HS 470—Epidemiology

T-TH 9:45-11:15—Clarke 149

Brother Tyler WatsonOffice – 145 B Clarke

hone – x 1378

Office Hours --- 9-10 M, W, F Thursday 4-5

Required Text: Gordis, L. (2004). Epidemiology, 3rd Edition, Elsevier Sanders, Philadelphia, Pa. ISBN: 1-4160-2530-8

Heymann, D. L. (2004). Control of Communicable Diseases Manual, 18th Edition, American Public Health Association, Washington, DC. ISBN: 0875530346

Introduction to the course

Epidemiology is “the study of how disease is distributed in populations and the factors that influence or determine this distribution” (Gordis, 2004). It is much more than a definition though… Epi is one of the basic underlying sciences in public health and health care in general. It is how we measure the likelihood that someone who is inactive will develop diabetes… it is how we predict how well a treatment protocol will work for brain cancer patients… it is how we figure out if the potato salad or the honey glazed ham made 300 people sick at the stake picnic. Epidemiology is an exciting field of study and practice that informs the public and health care practitioners about disease and disease risks. I will do my best to make it exciting and relevant, but you will need to read the book, complete practice exercises, and stay engaged in learning this interesting and practical subject.

We will be doing applied statistics in this course in order to solve health care problems. A basic understanding of statistics and algebra (manipulating equations, adding, subtracting, multiplication, division, and decimal place movement) will be VERY valuable in this class, and is assumed.

We will work on a number of case studies in class. The purpose of case studies is to help you apply the information that you learn in class and from your text. There are times when the case will ask you to make a decision, or do something that WE HAVE NOT COVERED IN CLASS. That is intended. These are exercises that should make you stretch and grow and try to understand and apply the principles and concepts of epidemiology. Do not be afraid to try… Push and stretch and you will master this subject.

Course Objectives:

  1. Understand the basic principles of epidemiology
  2. Be able to extract numerator and denominator data and use them in epidemiological analysis
  3. Demonstrate the ability to calculate incidence, prevalence, attack rates, and determine outbreak occurrence
  4. Be capable of conducting an epidemiological investigation using appropriate study design
  5. Critically analyze epidemiological data and case reports
  6. Develop team follower-ship and leadership skills

This class also shares the following objectives of the National Commission on Health Education Credentialing, Inc.

Responsibility 1--Assess Individual and Community Needs for Health Education

Competency A – Assess existing health related data

  1. Conduct health–related needs assessments
  2. Implement appropriate measures to assess capacity for improving health status

Competency C-- Distinguish between behaviors that foster and hinder well–being

  1. Identify diverse factors that influence health behaviors
  2. Identify behaviors that tend to promote or comprise health

Competency F-- Infer needs for health education from obtained data

  1. Analyze needs assessment data

Class Policies:

Mutual respect: Public health/medical issues can, at times, be controversial. Discussion of the pros and cons, ethics, and policy proposals may be discussed in this class. Purposeful and respectful debate help stimulate critical thinking, but degrading and disrespectful argumentation create a negative learning environment. Opinions, brainstorming, analysis and debate should be respected and encouraged. It is also important to remember that academic debate does not necessarily reflect an individual’s personally held opinion of a particular topic.

Attendance: I will not be counting heads or taking attendance in class. You are all professionals and are expected to attend class. Furthermore, there will be in-class quizzes or assignments that will require your attendance for points. Finally, I promise that you will have considerable difficulty on the exams if you are not in class most of the time.

Cell Phones: I understand that each of us need to remain connected with our lives and the primary way in which we do that is through our cell phones. However, in the classroom, cell phones can be distracting. Even when on “vibrate” they disrupt the flow of class. So… Turn your Phone OFF! If you have a legitimate need for your cell phone during class (you are on call, you have a sick child at home, other emergency) talk to me BEFORE CLASS, otherwise make sure it is off.

IF YOUR PHONE GOES OFF WHILE IN CLASS, YOU WILL LOSE 5 POINTS ON YOUR FINAL GRADE!

University Policies: My goal is to help you become the best professionals possible. I will therefore diligently work with you to uphold the standards you have committed to.

Services for Students with Disabilities: The BYU-Idaho catalog (page 55) addresses the needs for services for students with physical and academic disabilities. If you have any specific needs that relate to this policy please discuss them with me either in my office or through e-mail.

Academic Honesty:BYU-Idaho students should seek to be totally honest in all their dealings. They should complete their own work and be evaluated for that work. They should avoid academic dishonesty and misconduct in all its forms, including but not limited to plagiarism, fabrication or falsification, cheating, and other academic misconduct. (BYU-Idaho Student Catalog, pg 45, BYU-I Honor Code)

Dress Code: The dress and grooming of both men and women should always be modest, neat and clean, and consistent with the values and principles of Brigham Young University–Idaho and The Church of Jesus Christ of Latter-day Saints.

Good taste, common sense, discretion, consideration, and high moral standards are the watchwords for dress and grooming. Flagrant behavior or extreme dress and grooming at any time or in any place may result in a review of the individual’s understanding of the expected behavior or grooming. Clothing is to be modest in fabric, fit, length, style, and appropriate for the occasion. Men’s and women’s dress should be reflective of their gender, while excessive or extreme styles should be avoided. For women, wardrobe selection should reflect modesty and femininity becoming a Latter-day Saint woman. For men, clothing should reflect good taste and masculinity becoming a priesthood bearer.

Please make sure you have read and understand the policies in the undergraduate catalog

Grading: Students will be graded on a linear scale (not curved). An “A” is a grade of merit and will take dedication to coursework and mastery of subject matter. Just completing the minimum expectations does not denote “A” effort. You will need to take the time to study, apply, and understand these topics in order to get an A. The grading system for this class is below.

A = 93-100A- = 90-92

B+ = 87-89B = 83-86B- = 80-82

C+ = 77-79C = 73-76C- = 70-72

D+ = 67-69D = 63-66D- = 60-62Failing = < 60

Assignments:

60 Pts-- Test 180 pts-- In-class open book quizzes (communicable disease book

60 pts-- Test 210 X 10 pts= 100 pts-- Chapter quizzes

60 pts-- Test 320 pts—Debate

20 pts-- Internet information exercise50 pts—Article assign/presentation

TOTAL 450 PTS

TESTS

There will be 3 tests in this class. The first 2 will be given in the testing center. The third will be a comprehensive, problem-based, take home test. I will open the test at the beginning of the day on the day listed. It will close on the day listed as well. I do not leave the test in the testing center for a week or more (most likely 2-3 days). Exceptions must be made WELL in ADVANCE. If you miss a test because you forgot the date (or other similar excuse) you are not likely to be given the chance to make up the test, so plan ahead, come to class, and don’t wait until the last minute.

QUIZES (communicable disease)

The little green book is extremely useful for people in our profession. It is a quick reference guide to understand infectious diseases, their incubation period, how they are transmitted, what to do when you have a patient with the condition, and how to prevent outbreaks. You will be given a quiz EVERY Tuesday at the beginning of class. These are open book quizzes and are intended to help you become familiar with the book, and how to use the information that it contains. You will become more proficient as the semester goes on. Some diseases are quite similar, with similar symptoms, incubation periods, (some are even just different variants of the same infection) and so forth, so read the information carefully, or you may end up with the wrong answer.

INTERNET INFORMATION EXERCISE

The internet is a wealth of knowledge… unfortunately, it is not always reliable, accurate, or easy to interpret. Even reputable sources of information contain difficult to understand reports, databases, and such. Epidemiology relies on accurate and complete information. In order to complete epidemiological analysis, you will need to know where to get good information. This exercise is meant to help you navigate and find reliable information, make sense of it, and use it in your analysis.

CHAPTER QUIZZES

You will be quizzed at the end of most chapters to help you practice and integrate the material we are working on in class. The quizzes will cover:

  1. Chapter 1 and 2—Intro and disease transmission
  2. Chapter 3 and 4—Morbidity and Mortality
  3. Chapter 5—Sensitivity and Specificity
  4. Chapter 6—Survival
  5. Chapter 7 and 8—Efficacy, # needing treatment, randomized trials
  6. Chapter 9—Cohort studies
  7. Chapter 10—Case control and cohort studies
  8. Chapter 11 and 12—Risk (odds ratio, relative risk)
  9. Chapter 14—Causation
  10. Chapter 15—Bias, confounding, interactions

DEBATE PARTICIPATION

We will debate a controversial public health topic at the end of this class. This debate will be your opportunity to apply epidemiology to policy recommendations. You will be assigned to the pro or con side of the debate through randomization (whether you agree with the pro or con side is not relevant to this exercise). You and your team will research the topic, apply epidemiological principles, and come up with a concrete plan to present your case convincingly. Some research material will be given to you, but you will have to find much more to effectively understand the topic. This is a capstone event and one that most students find to be the best part of the class. It is exciting, energetic, and difficult. However, you will be well prepared to continue to use epidemiology throughout your life.

Class Schedule:

1/10 / Intro… Why epidemiology / 3/6 / More on risk
Test 2 closes 3/7 / Chap 12
1/15 / Intro to epidemiology principles
Disease transmission / Chap 1-2 / 3/11 / Risk catch up
QUIZ 8
1/17 / Measuring Disease
QUIZ 1 / Chap 3-4 / 3/13 / Causation / Chap 14,
1/22 / Graphical/mapping methods
QUIZ 2 / 3/18 / Quiz 9
Bias etc
1/24 / Visalia Case study / 3/20 / Bias Etc / 15, 16
1/29 / Sensitivity and Specificity
Internet activity assignment due / Chap 5 / 3/25 / Quiz 10
Epi article assignment
1/31 / Sensitivity and specificity / 3/27 / Article presentations
2/5 / HIV case study
QUIZ 3 / 4/1 / Case study
Test 3
2/7 / Catch up
Test 1 opens / 4/3 / Epi policy-Prep for debate
Test 3 due / Chap 19
2/12 / How long do I have doc?
Test 1 closes / Chap 6 / 4/8 / Preparation for debate
2/14 / Treatment 1 v. Treatment 2
Quiz 4 / Chap 7 / 4/10 / Debate issue
2/19 / More Randomized Trials / Chap 8
2/21 / Case Control and Cohort Studies
QUIZ 5 / Chap 9-10
2/26 / Case control and cohort
QUIZ 6 / Chap 13
2/28 / Case control and cohort catch up and case study
3/4 / Risk
QUIZ 7
Test 2 opens / Chap 11

**Schedule subject to change**

Practice problems:

Chapter in Gordis / Practice problems
Chap 2 / Gordis review (GR) Chap 2:1-5
Chap 3-4 / GR
Chap3: 2,5,6,7
Chap 4: 1-4, 6, 8-10
Chap 5 / Handout
Chap 6 / GR Chap 6:2
Chap 8 / GR
Chap 8: 1-3, 6-7
Chap 10 / GR Chap 10: 1-7
Chap 9 / GR Chap 9: 2-5
Chap 14, 15 / GR Chap 14: 1-6
Chap 15: 1-2