard. It is the student’s
responsibility to obtain a UTORid if they do not already have one. Information and assistance on setting up a
UTORid account is available at Information Commons at Robarts Library
(help.ic.utoronto.ca/category/2/accounts-and-passwords.html).
Grading:
Mid-term exam (20%)
Quizzes (25%)
Written assignment 1 (30%)
Written assignment 2 (20%)
Participation (5%)
Mid-term exam (20%): A mid-term exam will be held in class on February 12, 2015. The exam will consist of
short-answer questions and calculations based on the material covered in the lectures and tutorials in the first
5 weeks of the course. Students will require a calculator. Students will not be permitted to use the calculator
function on a cell phone, smart phone, laptop, or other personal electronic device.
Quizzes (25%): Seven short quizzes will be held during the tutorials (see the last section on Schedule and
Readings). Five of these quizzes will count toward the student’s final grade (5% each). Two quizzes of the
student’s choice will be discounted; unless otherwise specified by the student, the two lowest grades will be
automatically dropped. The quizzes are designed to test students’ familiarity with the material covered in that
week’s lecture and assigned readings. Success on the quizzes will depend on the student keeping up with the
readings and course material.
Written assignment 1 (Part 1: 10%, Part 2: 20%, Total: 30%): Students will write a paper summarizing an
epidemiological study of their own design, an assignment which will be completed in two parts. The
assignment will be completed in small groups, to be assigned in class by the instructors. All members of the
group will receive the same grade, although there will be an opportunity to evaluate the participation of your
fellow group members. The purpose of this assignment is to test students’ understanding and ability to apply
the concepts learned throughout the course.
Part 1 (10%) (Due: March 5, 2015): In part 1 of this assignment, students will write a paper no longer than 4
double-spaced pages, outlining the research question they intend to answer, including the study design they
would like to use. Any references, tables or charts may be appended, as appropriate, and do not count
towards the page limit. The paper should:
 Identify the health phenomenon to be addressed and the purpose of the study
 Summarize what is currently known about the health phenomenon and why the proposed study is needed
 State the research question(s) and (if applicable) hypothesis
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
Describe and provide a rationale for the selected study design
Part 2 (20%) (Due: April 2, 2015): In part 2 of this assignment, students will build on the feedback received
from part 1 and provide methodological details of their epidemiological study. The final paper will be no longer
than 8 double-spaced pages, and will include some of the content from part 1 in this page allotment (ie. brief
literature review, rationale, research question). In addition to the content from part 1 of the assignment, the
paper in part 2 of this assignment should include further methodological details such as:
 Describe of the people who will be included in the study and how they will be recruited.
 Describe the measures to be calculated (e.g., morbidity, mortality, prevalence, incidence) and/or the
associations to be tested (e.g., risk ratio, odds ratio)
 Consider potential biases associated with your study design and describe how these will be addressed
 State the strengths and limitations of your study
The paper will be graded based on the clarity and coherence of the literature review, application of the
concepts and materials learned in the course, coherence and quality of the study design and consideration of
its strengths and weaknesses, and overall paper structure and clarity.
A note about group work: Each group member must fulfill each of the following four authorship criteria
(adapted from the International Committee of Medical Journal Editors,
http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-andcontributors.html):
 Substantial contributions to the conception or design of the work; AND
 Drafting the work or revising it critically for intellectual content; AND
 Final approval of the version to be submitted; AND
 Agreement to be accountable for all aspects of the work in ensuring that questions related to the
accuracy or integrity of any part of the work are appropriately investigated and resolved.
Each group will append a page to part 2 of the assignment, listing these criteria and with the signature of each
student in the group to signify that he/she has fulfilled the criteria.
Written assignment 2 (20%): Students will write a paper summarizing and critiquing one of the published
articles from the list provided (due March 19, 2015). The paper should be no longer than 2 single-spaced pages
(4 double-spaced pages), excluding references. A copy of the published article should be appended, along with
any references used in the student’s critique. The paper should include a summary of the study, including the
research question(s), study design, findings and main conclusions, followed by the student’s own critique of
the article. The critique should address the following questions:
 Were the methods appropriate to address the research question(s)? Why or why not?
 Did the study answer the research question(s)? Why or why not?
 How confident are you in the results of this study? Are there any potential sources of bias to be concerned
about? Explain.
 If you were going to conduct this study, would you do anything differently? Why or why not?
 What did you learn from the article? After reading the article, what further information would you like to
learn?
The paper will be graded based on the quality of the study summary, application of the concepts and materials
learned in the course, and overall paper structure and clarity. Chapter 9 from the textbook is a useful
reference for completing this assignment.
Class participation (5%): The participation grade will be based on attendance in classes and tutorials, as well as
involvement in discussions in class and/or online. Students are expected to come to class having read the
assigned readings, so that they can participate fully in class discussions and get the most out of the lectures.
Questions on the readings are welcome at any point during class sessions or online (through Blackboard)
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outside of class hours. The participation grade will be determined based on the quality of students’ input, not
on the quantity or number of times that a student speaks in class and posts online.
Course policies on quizzes, mid-term and assignments:
No make-up quizzes will be offered.
There will be no make-up mid-term examination, except in the case of a valid health or family emergency. It is
the student’s responsibility to provide the instructor with a letter from the College Registrar. If you do not
provide the instructor with a College Registrar’s Letter, you will receive a grade of zero on the mid-term.
The written assignments must be type-written (hand-written assignments are not accepted). Students are
required to submit the assignments electronically using the Blackboard assignment tool. It is the students’
responsibility to learn how to use the Blackboard assignment tool. The file name for the assignments should
consist of the student’s first initial and last name, assignment number, and date (i.e., jbethell_a1_march10).
The written assignments are to be submitted by 1pm on the day that they are due (i.e., before the start of
class). Late assignments will be penalized 5% per day, for up to 5 days. Assignments submitted more than 5
days after the due date will not be accepted, and students will receive a grade of zero on that assignment. Late
assignments will be accepted without penalty only in the case of a valid health or family emergency. It is the
student’s responsibility to provide the instructor with a letter from the Registrar confirming that the Registrar’s
office has documentation verifying the situation.
Technical difficulties on the student’s part (e.g., problems with the student’s computer or internet connection)
are not valid reasons for submitting an assignment late. Late penalties will apply to assignments submitted
after the due date because of technical difficulties on the student’s part. If technical difficulties related to
Blackboard are encountered, the assignment should be submitted directly to the instructor
(Jennifer.bethell@utoronto.ca) prior to the deadline. Students must, in this case, keep a copy of the email in
their outbox as a record of submitting the assignment. Failure to submit an assignment on time due to
technical difficulties with Blackboard will result in late penalties.
Writing support:
Writing support, including workshops and one-on-one assistance, is available through the UC Writing Centre
(www.uc.utoronto.ca/writing-centre). Additional resources on writing are available at
www.writing.utoronto.ca, including a wealth of good advice for planning, organizing, editing, and
appropriately sourcing your material (select the link to Advice). Information on the Writing Plus workshop
series is available at www.writing.utoronto.ca/writing-plus. Information about the English Language Learning
program (ELL) is available at http://www.artsci.utoronto.ca/current/advising/ell.
Students are encouraged to consult these highly valuable university resources.
Academic Integrity and Plagiarism:
Academic integrity is essential to the pursuit of learning and scholarship in a university, and to ensuring that a
degree from the University of Toronto is a strong signal of each student’s individual academic achievement. As
a result, the University treats cases of cheating and plagiarism very seriously. The University of Toronto’s Code
of Behaviour on Academic Matters
(http://www.governingcouncil.utoronto.ca/Assets/Governing+Council+Digital+Assets/Policies/PDF/ppjun0119
95.pdf) outlines the behaviours that constitute academic dishonesty and the processes for addressing
academic offences. Potential offences include, but are not limited to:
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In papers and assignments:
1.
Using someone else’s ideas or words without appropriate acknowledgement.
2.
Submitting your own work in more than one course without the permission of the instructor.
3.
Making up sources or facts.
4.
Obtaining or providing unauthorized assistance on any assignment.
On tests and exams:
1.
Using or possessing unauthorized aids.
2.
Looking at someone else’s answers during an exam or test.
3.
Misrepresenting your identity.
In academic work:
1.
Falsifying institutional documents or grades.
2.
Falsifying or altering any documentation required by the University, including (but not limited to)
doctor’s notes.
All suspected cases of academic dishonesty will be investigated following procedures outlined in the Code of
Behaviour on Academic Matters. If you have questions or concerns about what constitutes appropriate
academic behaviour or appropriate research and citation methods, you are expected to seek out additional
information on academic integrity from your instructor or from other institutional resources (see
http://www.artsci.utoronto.ca/osai).
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Schedule and readings:
Week
Date
1
Jan 8
2
Jan 15
3
Jan 22
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Readings from
Webb & Bain
Topic
Ch. 1 (p.1-27)
-
-
Ch. 2 (p.30-53)
-
Written Assignment #1
Descriptive epidemiology and sources of data
Ch. 3 (p.71-92)
#1: Defining epidemiology,
calculating incidence and
prevalence
-
Jan 29
Introduction to observational study designs
Ch. 4 (p.94-121)
#2: Standardization of rates
-
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Feb 5
Analyzing epidemiologic data: measures of effect
Written Assignment #2 Assigned
Ch. 5 (p. 126-133,
143-146)
#3: Identifying different
study designs
-
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Feb 12
Midterm Exam
-
-
Feb 19
Reading week – no class
Ch. 6 (p. 154-166)
Ch. 7 (p.168-194)
-
Written Assignment #1
Ch. 4 (p.97-106)
#4: Identifying and
describing sources of bias
-
Ch. 4 (p.107-112)
Ch. 5 (p.143-146)
Ch. 8 (p.197-219)
#5: Evaluating a cohort study
-
Ch. 4 (p.112-117)
Ch. 10 (p.238-251)
#6: Evaluating confounding
in analysis
-
-
Written Assignment #1
#7: Evaluating causality and
outbreaks and surveillance
-
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Feb 26
8
Mar 5
What is epidemiology?
Quiz
Tutorial
Group work
Measuring disease frequency
Written Assignment #1 Assigned
Introduction to role of chance and sources of bias
in epidemiologic studies
Study designs: ecologic, cross-sectional, cohort
Due: Written assignment #1, Part 1
9
Mar 12
Study designs: case-control
Introduction to confounding
10
Mar 19
Experimental study designs
Association vs. causation
Due: Written assignment #2
11
Mar 26
Outbreaks and surveillance
12
Apr 2
Prevention and early detection
Due: Written assignment #1, Part 2
Ch. 12 (277-300)
Ch. 13 (307-315)
Ch. 14 (323-343)
Ch. 15 (345-372)
Last day to drop S section course: March 8, 2015
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