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:
- Describe and discuss the application and scope of epidemiological research
- Define, calculate and interpret epidemiological measures, including measures of disease frequency, measures of association and measures of population impact
- Plan, discuss and evaluate epidemiological study designs and analytical strategies
- Describe the uses and limitations of different data sources in the context of epidemiological measures
- 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
- Discuss the concepts of reliability and validity
- Evaluate the results and interpretation of published epidemiological research
- 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
- Scope of epidemiology: definition, descriptive and analytical epidemiology, contribution to population health.
- 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.
- Measures of association: definition and calculation of risk ratio, rate ratio, odds ratio, absolute risk and rate differences, choosing suitable measures.
- Disease trends and standardization: direct and indirect, standardised mortality ratio, proportional mortality ratio, life tables.
Epidemiological study designs
- Case control studies: retrospective, prospective/nested study designs.
- Cohort studies: cross-sectional, retrospective and prospective cohort study designs, special cases e.g. case-cohort.
- Intervention studies and RCTs: including clinical trials, characteristics, confounding and bias, randomisation.
- 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.
- 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
- Bias: definition, information and selection.
- Confounding: definitions, detection and control.
- Interaction and effect modification: definition and detection.
- Association and causation: causal paradigms and criteria for causality, Mendelian randomisation.
- Validity and reliability: definitions, generalisability, sensitivity, specificity, positive and negative predictive value of a test, questionnaire design, problems of self-reporting.
- Principles of genetic epidemiology and genomics
- 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