Epidemiology II

Study Course Description

Course Description Statuss:Approved

Course Description Version:5.00

Study Course Accepted:29.08.2024 11:14:43

Study Course Information
Course Code:		SVUEK_064		LQF level:		Level 7
Credit Points:		6.00		ECTS:		9.00
Branch of Science:		Clinical Medicine; Public Health		Target Audience:		Public Health
Study Course Supervisor
Course Supervisor:		Ģirts Briģis
Study Course Implementer
Structural Unit:		Institute of Public Health
The Head of Structural Unit:
Contacts:		Riga, 9 Kronvalda boulevard, svekrsu[pnkts]lv, +371 67338307
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		4	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		8
Classes (count)		4	Class Length (academic hours)		4	Total Contact Hours of Classes		16
Total Contact Hours								24
Full-Time - Semester No.2
Lectures (count)		8	Lecture Length (academic hours)		4	Total Contact Hours of Lectures		32
Classes (count)		8	Class Length (academic hours)		2	Total Contact Hours of Classes		16
Total Contact Hours								48
Study course description
Preliminary Knowledge:
Basics of Epidemiology at the introductory course level. Basics of statistical analysis. English language skills to read modern epidemiological literature. Computer skills.
Objective:
The course prepares Master level students for the research work using theory and means of analytic epidemiology.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Introduction, causality, basic epidemiologic concepts.			Classes		1.00	auditorium
2	Introduction, causality, basic epidemiologic concepts.			Lectures		1.00	auditorium
3	Clinical studies.			Lectures		1.00	auditorium
4	Clinical studies.			Classes		1.00	auditorium
5	Age, cohort and period effects.			Lectures		1.00	auditorium
6	Age, cohort and period effects.			Classes		1.00	auditorium
7	Design of observational studies.			Classes		1.00	auditorium
8	Design of observational studies.			Lectures		1.00	auditorium
9	Outcome measures.			Lectures		1.00	auditorium
10	Outcome measures.			Classes		1.00	auditorium
11	Measures of association.			Classes		1.00	auditorium
12	Measures of association.			Lectures		1.00	auditorium
13	Systematic errors.			Classes		1.00	auditorium
14	Systematic errors.			Lectures		1.00	auditorium
15	Confounding factor.			Lectures		1.00	auditorium
16	Confounding factor.			Classes		1.00	auditorium
17	Interaction.			Lectures		1.00	auditorium
18	Interaction.			Classes		1.00	auditorium
19	Stratification and standardisation.			Lectures		1.00	auditorium
20	Stratification and standardisation.			Classes		1.00	auditorium
21	Multifactorial analysis.			Lectures		1.00	auditorium
22	Multifactorial analysis.			Classes		1.00	auditorium
23	Quality assurance and control of studies. Presentation of study results.			Lectures		1.00	auditorium
24	Quality assurance and control of studies. Presentation of study results.			Classes		1.00	auditorium
Assessment
Unaided Work:
• Work with literature. • Extended report on assigned topic. • Preparing presentations.
Assessment Criteria:
• Regular assessment of understanding during the class. • Assessment of the reports of students unaided prepared theoretical matherial. • Results of control tests in every seminar. • Written final test with theoretical questions and solving a task.
Final Examination (Full-Time):		Exam (Written)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		1. Multifactorial theory of health determinants; models of causal inference: a. Will define and state multifactorial theory of health and disease related events. b. Will critically state and interpret Breadfor-Hill causality criteria. c. Will differ causal and non-causal association possibilities of factors with parameters of health outcomes. d. Will solve and assess causal directed acyclic graphs. 2. Age, cohort and period effects: a. Will define age, cohort and period effect. b. Will explain cross sectional relationships at the point in time, taking into account several possible time dimensions. 3. Strategy to choose observational study design; design of special studies: a. Will classify and systematise studies according to population groups and in relation to time. b. Will choose the most appropriate study design corresponding to study task. c. Will explain difference between experimental and observational study design. 4. Measuring health events and states: a. Will recall formulas of measuring health events and states. b. Will identify mathematical difference between states and events. c. Will oppose measures of proportions in closed and rates in opened populations. d. Will describe life table and Caplan-Mayer methods for the survival analysis. 5. Measuring associations of exposure and outcome: a. Will name measures of associations and their estimation formulas. b. Will distinguish absolute and relative difference to express exposure function. c. Will recognise concept of built-in bias. d. Will relate measures of associations to cohort and case-control studies. 6. Random and systematic errors of studies: a. Will distinguish random errors and biases. b. Will list causes of biases and their types. c. Will explain biases of differential and non-differential misclassification. d. Will describe impact of combined biases on effectiveness studies of disease surveillance and screening programmes. 7. Confounding factors: a. Will recognise concept of confounding factor; will report its essence. b. Will define general laws of confounding factors and their exceptions. c. Will list types of confounding factors. d. Will list strategies to control confounding factors. 8. Interaction: a. Will differ cause modifiers from confounding factors. b. Will name and distinguish alternative definitions of interaction. c. Will list and explain strategies to assess interaction. d. Will differ additive and multiplicative interaction. 9. Stratification and standardisation: a. Will expound tasks and methods of stratified analysis. b. Will list and describe methods of standardisation. c. Will explain sense and application of standardisation. d. Will formulate Mantel-Haensel method. 10. Models of multifactorial analysis for adjustment. a. Will identify statistical model of multifactorial analysis corresponding to the design of study. b. Will interpret parameters of multifactorial analysis. c. Will expound principles of statistical modelling. d. Will explain sense of statistical modelling. e. Will conclude about causal relationships using statistical models. 11. Control of reliability and validity of studies: a. Will name methods to assess reliability and validity of studies; will differ reliability and validity. b. Will identify studies of poor quality and inconsistent conclusions. c. Will list and define measures of reliability and validity. 12. Reporting study results: a. Will classify types of graphical presentation. b. Will order data in tables.
Skills:		1. Multifactorial theory of health determinants; models of causal inference: a. Will construct conceptual models for epidemiologic studies. 2. Age, cohort and period effects: a. Will explain impact of age, cohort and period effect on causal inferences. b. Will critically assess eventually clear-cut causal relationships. 3. Strategy to choose observational study design; design of special studies: a. Will evaluate validity of study conclusions depending on advantages and disadvantages of study design at choice. b. Will construct study design in relation to its aim and objectives. 4. Measuring health events and states: a. Will calculate epidemiological measures. b. Will calculate survival probabilities. c. Will construct survival probability plots. d. Will divide the total person time in categories. 5. Measuring associations of exposure and outcome: a. Will calculate measures of association. b. Will apply appropriate measures depending on study design. 6. Random and systematic errors of studies: a. Will estimate impact of biases on study results. b. Will critically assess ignorance of misclassification. 7. Confounding factors: a. Will assess presence of confounding factor by means of different strategies. 8. Interaction: a. Will estimate interaction with two strategies to assess interaction. b. Will discuss effects of heterogeneity. 9. Stratification and standardisation: a. Will calculate standardised measures. b. Will calculate adjusted measures by Mantel-Haensel method. c. Will use stratified data analysis. 10. Models of multifactorial analysis for adjustment: a. Will analyse correlation and regression lines. b. Will check for the presence of confounding factor by statistical multifactorial regression models. c. Will compare non-adjusted and adjusted measures of association. 11. Control of reliability and validity of studies: a. Will calculate reliability and validity of studies. b. Will assess the quality of research. 12. Reporting study results: a. Will discuss the quality of study results' reports.
Competencies:		• Will design and plan epidemiological studies. • Will critically assess epidemiological studies. • Will justify decisions with impact on public health with quantitative evidence.
Bibliography
No.	Reference
Required Reading
1	M. Szklo, M. Nieto, F.J. 2019. Epidemiology Beyond the Basics. 4th Edittion. Burlington: Jones & Bartlett Learning.
Additional Reading
1	Rothman, K.J., Greenland, S., Lash, T.L. 2021. Modern Epidemiology. 4th edition, Lippincott – Raven Publishers
2	L.M. Friedman, L.M,. et al. 2015, Fundamentals of Clinical Trials. Springer Science+Business Media.
3	Jan P. Vandenbroucke, J.P. PearceInternational, N. 2012. Case–control studies: basic concepts. Journal of Epidemiology, 2012;41:1480–1489
4	Lystad, R.P., Brown, B.T. 2018. “Death is certain, the time is not”: mortality and survival in Game of Thrones. Injury Epidemiology, 2018, 5:44.
Other Information Sources
1	Internnational Epidemiological Association
2	Introduction to Survival Analysis
3	How to Interpret and Use a Relative Risk and an Odds Ratio