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School of Population Health
POPLHLTH 304
Principles of applied epidemiology
Semester 1, 2011
Course Coordinator: Simon Thornley
Copyright Warning Notice
This course book is protected by copyright and has been copied by and solely for the educational purposes of the University under licence.You may not sell, alter or further reproduce or distribute any part of this course book to any other person. Where provided to you in electronic format, you may only print from it for your own private study and research. Failure to comply with the terms of this warning may expose you to legal action for copyright infringement and/or disciplinary action by the University.
Contents
Introduction 3
Course coordinator 3
Course description 4
Key course objectives 4
Structure of the course 4
Lecture Schedule 6
Tutorial Schedule 8
Course Assessment 8
Attendance 8
Examination 8
Assignments 9
Assignment 1 9
Assignment 2 9
Assignment 3 9
Submission of assignments 9
Late Assignment 10
Presentation of assignments 10
References 10
Guidelines on confidentiality of student material (optional) 10
Assignment marking 11
Reading or Recommended Textbook(s) 11
Prescribed texts 11
Other useful reference texts 11
Grading 12
Moderation of Final Marks 13
Academic honesty and Turnitin 13
Plagiarism 13
Additional information 14
Study guide 14
Study groups (optional) 14
Study problems 14
Course evaluation 14
Appendix 1: Survival skills 14
CECIL (http://cecil.auckland.ac.nz ) 14
EC Mail (http://webmail.ec.auckland.ac.nz ) 14
Redirect/forward EC Mail 15
Appendix 2: Useful web URLs 15
Appendix 3: Turnitin 16
Introduction
Kia ora and welcome to POPLHLTH 304, Principles of Applied Epidemiology. The course will introduce students to the practical skills required to design, analyse, publish and interpret epidemiological studies.
Course coordinator
Simon Thornley
Lecturer
Section of Epidemiology and Biostatistics
School of Population Health
University of Auckland
Private Bag 92019
Auckland
Tel: (09) 373 7599 ext 81971
Mobile: 021 2991752
Email:
Course description
The course focuses on the principles of epidemiology with particular reference to New Zealand. We will explore the different study designs used by epidemiologists to assess the effects of different exposures, and under what circumstances such studies are best used. You will also gain ‘hands on’ experience with the analysis of data from real studies, and presenting the findings for publication.
Key course objectives
By the end of the course, each participant will be expected to:
· Become familiar with the main epidemiological study designs, their applications, strength and weaknesses.
· Be familiar with the methods of calculating main study effect measures and confidence intervals.
· Gain skills using Epi Info, a public-domain software package, which allows users to develop a questionnaire or form, customize the data entry process, and analyze data.
· Gain insight into how epidemiological studies have changed the course of medical and public health practice.
At the end of the course the student should have an appreciation of:
· The uses of epidemiological research.
· The limits of epidemiological methods.
· Practical steps involved in developing epidemiological studies.
Structure of the course
The course will consist of approximately 36 contact hours comprising the following teaching modes:
· One hour lectures
· Tutorials of one hour duration.
· Presentations by guest speakers, experts in their field.
Lecture / Wednesday / 10:30-11:30 / 721-201Thursday / 1:30-2:30 / 721-201
Tutorial / Wednesday / 12:30-1:30 / 730-268
Thursday / 2:30 – 3:30 / 730-268
You only have to attend one tutorial per week as the content will be the same in each.
Locations for the lectures and tutorials are available in your class timetable when you log in to Student Services Online.
Students are expected to access their course information on Cecil and receive all information on their University email. See Appendix 2 Survival Skills on page 16 for important information on your email.
Lecture Schedule
Week / Date / Lecture / Topic / Readings1 / 2 Mar / 1 / Course introduction,
Epidemiology and Epi info / Chapter 1, Getting started: The anatomy and physiology of Clinical Research
Selected excerpts from Freedman “Wrong: Why experts keep failing us and how to know when not to trust them”. Little, Brown and Company, 2010.
3 Mar / 2 / Epidemiological measures and attributable risk; discuss first assignment / Epidemiology for the uninitiated; Chapter 2. Available on the web here:
http://resources.bmj.com/bmj/readers/readers/epidemiology-for-the-uninitiated/2-quantifying-disease-in-populations
2 / 9 Mar / 3 / Overview of Epidemiological study design / Hulley, Chapters 7 to 10.
10 Mar / 4 / Sharpening your tools – measurement in epidemiology and an introduction to causation / Hulley, Chapter 9. Epidemiology for the uninitiated; Chapter 4. http://resources.bmj.com/bmj/readers/readers/epidemiology-for-the-uninitiated/4-measurement-error-and-bias
3 / 16 Mar / 5 / Case-control studies (ST) / Hulley, Chapter 8.
17 Mar / 6 / Random error, confidence intervals and power (ST) / Hulley, Chapters 5 and 6
4 / 23 Mar / 7 / Bias, Confounding and Effect modification (ST) / Hulley, Chapter 9. Epidemiology for the uninitiated; Chapter 8. http://resources.bmj.com/bmj/readers/readers/epidemiology-for-the-uninitiated/8-case-control-and-cross-sectional-studies
24 Mar / 8 / Epidemiology and progress: The NZ cot death study (RS) / Scragg R, Stewart AW, Mitchell EA, et al. Public health policy in bed sharing and smoking in the sudden infant death syndrome. NZMJ 1995; 108: 218-22.
5 / 30 Mar / 9 / Cohort studies (ST) / Hulley, Chapter 7
31 Mar / 10 / Cohort studies: an example / To be confirmed
6 Apr / 9 / Cohort studies (ST) / Hulley, Chapter 7
7 Apr / 10 / Cohort studies: an example / To be confirmed
Semester Break
Week / Date / Lecture / Topic / Readings
6 / 27 April / 11 / Multivariate analysis (RM) / Slides and handouts to be provided
28-Apr / 12 / Publication: presenting your results (ST) / To be advised
7 / 4 May / 13 / Epidemiology and Progress: The adverse reactions story (ST) / Pearce, N. Adverse Reactions: the fenoterol story. 2007. Auckland University Press.
5 May / 14 / Epidemiology and Progress: Vitamin D (RS) / Scragg, Robert. Vitamin D Deficiency: A New Risk Factor for Cardiovascular Disease? Australasian Epidemiologist, Vol. 16, No. 1, Apr 2009: 30-34.
8 / 11 May / 15 / Cross-sectional studies (ST) / Hulley, Chapter 8.
12 May / 16 / Randomised controlled trials (NEWS) (ST) / Thornley S, McRobbie H, Lin RB, Bullen C, Hajek P, Laugesen M, Senior H, Whittaker R. A single blind, randomized, crossover trial of the effects of a nicotine pouch on the relief of tobacco withdrawal symptoms and user satisfaction. Nicotine and Tobacco Research. 2009: ntp054
9 / 18 May / 17 / Health data sources and epidemiological studies (ST) / Hulley, Chapter 13
19 May / 18 / Epidemiological research and Maori / To be confirmed
10 / 25 May / 19 / Epidemiology and progress: the passive smoking story / Woodward A, McMichael AJ. Passive smoking and cancer risk: the nature and uses of epidemiological evidence. European Journal of Cancer and Clinical Oncology 1991;27(11):1472-1479.
26 May / 20 / Causation: Bradford Hill, Rothman and Bayesian views. / Chapter 10, Who sank the boat? Association and Causation pp 215 to 248
Mente A, de Koning L, Shannon HS, Anand SS. A Systematic Review of the Evidence Supporting a Causal Link Between Dietary Factors and Coronary Heart Disease. Arch Intern Med 2009;169(7):659-669.
11 / 1 Jun / 21 / Ethical considerations, project management and grant applications (ST) / Hulley, Chapters 13,14,15, 17.
2 Jun / 22 / Epidemiology and progress: recalibrating CVD risk assessment (RJ) / Jackson R, Lawes CMM, Bennett DA, Milne RJ, Rodgers A. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual's absolute cardiovascular risk. The Lancet 2005;365(9457):434-441
Tutorial Schedule
Week / Date / Topic1 / 2/3 Mar / Introduction; discussion of first assignment.
2 / 8/9 Mar / Questionnaire Design
3 / 15/16 Mar / Cot death study: introduction
4 / 22/23 Mar / Cot death study: basic effect measures
5 / 30/31 Mar / Cot Death study: confounding and interaction (1)
Semester Break
6 / 27/28 Apr / Cot death study: confounding and interaction (2)
7 / 4/5 May / Cot death study: multivariate analysis (1)
8 / 11/12 May / Cot death study: multivariate analysis (2)
9 / 13/14 May / Sample size calculation
10 / 25/26 May / Revision
11 / 1/2 Jun / Review for exam
Course Assessment
The assessment of this course is 50% on-course, and 50% final examination.
The assessment consists of:
· Three Assignments: worth 10%, 10% and 30%
· Final examination: 50%. There is a choice of questions to answer during a two hour period. Books are not permitted in the exam, although scientific calculators are required. Date to be announced.
Attendance
A fundamental principle of the course is the assimilation of knowledge and the acquiring of new skills within a cooperative, collegial learning environment. It is therefore expected that students will attend all the sessions.
Examination
The final two-hour examination is worth 50% of the final mark for the module. This will be similar to the papers available in the library, will comprise 10 multiple choice questions and 4 (out of a possible 5) short answer questions, will be two hours long and will focus on both the principles of epidemiology, as well as some of the applications covered in this course only. Examination papers are peer reviewed and a sample of examination questions and/or assignments double-marked by an external assessor. The role of the external assessor is to ensure that questions/assignments are appropriate and marks given reflect the standards expected.
The 2011 semester one examination period is Thursday June 9 – Monday June 27. Note that the examination timetables are not finalised and available to students until 6-8 weeks into the semester.
Assignments
There will be three assignments for this paper:
Assignment 1 (10% of the final mark) Due by 5pm Monday 21 March 2011
Assignment 2 (10% of the final mark) Due by 5pm Monday 4 April 2011
Assignment 3 (30% of the final mark) Due by 5pm Monday 16 May 2011
Assignment 1
You will be provided with a reading from this book (1), which describes the main reasons why scientific studies fail to come up with the correct answers. In less than one thousand words, briefly summarise the main reasons that Freedman cites that result in scientists drawing the wrong conclusions.
This assignment is due by 5pm Monday 21 March 2011 (10 marks). The word limit is 1000 words (excluding references).
Assignment 2
You will be given a worksheet along with a dataset, and be asked to work out some basic effect measures.
This assignment is due by 5pm Monday 4 April 2011 (10 marks). Short answers, along with working is all that is required.
Assignment 3
You will be given a case control study, in which researchers were investigating potential risk factors for coronary artery disease. You will be asked to present the findings of the study as you would in a brief scientific publication, including background, aims, method, results and discussion.
This assignment is due by Monday 16 May 2011 (30 marks). The word limit is 2500 words (excluding references and tables).
Submission of assignments
A hard copy of each of your assignments is required for marking purposes. You are also required to submit an electronic copy of your report to www.turnitin.com (see appendix 3).
DO NOT email assignments directly to the course co-ordinator or tutor unless by prior approval.
The School Policy on submission of assignments is as follows:
1. Due dates for assignments must be strictly observed.
2. Extensions will only be given in very exceptional and unavoidable circumstances, and if approved by the Course Coordinator prior to the assignment due date.
3. No assignments will be accepted after 2 weeks.
Late Assignment
The School policy in relation to late assignments will be applied. Extensions will be considered only in exceptional circumstances and where the request is made within a reasonable timeframe prior to the assignment due date. Assignments received more than 2 weeks after the due date will not be marked and will be graded 0.
Problems / Extension / Late (Do not have a valid reason) / TurnitinIllness or Circumstances / 5% a day (working days)
2 weeks limit
Minor – documentation / Up to 1 week*
Moderate - evidence / Up to 2 weeks
Severe – lots of evidence and get assessed / Help as much as possible
*5 working days as a week
· The extension application should be in 24 hours before the due date.
· One or another (hard copy and Turnitin) is late, punishment applies.
Presentation of assignments
· You must type/word-process your assignments
· Please use two sides of the page to preserve paper
· Please use double spacing (to allow for marker’s comments)
· Please use size 12 font
· Ensure all pages are numbered
· If your graphs and/or diagrams need to be in colour to be interpreted, please ensure you print them in colour
· Please leave an good sized margin down the side for the marker's comments
· Please number the pages and include your ID on each page (header or footer) – do not put your name on the body of your assignment
· Please work within the word limit (you will be penalised for being significantly under or over)
· Please use the cover sheet downloadable from Cecil, and the declaration form.
References
Either the APA system (author, date) or the Vancouver system (numbers) may be used for citing references. Please refer the library website for further details on referencing systems: http://www.library.auckland.ac.nz/subjects/med/referencing-fmhs.htm
Either end notes or footnotes may be used, but stay with one system on a particular assignment.
Guidelines on confidentiality of student material (optional)
Some student assignments may draw on or cite confidential material. The University has prepared general guidelines for the use of information contained in student assignments and thesis material.
The following guidelines apply to student assignments: