University of Alberta

Course Guide for SPH 696 B3 Winter Term School of Public Heath

Epidemiology Methods II Fridays, 9:00 – 11:50 ECHA L1-430

Instructor: Katerina Maximova Phone: (780) 248-2076 Email: [email protected] Office: ECHA 3-268

Course Description

This course presents concepts and methods of epidemiology at the intermediate level. This course is intended for graduate students in the MPH, MSc and PhD degree programs specializing in epidemiology and biostatistics. It is designed for students to develop the ability of conduct epidemiologic research independently. The course covers: concepts of causation, measures of disease occurrence and effect, study designs, biases in epidemiologic research, confounding and interaction. Critical assessment of the literature is emphasized.

Competencies

• Describe epidemiological study designs and understand the advantages, limitations and practical aspects of each study design; understand the strengths and limitations of descriptive epidemiology and analytic epidemiology. • Describe the principles of epidemiology in design, conduct and analysis of public health research and/or practice. • Demonstrate ability to match research questions with the appropriate study design. • Identify and communicate potential and/or common pitfalls in using various research methods and statistical analysis approaches. • Understand and identify sources of bias and confounding. • Interpret research results of epidemiological studies and make appropriate inferences based on these results; disseminate findings of epidemiological studies to a variety of audiences. • Understand and interpret descriptive epidemiological measures of disease burden of a given condition, and disease impact for clinical and public health relevance. • Recognize major epidemiological studies and how they inform(ed) past and current scientific, ethical, economic and political discussions and decision making in the area of health and health policies. • Be familiar with and understand the current guidelines for transparent and comprehensive reporting of observational studies and RCTs.

Learning Objectives

SPH 696 2016 Course Syllabus

This course is an extension of the fundamental concepts, principles and methods of epidemiological research and study design addressed in SPH 596 (Epidemiology Methods I). Upon completion of this course, students will be able to:

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1. Be able to formulate a research question and identify appropriate study designs and analytic strategies to address it. 2. Deepen understanding of major epidemiologic study designs, and enhance the ability to evaluate their strengths and weaknesses, and implications for causal inference. 3. Enhance understanding of issues of confounding and bias, and advance the ability to apply strategies to control and minimize it. 4. Calculate, interpret and differentiate properties of measures of association, measures of impact, standardization (direct, indirect, Mantel-Haenszel), mortality and morbidity, including life table approaches. 5. Enhance understanding of effect modification and understand how to evaluate it. 6. Understand different approaches (population-based, high risk) to disease prevention and health promotion. 7. Apply STROBE, CONSORT, TREND statements for reporting results from epidemiologic studies.

Course Format

This is a 14 week course (2 hr 50 min of class time per week) plus final exam.

Required textbook

Rothman KJ. Epidemiology. An introduction. New York, Oxford University Press. 2012

Other required reading

Handouts, slides, and relevant papers will be posted on the course website via eClass (http://www.ualberta.ca/ELEARNING).

Other requirements

Hand calculator, access to a PC computer, the internet, Acrobat Reader.

Prerequisites

SPH 596 and SPH 519 or consent of instructor.

Co-requisites

Concurrent enrollment in SPH 619 is highly recommended.

Course weight

3 credits.

SPH 696 2016 Course Syllabus

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Course structure

Class work Classes will begin with a lecture and large group discussions reviewing the topic of the session and the readings from the textbook or other required readings as assigned. Students are expected to come to class having read and reviewed all assigned materials and be ready to participate in the class. In addition to didactic lectures, students will engage in case studies, group discussions, journal article appraisals, and work on problem sets, quizzes, and exercises.

Library

The University of Alberta library system’s website www.library.ualberta.ca details the range of services offered to students on and off campus. If you need further information or assistance, contact the Library's Electronic Reference Desk at www.library.ualberta.ca/ereference/index.cfm or call 1-800-2070172.

Course Evaluation Mid-Point Course Evaluation:

As is the case with all SPH instructors, I am interested in improving the course. I welcome feedback and recommendations from you throughout the course.

Final Course Evaluation:

Following completion of the course, you will receive a standardized summative evaluation. The standard University of Alberta course evaluation procedure will be followed. This will involve a standard questionnaire with anonymous responses returned to the Student Services Coordinator.

Student Evaluation Percentage

Date

Homework assignments

30%

Posted on eclass

Mid-term exam

35%

February 26, 2016

Final exam

35%

TBD

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Evaluation of Course Homework Assignments: 30% Approximately 10 homework assignments will be completed during Work the course. The goal of these assignments is to provide practice in critical thinking, in calculating, interpreting and applying epidemiological measures, in evaluating and synthesizing material and in applying and evaluating the epidemiological methods and principles covered in class and in readings. Assignments and their due dates will be posted on eclass on the day of the lecture. Assignments must be handed in to the instructor at the beginning of the class the following week. Late assignments will not be accepted. Students may work on these assignments individually or in groups; group work is encouraged. Students working in groups, however, must still prepare the final formulation of their answers individually, not as a group. It is not permitted for a team of students to submit several identical copies of the same answers.

Mid-term exam: 35% Mid-term exam is a closed book exam on material covered to date as well as the introductory material that has been covered in course SPH 596. The mid-term exam is therefore designed as an opportunity to review and consolidate previously acquired knowledge. The format of the exam will be short answer questions. Students will be expected to be familiar with the required readings and material covered in class. The exam lasts 2.5 hours. Desk calculators and paper dictionaries are allowed. Calculators on mobile devices are not permitted. All students must be present. Final exam: 35% Final exam is a closed book exam covering the entire course material, required textbook and readings, including material prior to the mid-term exam. The format will be short and/or medium answer (e.g., an answer requiring a paragraph) questions. The exam lasts 3.0 hours. Desk calculators and paper dictionaries are allowed. Calculators on mobile devices are not permitted. All students must be present.

SPH 696 2016 Course Syllabus

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Grading University of Alberta Calendar Section 23.4 Regulations and Information for Students Evaluation Procedures and Grading System The University of Alberta Grading System The University of Alberta uses a letter grading system with a four-point scale of numerical equivalents for calculating grade point averages. Grades reflect judgments of student achievement made by instructors. These judgments are based on a combination of absolute achievement and relative performance in a class. Some instructors assign grades as intervals during the course and others assign marks (e.g. percentages) throughout the term and then assign a letter grade at the end. Instructors must adapt their approaches to reflect the letter grading system. Grade distribution should reflect those shown in this document. (EXEC 03 FEB 2003)

Descriptor Excellent Good Satisfactory Failure

Academic Integrity

Grading in Graduate Courses Letter Grade Grade A+ A AB+ B BC+ C CD+ D F

Point Value 4.0 4.0 3.7 3.3 3.0 2.7 2.3 2.0 1.7 1.3 1.0 0.0

Plagiarism is a serious offence. The University of Alberta is committed to the highest standards of academic integrity and honesty. Students are expected to be familiar with these standards regarding academic honesty and to uphold the policies of the University in this respect. Students are particularly urged to familiarize themselves with the provisions of the Code of Student Behaviour (online at www.ualberta.ca/CodeofStudentBehaviour) and avoid any behaviour which could potentially result in suspicions of cheating, plagiarism, misrepresentation of facts and/or participation in an offence. Academic dishonesty is a serious offence and can result in suspension or expulsion from the University. University of Alberta policy about course outline can be found in Section 23.4(2) of the University Calendar. (GFC 29 SEP 2003).

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DETAILED COURSE OUTLINE BY WEEK

Date/2016 January 8

Readings/ Homework

Topics Introduction to the course: understanding the importance of biases, measurement, interpretation, ethical issues

Chapter 1, 2

Research Question: formulating a research question that is conducive to epidemiologic inquiry January 15

January 22

January 29

February 5

Causation: overview of key concepts of causal inference in epidemiology; introduction to the counterfactual ideal

Chapter 3 Assignment 1

Confounding and its control: direct and indirect standardization; Mantel-Haenszel procedure; over and under adjustment; propensity scores; instrumental variables; confounding by indication

Chapter 10, 12

Interaction: effect modification vs. confounding; statistical vs. biological interaction; multiplicative vs. additive models; counterfactual approach to interaction

Chapter 11, 12

Case-control, Case-cohort, Other designs in epidemiology; rare disease assumption

Chapter 5, 7

Assignment 2

Assignment 3

Assignment 4

Matching; confounding of the odds ratio February 12

Public health strategies: general population vs. high risk approaches; harm reduction

Chapter 2, 4 Assignment 5

Measures of impact: understanding attributable risk vs. population attributable risk Overview for mid-term exam February 19

Reading week: No class

February 26

Mid-term exam

March 4

Review of mid-term exam

Chapter 5, 7

Selection bias: differentiating variations of selection bias in observational study designs SPH 696 2016 Course Syllabus

Assignment 6

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March 11

March 18

Cohort studies: time in epidemiology; induction and latent periods; immortal person-time; length bias; lead time bias; censoring; Cohort studies: analysis of longitudinal data; life table and survival analysis of cohort data; SIR/SMR; life expectancy; DALY; PYLL

March 25

Good Friday: No class

April 1

Information bias: measurement error and its quantification

Chapter 4, 13 Assignment 7 Chapter 9 Assignment 8

Chapters 7, 8 Assignment 9

April 8

STROBE, CONSORT, TREND statements Overview for final exam

TBD

Optional Assignment 10

Final exam

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