Universitat Internacional de Catalunya
Introduction to Epidemiology
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)
Mgt Jorge Piqueras Marqués
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.
Competences/Learning outcomes of the degree programme
- 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 of the subject
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 |
|
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 |
|
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 |
|
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 |
|
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)
- Theoretical-Practical Classes (LM): Sessions for the entire group. The teaching team will explain the theoretical concepts of each topic and propose exercises to be solved in class based on the theoretical concepts explained in the classroom. The dynamics of the classroom will integrate theoretical work with small practical assessments in the classroom.
Due to the density of contents, some topics will not be extensively developed in the classroom, and students will be asked to prepare them on their own with the help of recommended materials and forums and tutorials.
- Problem-Solving Practical Classes (PRc): Group classes divided in a conventional classroom. In each session, review exercises will be carried out around problems that will be given to the students in advance.
The exercises will be designed to provide opportunities for INDIVIDUAL practice with basic concepts before quizzes and the final exam. Tasks are intended to be a learning opportunity. Between 4 and 5 exercises will be uploaded to Moodle one week before the problem-solving sessions that will be worked on in the classroom.
On the day of the PRc session, students who want their work to be counted for grading must bring the exercises PRINTED and make corrections on paper in a different color from the one used. The exercises will be corrected, and students will submit the paper to the teacher at the end of the class, who will validate it. Practical classes have an assessable content of up to 1.5 points (see assessment systems and criteria)
3. Epidemiological Study Project (ABP): Elaboration and defense of the team project. The team project involves the individual submission of a voluntary group project at the end of the subject, where each group member must submit the complete project and a dossier with their individual contributions. The work will commence after the first case method, dedicating half an hour at the end of the MC sessions to achieve specific objectives toward completing the group work.
Students wishing to participate in the project implementation must communicate this within the first two weeks of the course, where the work design will be assigned. The ABP represents an evaluative content rating of 1 point (see evaluation systems and criteria). If the ABP is not presented, the maximum grade obtainable will be 9 points.
The assessment of the project memory work will be individual and based on the criteria detailed in the evaluation rubric. Optionally, and at the professor's request, the group may be called for an individual tutorial with the professor, where the group will present and discuss the project.
Course Moodle Page: The subject's website will present available material (program, bibliography, review exercises, forms, data files, etc.), tasks, and schedule. In addition, consultation forums will be created for subject-related doubts.
To achieve the objectives, the student's constant work is essential. Continuous practice of the subject material is crucial.
Attendance:
The subject is carried out in a face-to-face format. Lectures will be held in a face-to-face format and divided-turn classes will be in a face-to-face format with half the group in the classroom. None of the classroom activities are mandatory, but students should know that continuous assessable PRc activities will be face-to-face and not recoverable.
In divided-turn classes, attendance to the indicated turn must be respected. Turn changes will only be made with the coordinator's authorization and prior notification before the session. Non-attendance will not be made up.
The subject has two credits, estimating an average individual work time of 37 hours, therefore requiring 57 student work hours (20 in the classroom and 37 outside the classroom).
The estimated number of hours per activity is as follows:
|
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 |
FINAL GRADE REVIEWS:
The final grade reviews will take place in a final grade review session after the final exam.
A list of students requesting verification will be made available to claim or review the grading. The faculty will review the evidence and communicate any changes in the grade. If students wish to review the exam, those on the list can attend an in-person review during the scheduled time.
Continuous assessment tasks will not be globally reviewed and reassessed. Grades received for these tasks are final unless a grading error has occurred. Students are encouraged to schedule a tutorial before deadlines to discuss the tasks.
Questions about assignments should be posted in forums, where all students are encouraged to participate for clarification. There will be no email queries regarding assignments, and forum queries may not receive a response from the professor unless they require only a brief and clarifying answer.
TUTORING AND ATTENTION OUTSIDE THE CLASSROOM:
We encourage you to contact the teacher with concerns about the course's progress. To do this, you can request a tutorial during a shared calendar schedule to choose a face-to-face appointment to discuss aspects with the teaching staff. We encourage you to address problems when you have concerns about the course.
COURSE REGULATIONS:
Communication:
The subject's communication channels will ONLY be the topic forums.
The subject will have two forums:
NOTICES FORUM: A unidirectional forum where the teaching staff will communicate with students regarding the subject's procedures or content of general interest. This forum is mandatory reading, and the student must stay informed about the messages.
COURSE REGULATIONS
Communication:
The communication channels for the subject will ONLY be the topic forums.
The subject will have two forums:
NOTICES FORUM: A unidirectional forum where the teaching staff will communicate with students regarding the subject's proceedings or contents of general interest. This forum is mandatory reading, and the student must stay up-to-date with the messages.
CONSULTATION FORUM: A communication forum for students' questions and inquiries, with shared participation. Any enrolled student can participate in the forum. The teaching staff will moderate the forums and be voluntary reading, allowing student communication. Messages directed directly to the teaching staff will be attended to in the forum within a period of 48 hours.
Email will be reserved for communications of strictly personal matters. There is no obligation for the teaching staff to respond to emails.
Submission Deadlines:
All submission deadlines are fixed and will be through established channels. No extensions or exceptions will be granted for these dates. Students are responsible for the material's content as it has been delivered, which must be in accepted formats (PDF). If there are errors of any kind in the documents submitted, or if they are not in the correct channel or format, amendments or exceptions will not be accepted. Unsolicited submissions by email will not be accepted.
Plagiarism:
Plagiarism is the use of ideas or phrases from others in one's own work, 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 by expulsion and permanent notation in the student's personal academic record.
The use of plagiarized content from any source, from another student, from the same or another academic year, will be considered plagiarism, and the work will be canceled. This fact will be automatically reported to the student's advisor and the University Coexistence Committee to take appropriate disciplinary measures.
Copying:
"Copying" refers to obtaining unauthorized information, answers, or solutions during an academic test. This may include looking at another student's answers, using unauthorized material such as notes or electronic devices, or receiving unauthorized assistance in any form during the exam.
Copying is a very serious offense according to Law 3/2022, of February 24, on University Coexistence, as it is a form of academic dishonesty and undermines the integrity of the evaluation process by negatively affecting the equity and validity of results.
For these reasons, activities detected with suspicion of being copied will be invalidated as grading criteria and immediately reported to the Degree Coordination and the University Coexistence Committee for appropriate disciplinary measures.
Material Submission:
Material submissions will only be accepted through the subject's Moodle. Submissions by email will not be accepted unless requested by the teacher. Submitting assignments or tasks should be in portable document format (.pdf).
Last Name1 Last Name2 Name_ExerciseNumber_ExerciseName
Audiovisual Recording of Sessions or Photography in Classrooms:
The explanations of the teaching staff are "lecture explanations" and are subject to intellectual property. Their presence in the classroom is subject to image rights. Unless expressly authorized by the teacher, recording sessions or taking photographs and sharing them is prohibited. The same criteria apply to recordings of interventions or content by classmates.
Notes are versions of the teacher's speech record and are also subject to copyright. Distribution among students for the originally intended purpose is authorized, but public distribution outside the course duration without express authorization from the teacher is not permitted.
According to Law 3/2022, of February 24, on university coexistence (art. 12e), using content or means of reproduction improperly and recording university activities subject to intellectual property rights is a serious offense. If detected, it will be reported to the coexistence committee to establish applicable sanctions for these offenses.
Use of Computers and Mobile Devices:
Technology is a tool, but it is not a source of distraction in the classroom. The use of phones or tablets in sessions for purposes not directly related to the subject will not be allowed. Students found misusing these devices will be expelled from the classroom.
The use of phones or computers during the exam is not allowed. These must be kept out of reach. They will not be stored in pockets or open bags.
Punctuality:
Students will be allowed to enter and leave class or exams once they have started, as long as they enter the classroom discreetly and maintain appropriate order for an academic activity.
Regulations on Respectful Treatment in the University Environment:
The university is an environment of debate, mutual respect, and consideration for all educational community members, including faculty and other students. Respectful and cordial communication is essential to maintain a positive and collaborative academic environment.
Students are encouraged to express their opinions and concerns constructively and respectfully, fostering open and enriching dialogue. Any incident of disrespect will be addressed seriously, and the corresponding sanctions will be applied to maintain a university environment that promotes learning and mutual respect.
Addressing peers or faculty with a disrespectful or inappropriate tone will be considered a serious offense. Any verbal or written expression that indicates a lack of respect, disregard, or inappropriate tone towards faculty will be communicated to the Degree and the University Coexistence Committee and subject to disciplinary measures according to the institution's regulations.
It will be considered serious misconduct in this course:
Any serious misconduct will result in disciplinary action and may lead to a loss of the final grade. Serious offenses will result in automatic fail from the course. Any student committing a serious offense will also be reported to their advisor and the degree coordinator.
(a) Consulting with others during a quiz or exam or using technology for consultation. Students suspected of engaging in these behaviors will be expelled and receive a failing grade.
(b) Accessing a phone, tablet, or other online device during a quiz or exam.
(c) Presenting one's own tasks when they are the work of others without acknowledgment.
(d) Submitting someone else's task as one's own (although collaborating with other students to check their own errors/calculations is allowed, presentations must be individual).
(e) Performing individual activities within a group when it is not indicated to be possible.
(f) Plagiarism or copying of content in any course activity.
(g) Presenting a group project without having participated in its completion.
(h) Displaying a disrespectful or inappropriate tone towards the professor or other students.
Evaluation systems and criteria
In person
ORDINARY CALL
Final Exam
The final exam is a theoretical-practical assessment consisting of two parts:
a) Multiple-choice questions: 30 questions with penalties for errors (60% of the grade).
b) Practical exercises (40% of the grade): This section evaluates competencies related to the selection, application, and interpretation of designs and measures within the program. Two practical exercises, similar to those conducted during case method sessions, are included.
The format of the Final Exam questions will closely resemble the Quizzes and exercises from Case Method sessions conducted throughout the semester. The final exam is conducted on paper in a conventional classroom at the end of the semester. All course materials in paper format (NO computers, tablets, or phones) and a non-programmable scientific calculator are allowed for the exam.
Norms for final exam
The exam will take place on April 2, 2024, from 14:00 to 16:00.
As the exam has been scheduled during class hours, the entrance doors will open promptly, and the exam will begin when all students are seated in the assigned positions. Having phones or tablets nearby during the exam is not allowed: they must be placed under the table, out of reach, and not visible (not in pockets or open bags).
At the end of the exam, it should be left on the table. Exams will not be collected in their positions; students must leave them on the table before the teacher leaves the classroom. The teacher will leave the classroom promptly (at 16:00), only those exams that have been placed on the table.
Continuous Assessment Activities
None of the continuous assessment activities are mandatory. However, they can contribute up to 2.5 points to the overall grade, provided the student passes.
-
Individual Problem-Solving Learning Portfolio (+1.5 points): This comprises a compilation of practical tasks from case method sessions. A week before each case method session, case activities will be uploaded for resolution. To earn the extra grade, students must make two submissions for each session:
a) Pre-activity: Before the case session, each student will upload on Moodle the number of exercises they individually intend to solve.
b) Activity: As per the methodology, during the case session, students must bring a printed copy of the completed task. In the session, each student will correct and self-assess, in a different color, ALL attempted exercises, clearly indicating the corrections. At the end of the session, they will submit this correction on paper to the professor, who will validate it.
The extra grade will be based on the number of exercises submitted and self-assessed by the student. For instance, if a student attempts and corrects 10 pre-activity exercises out of a total of 20 conducted in the classroom, they will receive a +0.75 grade that will be added to the exam. If they attempt and correct all 20 exercises, they will receive +1.5 continuous assessment points, provided the exam is passed.
In all cases, submitting an attempt for the activities before the end of the course is mandatory to pass the subject.
-
Development and Defense of Team Project (+1 point): Evaluation of a voluntary team project (maximum 5 members). This evaluation involves individual submission of a group project at the end of the subject. Interested students must express their intent before the second class session. As individual participation in the work may vary, each student must submit the complete project and a dossier with their individual contributions. Depending on the evaluation, the group may be called for an individual tutorial with the professor, and each group member will be questioned about the project. Only students who have submitted this project will be assessed.
-
Extra Credit Activities (up to 0.3 points): Throughout the subject, small contributions can be made in the classroom or forums, based on prior readings or classroom explanations. Relevant participation will be evaluated with up to 0.3 points to refine the grade, which can be added to the final grade.
Only the attempt activity, to be submitted at the end of the course, is mandatory in continuous assessment. The rest of the assessment activities are not obligatory. However, any instances of copying or plagiarism will not be tolerated in any assessment activities (cases, group work, or exams).
In case of suspicion of such conduct, all involved activities will be invalidated and will not count in the assessment.
GRADE FOR THE ORDINARY CALL
The grade for the ordinary call will be calculated in two ways:
a) Final Exam Grade: Exam (90%, with a minimum of 4 out of 10 points on the exam) + Group work grade (10%).
b) Continuous Assessment Grade + Exam: Exam (75% with a minimum of 4 out of 10 points on the exam) + Portfolio grade (15%) + Group work grade (10%).
The final grade will be the higher of A or B. In both modalities, it is necessary to score a minimum of 4 points in the exam to include the activities.
A passing grade is 5 points in the final grade.
SECOND CALL
In case of non-attendance at the first call exam or obtaining a failing grade in the first call, the student must take the final exam in the second call. The grade for the second call will be based solely on the exam grade. A passing grade in the second call will require a score of 5 points in the final exam.
Bibliography and resources
-
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
- Saracci R. Epidemiology: A Very Short Introduction. Oxford U.K.: Oxford University Press, 2010
- 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).
- Gordis L. Epidemiology. 3rd ed. Madrid: Elsevier España, S.A., 2014.
- Hulley SB, Cummings SR et al. Design of clinical investigations. 3rd ed. Lippincot Williams and Wilkins, 2008.