Module Aims:

This core module covers principles of both descriptive and analytical epidemiology. Students will learn how to describe the distribution and determinants of health-related states and events in a population, the main approaches to studying the relationship between exposures and outcomes and their principal applications to the control of diseases and other health problems.

Module Learning Outcomes:

By the end of the module, students should be able to:

1. Describe and discuss the application and scope of epidemiological research
2. Define, calculate and interpret epidemiological measures, including measures of disease frequency, measures of association and measures of population impact
3. Plan, discuss and evaluate epidemiological study designs and analytical strategies
4. Describe the uses and limitations of different data sources in the context of epidemiological measures
5. Express and describe the key concepts, implications and approaches to address random error, bias, and confounding in the context of epidemiological research and study design
6. Discuss the concepts of reliability and validity
7. Evaluate the results and interpretation of published epidemiological research
8. Describe strategies for causal inference in epidemiological research

 

Pre-requisites:

Fluent numeracy and a good understanding of elementary algebra (e.g. rearranging equations, graphical interpretation of a linear equation in two variables, simultaneous linear equations when solution is unique, quadratic equations), logarithms (and performing algebraic operations on logarithmic scale), summation notation (∑), and probability (including performing simple probability operations). Familiarity with scientific notation, and with performing automated calculations (e.g. in excel, R, or equivalent).

 

Teaching Strategy:

The module will be delivered using a combination of lectures, workshops, group discussion and experiential learning. Some reading will be required prior to some sessions.

Assessment:

A short-answer and MCQ assessment (50% of module grade).
Critical appraisal of one or more papers, as specified in the module assessment guidelines (1000 words; 50% of module grade).

Session List:

Principles of Epidemiology

1. Scope of epidemiology: definition, descriptive and analytical epidemiology, contribution to population health.
2. Measures of disease frequency: definition and calculation of prevalence, incidence, risk, rate, basic and net reproductive rate, choosing suitable measures, limitations of case and population definitions and their impact on measures of disease frequency.
3. Measures of association: definition and calculation of risk ratio, rate ratio, odds ratio, absolute risk and rate differences, choosing suitable measures.
4. Disease trends and standardization: direct and indirect, standardised mortality ratio, proportional mortality ratio, life tables.

Epidemiological study designs

5. Case control studies: retrospective, prospective/nested study designs.
6. Cohort studies: cross-sectional, retrospective and prospective cohort study designs, special cases e.g. case-cohort.
7. Intervention studies and RCTs: including clinical trials, characteristics, confounding and bias, randomisation.
8. Ecological/geographical studies and natural experiments: uses and interpretation of ecological studies, natural experiments in population health studies, advantages and disadvantages of ecological investigation, ecological fallacy and ecological bias.
9. Routine data sources: registries and record linkage, mortality, sociodemographic information; local, national and international Biobanks and other epidemiological resources (UKbiobank, EPIC, Consortia databases etc).

Extended Epidemiology topics

10. Bias: definition, information and selection.
11. Confounding: definitions, detection and control.
12. Interaction and effect modification: definition and detection.
13. Association and causation: causal paradigms and criteria for causality, Mendelian randomisation.
14. Validity and reliability: definitions, generalisability, sensitivity, specificity, positive and negative predictive value of a test, questionnaire design, problems of self-reporting.
15. Principles of genetic epidemiology and genomics
16. Measures of dynamics of infectiousness: transmissibility of infectious disease, definition and calculation of the net reproduction rate and the basic reproduction rate, infection and transmissibility periods, general dynamics of infection

Module Length: 8 days over 4 weeks