College of Char leston EPIDEMIOLOGY Fall 2016 Course Information HEAL 350 Section 02 Instructor: Dr. Leslie Hart Email: hartlb@cofc.edu Phone: (843) 953-5191 Preferred method of contact is email. Office Hours: W 9am 12pm Office Location: Silcox 312 3 credits CRN No. 11946 Johnson 206 TR 10:50-12:05 Prerequisites: PBHL/HEAL 215 COURSE OBJECTIVES 1. Define epidemiology, explain its role in public health practice, and describe the differences between descriptive and analytic epidemiology. 2. Discuss important historical events and individuals in the field of epidemiology. 3. Define and distinguish among certain disease concepts, including those used in infectious and chronic disease epidemiology. 4. Distinguish among epidemic, endemic, and pandemic and describe different types of epidemics and disease models. 5. Characterize a public health problem according to person, place, and time. 6. Define ratio, proportion, and rate as well as certain measures of association. 7. Formulate steps of an epidemiologic field investigation. 8. Describe and use certain measures of health status. 9. Define and distinguish between case-control and cohort studies. S T U D E N T LEARNING OUTC O M E S 1. Students will be able to define disease concepts and distinguish between infectious, non-communicable, and chronic diseases. 2. Students will be able to characterize a public health problem according to person, place, and time. 3. Students will be able to distinguish between descriptive and analytic epidemiologic study designs. 4. Students will be able to calculate and interpret measures of disease frequency and measurements of association. 5. Students will be able to distinguish between the concepts of association and causation. C O U R S E CATA L O G DESCRIPTION This course introduces the basic concepts of epidemiology and biostatistics as applied to public health problems. Emphasis is placed on the principles and methods of epidemiologic investigation, appropriate summaries and displays of data, and the use of classical statistical approaches to describe the health of populations.
August 2016 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Introduction and Epi Overview 24 25 Epidemiology in the News 26 27 28 29 30 Disease Concepts (DP 1 Due) 31 September 2016 Sun Mon Tue Wed Thu Fri Sat 1 Disease Concepts Worksheet 2 3 4 5 6 Measures of Disease Frequency 11 12 13 Descriptive Epi (PS 1 Due) 18 19 20 Case-Control Studies 25 26 27 Cohort Studies (PS 2 Due) 7 8 Disease Measures Worksheet (DP 2 Due) 14 15 Descriptive Epi Activity (DP 3 Due) 21 22 Case-Control Activity (DP 4 Due) 28 29 Cohort Studies Activity (DP 5 Due) 9 10 16 17 23 24 30
October 2016 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 Flex Day 9 10 11 Statistics in Epidemiology I (DP 6 Due) 16 17 18 Statistics in Epidemiology II 5 6 Midterm Exam 12 13 Stats I Worksheet 19 20 Stats II Worksheet 7 8 14 15 21 22 23 24 25 Causation vs. Association 26 27 Hill s Criteria Activity (DP 7 Due) 28 29 November 2016 Sun Mon Tue Wed Thu Fri Sat 30 31 1 Bias & Confounding (PS 3 Due) 2 3 Bias/ Confound. Activity 4 5 6 7 8 NO CLASS Fall Break 9 10 Experimental Epi (DP 8 Due) 11 12 13 14 15 Special Topics: Wildlife Epi 16 17 Outbreak Investigation Contagion 18 19 20 21 22 Outbreak Investigation Contagion (Causation Due) 27 28 29 Concept Mapping 23 24 NO CLASS Thanksgiving 30 25 26
December 2015 Sun Mon Tue Wed Thu Fri Sat 1 Flex Class or Final Exam Review 2 3 4 5 6 7 8 9 10 11 12 13 Final Exam 8am-11am 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 COURSE MATERIALS Required Text: Essentials of Epidemiology in Public Health (3rd edition) by Aschengrau and Seague Recommended Text: Epidemiology (5th edition) by Leon Gordis (2013)
Epidemiology Page 5 R E ADING ASSIGNMENTS BY TOPIC Topic Aschengrau Text Reading Due Date Introduction to Epidemiology Ch. 1 August 23 Disease Concepts OAKS August 30 Measures of Disease Frequency Ch.2, 3 September 6 Descriptive Epidemiology Ch. 5 September 13 Analytic Epidemiology Ch. 6, 9 September 20 Analytic Epidemiology Cohort Ch. 6, 8 September 27 Statistical Methods for Ch. 6-9 October 11 Causation vs. Association Ch. 15 October 18 Bias and Confounding Ch. 10, 11 October 25 Experimental Epidemiology Ch. 7 November 1 Special Topics Wildlife Epidemiology Field Epidemiology (Outbreak Investigation) OAKS November 8 OAKS November 15 EVALUATION MEASURES Assignment Date Point Value Problem Set 1 September 13 30 Problem Set 2 September 27 30 Midterm Exam October 6 100 Problem Set 3 November 1 30 Causation Evaluation November 22 50 Disease Project Throughout Semester 160 Final Exam December 13 100
Page 6 Fall 2016 DISEASE PROJECT (160PTS) Students will divide up into research teams (7 total teams of 4-5 individuals each). Each research team will choose a disease or health condition for which they will explore using concepts discussed in class. A weekly team meeting is suggested for successful completion of each assignment. Semi-weekly assignments can be posted to a team Dropbox folder on OAKS or Discussion Board, where indicated. Assignments are posted below and additional details will be provided in class. Late assignments will NOT be accepted. Assign. # Assignment Description Due Date 1 Select a disease/health condition to use as a study topic throughout the course. (Post to Discussion Board. NO REPEATS) August 30 2 Based on information in lecture and course readings, classify disease/health condition, identify transmission route/type, provide a case definition. Sept. 8 Assignment Descriptions 3 4 Find one example of a frequency measurement from a legitimate public health source and describe the example with respect to person, place and time. Be thorough! Develop your own descriptive study (using CofC students or faculty as study participants) to explore the magnitude of your disease/health condition. Sept. 15 Sept. 22 500 Total Point Value 5 Develop your own case-control study (using CofC students or faculty as study participants) to explore the relationship between an exposure and your chosen disease/health condition. Find a peer-reviewed source to support your hypothesized association between the exposure and disease/health condition. Sept. 29 6 Develop your own cohort study (using CofC students or faculty as study participants) to explore the relationship between a DIFFERENT exposure and your chosen disease/health condition. Find one peer-reviewed source to support your hypothesized association between the exposure and disease/health condition. Oct. 11 7 Set up equations and contingency tables that would theoretically house data collected from each of your descriptive, case-control and cohort studies (from assignments 4-6). Oct. 27 8 Based on the lecture material or course readings, discus two specific biases that would be present in each of your descriptive, case-control, and cohort studies (6 biases total). Nov. 10
Epidemiology Page 7 PROBLEM SETS (30PTS EACH, 90 TOTA L ) Epidemiology is a quantitative field, requiring the understanding of statistical methods and measurements of disease outcomes. Three problems sets will be required during the semester to practice analytical methods. Problem sets will be posted on OAKS. Problems will be in the form of calculations, multiple choice, and short answer. If necessary, you are permitted to work with other students in the class on these problem sets; however, I encourage you try them on your own first. The Problem Sets will be posted to OAKS. Please bring your completed Problem Sets to class on the specified due date. If you will not be in class on the specified due date, please make arrangements with Dr. Hart to turn in the assignment PRIOR to the due date. Late submissions will result in 10% deduction per day. Remember to show your work for partial credit! CAUSATION EVALUATION (50PTS) Students will use Hill s Criteria for Causality to critically evaluate the causal association between an exposure and health outcome presented in a peerreviewed journal article. The journal article will be posted on the OAKS website, as well as the criteria template for evaluation. Please bring completed assignment to class on the associated due date. Late assignments will NOT be accepted. MIDTERM EXAM (100PTS) The midterm exam will cover information presented through October 4. You will be allowed to use a non-cellular phone calculator and up to two sheets of paper (8.5x11 or smaller) on which you may write anything related to the course materials (front and back). Please write your name on the sheets as they will be turned in with your exam. No other materials will be allowed. Assignment Descriptions 500 Total Point Value If you will be absent from class on October 6 (excused absences only), please make arrangements with Dr. Hart (hartlb@cofc.edu) to take your CUMULATIVE FINAL EXAM(100PTS) The final exam will cover information presented over the entire semester. You will be allowed to use a calculator and three sheets of paper (8.5x11 or smaller) on which you may write anything related to the course materials (front and back). No other materials will be allowed. The exam must be taken on scheduled exam date unless prior arrangements have been made with appropriate documentation stating the reason why the exam must be taken at a different time.
Page 8 Fall 2016 C O N TA C T I N G DR. HART REGARDING Q U E S T I O N S OR ASSIGNMENTS I will be available for any questions or discussions in person during my office hours (Wednesdays 9am-12pm). Otherwise, please make an appointment to meet with me. If you need to contact me outside those hours, please submit questions or comments by email (hartlb@cofc.edu). I will try to be available by email; however, I cannot promise that I will be able to answer questions about assignments or exams after 5pm on the day prior to the assignment due date or examination date. G R A D I N G SCALE Important Policies Letter Grade Total Points Percentage A 448+ 90-100% A- 438-447 88-89% B+ 423-437 85-87% B 398-422 80-84% B- 388-397 78-79% C+ 373-387 75-77% C 348-372 70-74% C- 338-347 68-69% D+ 328-337 66-67% D 318-327 64-65% D- 308-317 62-63% F 307 or fewer 61% and below A T T E N DA N C E POLICY Attendance is mandatory and PLEASE BE ON TIME. Failure to attend class will reflect poorly on your attendance and participation grade. Attendance will be taken for each class. More than 3 unexcused absences will result in a deduction of 10 points from your final grade, 5+ absences will result in a deduction of 50 points. Ten or more unexcused absences will warrant consideration for course withdrawal. Excused absences must come from the College of Charleston Absence Notification System or an alternative pre-arrangement with Dr. Hart.
Epidemiology Page 9 S U B M I S S I O N OF ASSIGNMENTS Assignments must be submitted on time, which means either at the beginning of class on the date listed in the syllabus, or by the date listed on OAKS for assignments posted to Dropbox. Late work will only be accepted on a case-by-case basis, subject to approval by Dr. Hart, and a percentage of points will likely be deducted. If you have to miss class (due to an excused absence - e.g. planned college activity, religious observation, doctor s appointment, or other planned event) on the date on which an assignment is due, please make every effort to submit the assignment prior to the missed class. If you have an unplanned absence on an assignment due date, please contact Dr. Hart regarding approval for the absence and to make arrangements for assignment submission. You may work with other individuals in the class on Problem Sets; however I encourage each of you to attempt the problems by yourself first. You will not be permitted to work with other individuals on the exams, so it will be critical for you to be able to complete the problems independently. T E C H N O L O G Y IN T H E CLASSRO O M The use of laptops and tablets are encouraged to take notes; however, the use of smartphones and other cellular devices is prohibited as they can be disruptive to the instructor and your classmates. Use of these electronic devices will result in being asked to put the device away or dismissal from class. Please put all mobile devices on silent PRIOR to the beginning of each class. Important Policies P L A G I A R I S M Plagiarism, or the use of another s thoughts, data, or information as your own, is prohibited in this class. Plagiarism will not be tolerated. If you present information that is NOT your own, appropriate citation of the source is expected. Plagiarism definitions according to the CofC Handbook: 6.1. The verbatim repetition, without acknowledgement, of the writings of another author. All significant phrases,clauses, or passages, taken directly from source material must be enclosed in quotation marks and acknowledged in the text itself and/or in footnotes/endnotes. 6.2. Borrowing without acknowledging the source. 6.3. Paraphrasing the thoughts of another writer without acknowledgement. 6.4. Allowing any other person or organization to prepare work which one then submits as his/her own.
Page 10 Fall 2016 H O N O R CODE & CODE OF CONDUCT Lying, cheating, attempted cheating, and plagiarism are violations of our Honor Code that, when identified, are investigated. Each incident will be examined to determine the degree of deception involved. Incidents where the instructor determines the student s actions are related more to a misunderstanding will handled by the instructor. A written intervention designed to help prevent the student from repeating the error will be given to the student. The intervention, submitted by form and signed both by the instructor and the student, will be forwarded to the Dean of Students and placed in the student s file. Cases of suspected academic dishonesty will be reported directly by the instructor and/or others having knowledge of the incident to the Dean of Students. A student found responsible by the Honor Board for academic dishonesty will receive a XXF in the course, indicating failure of the course due to academic dishonesty. This grade will appear on the student s transcript for two years after which the student may petition for the XX to be expunged. The F is permanent. The student may also be placed on disciplinary probation, suspended (temporary removal) or expelled (permanent removal) from the College by the Honor Board. Students should be aware that unauthorized collaboration--working together without permission-- is a form of cheating. Unless the instructor specifies that students can work together on an assignment, quiz and/or test, no collaboration during the completion of the assignment is permitted. Other forms of cheating include possessing or using an unauthorized study aid (which could include accessing information via a cell phone or computer), copying from others exams, fabricating data, and giving unauthorized assistance. Research conducted and/or papers written for other classes cannot be used in whole or in part for any assignment in this class without obtaining prior permission from the instructor. Students can find the complete Honor Code and all related processes in the Student Handbook at http:// studentaffairs.cofc.edu/honor-system/studenthandbook/index.php Important Resources C E N T E R F O R D I S A B I L I T Y S E R V I C E S / S NA P Any student eligible for and needing accommodations because of a disability is requested to speak with the professor during the first two weeks of class or as soon as the student has been approved for services so that reasonable accommodations can be arranged. For more information on the Center for Disability Services, visit: http://disabilityservices.cofc.edu/ C E N T E R FOR STUDENT L E A R N I N G I encourage you to utilize the Center for Student Learning s (CSL) academic support services for assistance in study strategies, speaking & writing strategies, and course content. The CSL, located on the first floor of the library, offers a wide variety of tutoring and other academic resources that support many courses offered at the College. Services include walk-in tutoring, by appointment tutoring, study strategies appointments, Peer Academic Coaching (PAC), and Supplemental Instruction (SI). All services are described and all lab schedules are posted on the CSL website http://csl.cofc.edu/, or call 843.953.5635 for information. O N L I N E C O U R S E E V A L UA T I O N S Students will be able to fill out online course evaluations during class (see schedule). Evaluations can be accessed through My Charleston. Please let Dr. Hart know in advance if you will need access to a laptop for this purpose.
Epidemiology Page 11 CEPH AND CHES C O M P E T E N C I E S The Council on Education for Public Health (CEPH) publishes guidelines regarding the knowledge and skills that should be presented to students enrolled in public health courses. These guidelines focus on outcomes, or competencies, that are linked to workforce needs as defined by employers and the public health profession as a whole. Each course in the College of Charleston Public Health program covers one or more of these competencies. As courses advance from introductory to more advanced, the competencies covered by these courses must also progress. That is, what you learn in higher level courses should build on, and extend beyond, what you learned in lower level courses. The following CEPH competency is covered by HEAL 350: 3. Explain principles of epidemiology necessary to understand health and impairments of health including the uses of rates, the meaning of causation, and the evaluation of the effectiveness of interventions. Apply principles of epidemiology to reading research articles including case-control, cohort studies and randomized clinical trials. (Competency 3) For more information, please visit http://ceph.org/constituents/programs-baccalaureate-level/. In addition to pursuing the general public health competencies set forth by CEPH, some students may be interested in pursuing certification as a Certified Health Education Specialist (CHES). This certification requires the individual to sit for and pass an exam offered by the National Commission for Health Education Credentialing, Inc. In order to qualify to sit for the CHES exam, the individual must complete coursework covering a variety of competencies and subcompetencies. The following competencies and sub-competencies are covered by HEAL 350: Going Above and Beyond 1. Assess Needs, assets, and capacity for health education (Competency 1) 2. Implement health education (Competency 3) 3. Conduct evaluation and research related to health education (Competency 4) For more information, please visit http://www.nchec.org/.
Instructor: Dr. Leslie Hart Email: hartlb@cofc.edu Phone: (843) 953-5191 Preferred method of contact is email. Office Hours: W 9am 12pm Office Location: Silcox 312 Please Note: Class lectures, assignment due dates, and other policies listed in this syllabus are subject to change at Dr. Hart s discretion, with fair notice provided to students. A L I T TLE BIT A BOUT ME I earned my B.S in Biology and Environmental Studies from the College of William and Mary, my M.S. in Environmental Studies from the College of Charleston, and my Ph.D. in Epidemiology from the Medical University of South Carolina. My dissertation was titled, The Use of Longitudinal and Cross-Sectional Photographic Data to Study Skin Disease in Wild Bottlenose Dolphins. I have been an adjunct professor in HEHP and Environmental Studies and taught a graduate core seminar in the Masters of Environmental Studies Program. I was most recently employed as a wildlife and environmental epidemiologist with a private contractor for the National Oceanic and Atmospheric Administration (NOAA). In this role, I studied the impact of environmental and anthropogenic stressors on the health of wild bottlenose dolphin populations.