University of Alberta

Course Guide for SPH 766 Fall 2015 Location: Katz 7-003

Epidemiology Methods III Monday, 1:00-3:50 pm

Instructor: Karen Goodman, PhD Professor, School of Public Health Office: 7-142 Katz 87 Ave – 114 Street, Edmonton, AB, T6G 2E1 Phone: 780-492-1889 Fax: 780-492-7593 E-mail: [email protected] Teaching Assistant: Emily Walker Office: 5-027 ECHA Phone: 780-492-3680 Fax: 780-492-7593 E-mail: [email protected]

Course Description

This course covers essential concepts and principles of epidemiologic methods as framed by state-of-the-art texts and articles. Major topics will include: Causation; Effect Estimation; Study Validity & Precision; Concepts of Interaction; Fundamentals of Data Analysis; Bias Analysis Students will be required to:  Demonstrate understanding of topic-specific learning objectives  Complete assigned exercises before the relevant class session  Complete critiques of assigned readings for each topic  In relation to one course topic:  Lead an in-class learning activity  Complete a review of recent literature that includes an annotated bibliography of identified references

Prerequisites: (PHS 698 OR equivalent) AND (PhD status OR consent of instructor)

Class

The teaching style is based on the philosophy that graduate education aims to develop scholarly and professional abilities.

Format Scholarly abilities include  Synthesizing, integrating and applying knowledge  Systematic observation and analysis  Critical reflection  Evaluation  Depth of understanding Professional abilities include  Independent learning and problem solving  Critical review of developments in the field  Effective communication and collaboration with colleagues  Teaching and guiding others Students will be required to read reference material and reflect on it critically, apply methodologic approaches to solve problems, communicate with peers about course topics, articulate understanding of concepts and facilitate learning of classmates. Class time will be devoted to active learning experiences; didactic information will be conveyed primarily through assigned readings.

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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Objectives

The general learning objective is a solid understanding of essential concepts and principles of epidemiologic methods as framed by state-of-the-art texts and articles. Topic-specific learning objectives will orient learning in this course. Assigned reading for each topic will include multiple texts with varied approaches to covering the key concepts, so that learning goes beyond disciplinary jargon to underlying concepts.

Learning Goals

Students who take this course will:  Deepen their understanding of complex concepts pertaining to scientific inference, effect estimation, study design and validity, data analysis methods and bias analysis methods  Enhance their ability to synthesize and apply knowledge to solve epidemiologic problems  Become familiar with and reflect critically on developments in epidemiology as a scholarly discipline  Undertake independent scholarship to increase knowledge of selected topics  Communicate about epidemiology with fellow scholars

Learning Resources

In lieu of lectures, instructor-prepared topic-specific syntheses of key concepts are available in pdf and PowerPoint formats in eClass. Exercises and other resources for assigned learning activities are also available in eClass.

Library

The University of Alberta library system’s website 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: 800-207-0172 www.library.ualberta.ca/ereference/index.cfm The following texts are available from the library in electronic form: Rothman KJ, Greenland S, Lash TL. Modern Epidemiology, 3rd ed. Lippencott Williams & Wilkins, 2008 http://www.library.ualberta.ca/permalink/opac/6032157/WUAARCHIVE Szklo M, Nieto FJ. Epidemiology: beyond the basics, 3rd ed. Jones & Bartlett Learning, 2014. This link is to the first edition and will soon be updated to the third edition: http://www.library.ualberta.ca/permalink/opac/2374110/WUAARCHIVE (1st Edition, 2000)

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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Assignments Learning Objectives - Your learning of each topic should be guided by the Topic-Specific Learning Objectives posted in eClass. You should use these objectives to monitor your own understanding of course content. It is your responsibility to ask instructors for needed clarifications during relevant class sessions if time allows, or by email or an in-person tutorial that will be arranged at your request. Exercises - Exercises that apply key concepts for each topic are to be completed before the due date indicated in the course schedule and submitted at the start of each class. You should keep a copy of submitted exercises to refer to during class. In-class Learning – In-class learning activities for each topic will extend the exercises completed independently in the application of key concepts. You are expected to participate actively in each inclass learning activity. If you have a compelling reason to miss class, it will be your responsibility to learn the material you missed by obtaining copies of material presented in class and seeking information from classmates and instructors regarding in-class discussion. Exams - Exams will focus on the understanding and application of concepts covered in instructor-prepared materials, readings, and class activities, with an emphasis on topic-specific learning objectives. Exams will include a variety of test question formats to assess the abilities and skills fostered by the teaching style: integrating and applying knowledge in problem-solving, analysis, critical reflection, and depth of understanding. Memorization of details is not a goal of this course, thus exams will be open-book: you will be allowed to consult books and other printed material you bring with you (not contained on an electronic device that can download other information). Exams are intended to assess individual learning, thus you are expected to complete them without assistance from anyone other than the instructors. You will need a non-phone calculator for exams. Critiques of Assigned Reading – You are required to complete a structured critique of the assigned readings for each topic by the Friday before the corresponding class session. We are experimenting with a discussion forum in eClass for submission of reading critiques. Guest Instructor Assessment Within one week after the guest instructor’s class presentation, you are to email to the instructors a typed assessment that addresses the following: 1) Briefly summarized, what you learned that was new from this guest presentation 2) In a few sentences, what you found most worthwhile about this presentation 3) Any points or topics you would have liked covered more extensively

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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Summary of Reading Critiques For one course topic of your choice, to be presented during the scheduled class for this topic

• Synthesize the individual critiques posted by classmates  Highlight commonly expressed perspectives; list other expressed perspectives  Highlight areas that need clarification • Present synthesis and lead a discussion on it in class In-class Learning Activity For a second course topic of your choice, to be presented during the scheduled class for this topic

• You may design your own learning activity on your own or use the instructor’s resources:  Prepare a step-by-step lesson plan for a class activity that can be completed in 20-30 minutes  Prepare an answer guide  Make an appointment with the instructor or TA to present your lesson plan, answer guide and any required resource materials at least one week before you are scheduled to lead the activity  Make arrangements for any required advance preparation  Arrive on the scheduled class day fully prepared to lead the activity  Understand that circumstances may prevent the activity from proceeding on the scheduled day and in such cases will be postponed to a later class Literature Review Of the in-class learning activity topic you signed up for, due one week after the scheduled class for this topic

• Conduct a Systematic Search  Use key terms relevant to your topic  Search PubMed (other databases optional) for full articles published in 2012 or later  Narrow your topic and/or restrict your search to epidemiology and related (e.g. stats, public health) journals, and/or restrict your search to more recent years, for an optimal number of papers (~5), selecting all papers that meet your search criteria  You may seek the assistance of a librarian  Keep a record of your search strategy • Write up your Search Strategy and Results based on the guide available in eClass • Compile an Annotated Bibliography: your Search Strategy and Results plus a brief synopsis of each paper selected • Submit your Annotated Bibliography (including search strategy)

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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Evaluation of Course Work Evaluated Work and Deadlines

Grading Criteria

Reading Critiques - to be completed by the Friday before the Effort corresponding class Exercises – hard copy to be submitted at the start of class Effort (students are to check their own work against answer guides in eClass) Guest Instructor Assessment – digital copy to be emailed within 1 week after presentation

Effort

Exams – as indicated on course schedule

Accuracy of answers

In-class learning activity  Lesson plan – due 1 week before class activity  Class activity – when topic is covered in class

Quality of work and effort

Literature review – due 1 week after topic is covered in class Quality of work and effort

Grading

This is a Pass/Fail course. For a grade of “pass”, each assignment and exam must be completed on time and graded by the instructors at passing level in a graduate course (e.g., B or 80%). At the instructors’ discretion, arrangements can be made to make up or re-do assignments or exams that do not achieve a “pass”.

Academic Integrity Plagiarism is a serious offence.

The University of Alberta is committed to the highest standards of academic integrity and honesty. Students should avoid any behaviour that 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. 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 urged to familiarize themselves with the UofA Code of Student Behaviour. Information and resources are also available at the Guide to Academic Integrity and the Academic Integrity Graduate Handbook maintained by the Office of Student Judicial Affairs at the University of Alberta.

The instructors are open to feedback throughout the course and will respond to Course Evaluation suggestions for improvement. Students will have the opportunity to evaluate the course and instructors using the standardized University of Alberta course evaluation.

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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Essential Reading Primary Textbooks “ME3”: Rothman KJ, Greenland S, Lash TL. Modern Epidemiology, 3rd ed. Lippencott Williams & Wilkins, 2008  The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research. The 2012 printing appears to come with online access to the full text.

“Rothman”: Rothman KJ. Epidemiology: An Introduction. 2nd ed. Oxford University Press, 2012  Across the last forty years, epidemiology has developed into a vibrant scientific discipline that brings together the social and biological sciences, incorporating everything from statistics to the philosophy of science in its aim to study and track the distribution and determinants of health events. …the second edition of this essential introduction to epidemiology presents the core concepts in a unified approach that aims to cut through the fog and elucidate the fundamental concepts. Rather than focusing on formulas or dogma, the book presents basic epidemiologic principles and concepts in a coherent and straightforward exposition.

Comparison Texts Szklo M, Nieto FJ. Epidemiology: beyond the basics, 3rd ed. Jones & Bartlett Learning, 2014. Written for those who are familiar with the basic strategies of analytic epidemiology, Epidemiology: Beyond the Basics takes readers through a more rigorous discussion of key epidemiologic concepts and methods such as study design, measures of association, research assessment, and more. With real-life examples throughout, the book avoids complex statistical formulations and is an invaluable resource for intermediate students and practicing epidemiologists who wish to expand their knowledge of epidemiology and its role in the medical and public health sciences. The Third Edition includes new material on: basic measures of evaluation of diagnostic/screening tests; measures used in clinical research (efficacy, NNT); confounding; and an expanded section on DAGs.

Articles on Supplemental Reading List Essential Articles • Choi BCK, de Guia NA, Walsh P. Look before You Leap: Stratify before You Standardize. Am J Epidemiol 1999;149:1087-96 http://www.ete-online.com/content/4/1/3 • Diez-Roux AV. Bringing context back into epidemiology: variables and fallacies in multilevel studies. Am J Public Health 1998;88:216-22 • Goodman KJ, Phillips CV. Hill criteria of causation. In Encyclopedia of Statistics in Behavioral Sciences, Wiley, 2005; Available when logged into the UA library at: http://onlinelibrary.wiley.com.login.ezproxy.library.ualberta.ca/doi/10.1002/0470013192.bsa269/pdf • Goodman KJ, Colquhoun A. Principles of evidence-based cancer prevention strategies. In: IARC Helicobacter pylori Working Group. Helicobacter pylori Eradication as a Strategy for Preventing Gastric Cancer. Lyon, France: International Agency for Research on Cancer (IARC Working Group Reports, No. 8); pp. 88-94, 2014; Available from: http://www.iarc.fr/en/publications/pdfs-online/wrk/wrk8/index.php • Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology 1999;10:37-48 • Greenland S, Poole C. Resurrecting a Bayesian Perspective on Frequentist Statistics. Epidemiology 2013;24:62–68  & Rejoinder: Living with Statistics in Observational Research. 2013;24:73-8 Epidemiological Methods III

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• Hernán MA, Hernández-Díaz S, Werler MM, Mitchell AA. Causal Knowledge as a Prerequisite for Confounding Evaluation: An Application to Birth Defects Epidemiology. Am J Epidemiol 2002;155:176–84 • Hernán MA, Hernández-Díaz S, Robins JM. A Structural Approach to Selection Bias. Epidemiology 2004;15:615–625 • Hernán MA, Hernández-Díaz S, Robins JM. Randomized trials analyzed as observational studies. Ann Int Med 2013;159:560-2 • Hernán MA, VanderWeele TJ. Compound treatments and transportability of causal inference. Epidemiology. 2011;22:368-77 • Hertz-Piccioto I. What you should have learned about epidemiologic data analysis. Epidemiology 1999;10:778-83 • Kaufman, Jay S.; Hernán, Miguel A. Commentary: Epidemiologic Methods Are Useless: They Can Only Give You Answers. Epidemiology 2012;23:785-6  Weisskopf MG. What, me worry? Chemicals and causality. Epidemiology. 2012;23:785–786  Kramer MS, Moodie EEM, Platt RW. Infant feeding and growth: can we answer the causal question? Epidemiology. 2012;23:790–794  Harper S, Strumpf EC. Social epidemiology: questionable answers and answerable questions. Epidemiology. 2012;23:795–798 • Maldonado G. Toward a clearer understanding of causal concepts in epidemiology. Annals of Epidemiology 2013;23:743-9 • Maldonado G, Greenland S. Estimating causal effects. Int J Epidemiol 2002;31:422-9 • Pearce N. Traditional Epidemiology, modern epidemiology, and public health. Am J Public Health 1996;86:678-83 • Pearce N. Effect measures in prevalence studies. Environ Health Perspect. 2004;112:1047-50 • Phillips CV. Quantifying and Reporting Uncertainty from Systematic Errors. Epidemiology 2003;14:459-466 • Poole C. Introduction to Directed Acyclic Graphs. SER Workshop (pdf available in eClass) • Rosen L. An intuitive approach to understanding the attributable fraction of disease due to a risk factor: the case of smoking. Int J Environ Res Public Health 2013;10:2932-43 • Vandenbroucke JP, von Elm E, Altman DG et al, Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Epidemiology 2007;18: 805–35 • VanderWeele TJ. On the distinction between interaction and effect modification. Epidemiology 2009; 20:863-871 • VanderWeele TJ. A unification of mediation and interaction: a 4-way decomposition. Epidemiology 2014:749-61.

Epidemiological Methods III

Course Syllabus

University of Alberta, School of Public Health

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