1. Course Information a. Course Number and Title: PH410 Advanced Epidemiology b. Number of Credit Hours: 3 c. Course Meeting Days and Times: Wednesdays 2:00 4:50 PM d. Course Meeting Place: Biomed D-106 e. Pre-Requisite Courses: PH310 2. Instructor Information a. Name: Eric Hurwitz b. Phone Number: (808) 956-7425 c. Email: ehurwitz@hawaii.edu d. Office Location: Biomed D-104AA e. Office Hours: By appointment 3. Course Description The purpose of this course is for students to gain a deeper understanding of the core concepts used in epidemiologic research and practice. Students will build upon knowledge gained in PH 310 (Introduction to Epidemiology), including disease measures, sources of data, study design methods, causal inference, limitations and biases, and principles and practices of both clinical epidemiology and outbreak investigation. Upon completion of the course students will have the knowledge and skills necessary to conduct an epidemiologic study, and to pursue graduate work in epidemiology. 4. Course Schedule (Class Dates, Topics, and Assignments) Date Topic Assignments Due 8/23 Introductions and Orientation Reading: Ch. 1 1 8/30 2 Lecture: Review of Measures of Disease Frequency Activity: In-class Worksheet and Discussion Reading: Ch. 2 9/6 3 9/13 4 9/20 5 Activity: Self Assessment Jeopardy- Measures of Disease Frequency Lecture: Comparison of Disease Frequencies, and Adjusting Risks and Rates Discussion: Appropriate Use of Disease Frequencies Activity: Self Assessment Jeopardy- Comparison Disease Frequencies Discussion: Data Sources for Epidemiologic Studies and Sharing of Data Source Profiles Activity: Self Assessment Jeopardy- Data Sources Lecture: Making Sense of Time, Place, Person Data- Overview of Descriptive Epidemiology Discussion: Correlation vs. Causation Activity: Generation of Epidemiologic Questions and Associated Hypotheses OFFICE OF PUBLIC HEALTH STUDIES Undergraduate Course Syllabus Reading: Ch. 3 Data Source Profile Due Reading: Ch. 4 Reading: Ch. 5
9/27 6 10/4 7 10/11 8 10/18 9 10/25 10 11/1 11 11/8 12 Activity: Self Assessment Jeopardy- Descriptive Epidemiology Lecture: Overview of Epidemiologic Study Designs Discussion: Study Design Options to Address Research Questions or Hypotheses Guest Lecture: Data to Action- Collecting Data to Make a Difference (Emily Roberson, PRAMS?) Activity: Self Assessment Jeopardy- Study Design Lecture: Experimental Study Design (Randomized Controlled Trials) Discussion: What research questions or hypotheses are best addressed with experimental study designs? Discussion: Ethical Issues with Experimentation Discussion: Study Design Worksheet- Experimental Section Student Reports and Discussion Activity: Self Assessment Jeopardy- Experimental Study Design Lecture: Cohort Studies Discussion: What research questions or hypotheses are best addressed by cohort studies? Guest Lecture: TBA Discussion: Study Design Worksheet- Cohort Section Student Reports and Discussion Activity: Self Assessment Jeopardy- Cohort Studies Lecture: Case-Control Studies Discussion: What research questions or hypotheses are best addressed by case-control studies? Discussion: Study Design Worksheet- Case-Control Section Student Reports and Discussion Activity: Self Assessment Jeopardy- Case-Control Studies Lecture: Cross Sectional/ Ecologic Studies Discussion: What research questions or hypotheses are best addressed by cross-sectional or ecologic studies? Discussion: Study Design Worksheet- Cross Sectional Section Student Reports and Discussion Activity: Self Assessment Jeopardy- Cross-Sectional/ Ecologic Studies Guest Lecture: On-Going Epidemiology Studies- Dissertations (PhD Epidemiology Students) Lecture and Discussion: Review of Epidemiologic Studies- Addressing Limitations and Biases Activity: Self Assessment Jeopardy- Limitations & Biases Discussion: STROBE article and Assessing Study Designs Lecture: Causal Inference Discussion: Models Used for Causal Inference Discussion: Epidemiology Toolkit Final Project Assignment Reading: Ch. 6 Reading: Ch. 7 Study Design Worksheet: Experimental Study Design Section Due for Discussion Reading: Ch. 8 Study Design Worksheet: Cohort Study Design Section Due for Discussion Reading: Ch. 9 Study Design Worksheet: Case- Control Study Design Section Due for Discussion Completed Study Design Worksheet Due Reading: STROBE Article Reading: Ch. 10 Reading: Ch. 14 Reading: Ch. 15 11/15 Discussion: Epi Toolkit Research Questions and Analyzing Epi Toolkit Research
13 11/22 14 11/29 15 12/6 16 12/13 17 Epi Toolkit Data Lecture: Clinical Epidemiology- Screening and Diagnosis Discussion: Study Designs Used to Determine Effectiveness of Screening Programs Discussion: Criteria for Testing- Why are some diseases screened for, while others are not? Discussion: Epi Toolkit Methods Reports Lecture: Clinical Epidemiology- Prognosis & Treatment Discussion: Risk vs. Prognosis and Appropriate Study Designs for Assessing Prognosis Discussion: Outbreak Investigation Activity: Scenario-Based Activity Epi Toolkit Student Presentations Wrap-up and Course Evaluation Finals - UH Manoa Designated Finals Date Questions Due Reading: Ch. 16 Epi Toolkit Methods Section Due Epi Toolkit Discussion of Results Due Epi Toolkit Final Projects Due 5. Required Text or Readings Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health, 3rd edition. Burlington, Massachusetts: Jones & Bartlett Learning, LLC, 2014. Other required course materials will be available on Laulima. 6. Description of Course Assignments Data Source Profile: Profile of a data source information should include: data source, content of data source (what information is available), past uses of data sources (with examples of studies that have used), examples of how data can be used for action steps (e.g., to change policies, develop interventions, educate). Oral feedback on Data Source Profiles will be provided by the instructor during designated class discussions and written feedback will be provided after submission. [4-5 pages] Study Design Worksheets: Information should include: What is the research question? How did the experiment address the question? What were the study findings? Please bring all articles to class on appropriate weeks and be prepared to discuss. Oral feedback on Study Design Worksheets will be provided by the instructor during the designated class discussions. Students will then have an opportunity to revise each section following each class discussion before submission to the instructor. Written feedback will be provided following submission. [4-5 pages] Epi Toolkit Final Project: Given a generic data set (provided by instructor, which will include several variables, including exposure and outcome measures), students will develop their own research questions, and analyze the data set using Excel and online epidemiologic tools to address their specific question. Students will then develop a 5-10 minute presentation of their projects, and an 8-10 page written report, which will include the following sections: research question, methods (including type of study, variables used, and type of analysis used), discussion of results, and study implications. Written and oral feedback on the Epi Toolkit Final Project will be provided by the instructor after each section draft is submitted. Students will have an opportunity to revise each section prior to final submission during finals week.
7. Grading Rubric (For Course Assignments) Assignment Points Percentage of Total 1. Class Attendance/Participation/Reading 10 10% 2. Data Source Profile 10 10% 3. Study Design Worksheet (5 points per section) 20 20% 4. Epi Toolkit Final Written Report 40 40% 5. Epi Toolkit Final Oral Report 20 20% Total = 100 100% 8. Grading Scale: You must indicate whether or not you are using the + - grading system This course will NOT use +/ grading system A = 90-100 B = 80-89 C = 70-79 D = 60-69 F < 60 Excellent, distinctive work. Demonstrates sophisticated understanding: Nuanced and insightful account, powerful and effective application of concepts, frameworks and theories discussed in class and articulated in written work. Above average work. Demonstrates accomplished understanding: Thorough, welldocumented account; adequate and apt application of concepts, frameworks and theories discussed in class and articulated in written work. Average work, sufficient, but not distinctive. Acceptable view with some misconceptions or oversight; not fully supported; acceptable but limited application of concepts, frameworks and theories discussed in class. Poor, insufficient work. Naïve or inadequate understanding: simplistic account and use of concepts, frameworks and theories discussed in class. Unable to articulate thoughts and ideas in written work. Unacceptable work 9. Course Policies: 1. Do the assignments on-time. All students are expected to read the assigned articles/documents on Laulima by the respective dates of discussion, and complete all course assignments at undergraduate-level proficiency. Maximum benefit from this class can be achieved only if you attend class, complete the readings, assignments, and projects as they are assigned, and actively participate in the class discussions. It is the student s professional responsibility to be aware of the assignment deadlines. Your grade for the course can, and will, be affected by late work. Points will be deducted for late assignments, especially if the no communication has been made before the deadline passes. 2. Show up on time and participate. All students are expected to show up on time and attend all classes. Since so much in-class learning and participation will be occurring, missing a class means missing critical knowledge, activities, and experiences that are difficult to recreate. In this course, each class builds on previous class content and prepares the student for future classes. If more than two classes are missed, it could affect the student s grade for the overall course. It is the student s professional responsibility to notify the instructor of any anticipated absences in advance. 3. Use the proper format. All written assignments must be typed with student s name, course number, and date all listed at the top of the page of the assignment. Handwritten assignments are not acceptable. Submit all assignments by the due date through the drop box
system in Laulima system at https://laulima.hawaii.edu/portal. Please ensure that your document is Microsoft Word compatible. You should also have access to your assignments, either electronically or printed out, for review during class. 4. Grades. Final grades are based on completed assignments, prompt class attendance, and participation. All assignments must be completed for a passing grade. There will be no extra credit assignments. Assignments must be submitted at least an hour prior to class time on the due date to receive full credit for the assignment. Points will be deducted for late assignments. Grades can and will be affected by late work. 5. Use references wisely. Original written work is expected with appropriate citation of references, if applicable. All references need to have author, title, year, publishers, place of publishers, journal name, volume and issue number, and page numbers. All written work must follow a consistent citation and referencing style (APA, MLA, Medline, etc.). 6. Conduct Code Do original work. Plagiarism is unacceptable and will result in a failing grade for the assignment and possibly for the course, depending on the extent of the violation. Please be familiar with the University of Hawai i Student Conduct Code, available online, at the Office of Student Affairs at the Student Services. 7. Syllabus may be revised as needed. The course schedule and assignments may need to be revised and some topics re-scheduled depending on the availability of guest speakers, pace of the learning, size of class, and the needs of the students. 8. Appointments with instructor. Students are welcomed and encouraged to meet with the course instructor to review their progress, or clarify course assignments and expectations. Please contact the instructor before or after class, by phone, or by email to set up appointments. Demonstration of Professionalism. Students are expected to conduct themselves with a high level of professionalism throughout the course. 10. Student Learning Objectives: (for the Course): Upon completion of the course, the student will be able to: 1.Describe the historical contributions, philosophy, ethical principles, and modern uses of epidemiology. 2.Identify data sources for epidemiologic studies and apply the tools of epidemiology to generate hypotheses about patterns of disease and injuries according to time, place, and person. 3.Calculate, apply, and interpret measures of disease frequency, association, and impact. 4.Understand the concepts of causal inference and statistical significance, and the differences between hypothesis testing and effect estimation. 5.Give examples of different types of bias in epidemiologic studies, explain how these biases may lead to misleading findings, and discuss methods to avoid or ameliorate these biases. 6.Distinguish between different types of experimental and observational studies, identify study designs in published articles, and discuss the strengths and limitations of each design. 7.Understand the factors that should be considered in determining when a specific study design is indicated. 8.Critically appraise epidemiologic studies and determine their use in evidence-based public health policy making and development of recommendations. 9.Apply the tools of epidemiology to clinical situations and discuss the differences between using epidemiologic data for public health purposes vs. individual clinical decision-making. 10.Apply the tools of epidemiology to the investigation of disease outbreaks and clusters, calculate appropriate measures, and make proper inferences regarding cause and effect. 11. University Policies for Opportunity and Accommodation: Equal Opportunity and Affirmative Policy The University of Hawai i is an equal opportunity/affirmative action institution and is committed to a policy of nondiscrimination on the basis of race, sex, gender identity and expression, age, religion, color, national origin, ancestry, citizenship, disability, genetic information, marital status, breastfeeding, income assignment for child support, arrest and court record (except as permissible under State law), sexual orientation, national guard absence, status as a covered veteran, pregnancy, and domestic or sexual violence victim status. This policy covers admission and access to and participation, treatment,
and employment in the University s programs and activities. For more information on equal opportunity and affirmative action policies and complaint procedures for the UH Mānoa Campus, contact: a) Students: Lori Ideta, Assistant Vice Chancellor & Dean of Students, EEO/AA, Title IX & ADA Coordinator Ph.-956-3290 (V/T); Email ideta@hawaii.edu b) Employees: Mie Watanabe, EEO/AA Director, Title IX & ADA Coordinator Ph. 956-7077; Email - eeo@hawaii.edu c) Students with Disabilities: Ann Ito, KOKUA Program Director Ph. 956-7511 (V/T); Email kokua@hawaii.edu Accommodations A student who may need an accommodation based on the impact of a disability is invited to contact me privately within the first weeks of the course. I would be happy to work with you and the KOKUA Program (Office for Students with Disabilities) to ensure reasonable accommodations in my course. KOKUA can be reached at 808-956-7511 or 808-956-7612 (voice/text) in room 013 of the Queen Liliuokalani Center for Student Services. Counseling Services and Mental Health From time to time, we all need help managing stress and life problems. At times, school can be overwhelming, especially when balancing other responsibilities such as family and work. University of Hawaii at Manoa has a Counseling & Student Development Center (CSDC) that is available to all students. The phone number is (808) 956-7927. The website is http://manoa.hawaii.edu/counseling/ Hawaii Student Conduct Code and Academic Dishonesty Academic dishonesty such a plagiarism, cheating and other forms of dishonesty will result in a failing ( F ) grade for the assignment. More than one incident of academic dishonesty will result in failing ( F ) grade for the course. Equally, more than one incident will also result in reporting the academic dishonesty to the UH Office of Judicial Affairs. Student should familiarize themselves with the University of Hawaii Student Conduct Code: http://studentaffairs.manoa.hawaii.edu/policies/conduct_code/ Accordingly: The university expects students to maintain standards of personal integrity that are in harmony with the educational goals of the institution; to respect the rights, privileges, and property of others: and to observe national, state, and local laws and University regulations. 12a. Linking Mānoa Institutional Learning Objectives for Undergraduate Students that are Addressed: Keep appropriate ones and delete others. 1. Know -- Breadth and Depth of Knowledge Students develop their understanding of the world with emphasis on Hawai'i, Asia, and the Pacific by integrating:
1a. General education Arts and humanities Biological sciences Languages Physical sciences Social sciences Technology 1b. Specialized study in an academic field 1c. Understand Hawaiian culture and history 2. Do -- Intellectual and Practical Skills Students improve their abilities to: 2a. Think critically and creatively 2b. Conduct research 2c. Communicate and report 3. Value -- Personal and Social Responsibility Students demonstrate excellence, integrity, and engagement through: 3a. Continuous learning and personal growth 3b. Respect for people and cultures, in particular Hawaiian culture 3c. Stewardship of the natural environment 3d. Civic participation in their communities 12b. Linking Department Approved BA Public Health Competencies Addressed: Public Health Domains Overview of Public Health Role and Importance of Data in Public Health Identifying and Addressing Population Health Challenges Determinants of Human Health Competencies: Students should be able to: 1. Review the history and philosophy of public health. 2. Identify and explain the core functions of public health. 3. Articulate the differences in public health priorities in various regions of the world 1. Identify the basic concepts, methods, and be able to apply qualitative and quantitative tools of public health data collection, use, and analysis in elementary research analyses. 2. Explain the basic principles of epidemiology. 3. Review fundamental statistical concepts and apply them in elementary research analyses. 1. Apply core concepts of public health, grounded in an ecological perspective to assessing public health issues. 2. Articulate the natural and social determinants of health status in communities, and the dynamic interplay among these factors in various populations. 3. Identify current public health topics including an analysis of the societal attitudes that generate differential impacts to various communities 4. Describe Indigenous People s health in a historical context, and discuss the impacts of colonial processes and social determinants on health outcomes 1. Describe the major human diseases and their underlying etiologies. 2. Show proficiency in sub-disciplines including biological aspects of public health; epidemiology, genetics, and health informatics; environmental and global health
sciences; and infectious and chronic diseases. 3. Identify the impact of the environment, social disparities, and both communicable and non-communicable diseases on health. Project Implementation Overview of the Health System Health Policy, Law, Ethics, and Economics Health Communication 1. Explore the fundamental concepts and features of a public health-related project. 2. Use information literacy skills such as locating and evaluating pertinent public health information 3. Generate research questions, analyze and present data, and interpret and discuss findings. 4. Exhibit critical thinking and analytical abilities, including the capacities to engage in inductive and deductive thinking, quantitative reason, and to construct sound arguments 1. Distinguish the fundamental characteristics and organizational structures of the U.S. health system, as well as to the differences in systems abroad. 2. Explain the role that public health plays in disaster prevention and management and evaluate public policy issues with respect to access, quality and cost, when understanding health disparities within vulnerable populations. 1. Discuss basic concepts of legal, ethical, economic, and regulatory dimensions of health care and public health policy. 2. Articulate the impact of public health policies on vulnerable populations, including Indigenous Peoples. 1. Apply abstract reasoning and critical thinking skills to communicate public health research and practice to public and professional audiences. 2. Demonstrate effective written communication skills 3. Demonstrate effective public speaking skills during classroom discussions and presentations