Faculty of Medical and Health Sciences


POPLHLTH 304 - Principles of Applied Epidemiology

15 Points

Semester 1

Tāmaki  

Description


This course examines the application of an epidemiological approach in population health, including study of the principles of epidemiological thinking, epidemiological study design and analyses, and the application of these findings to population health. Modules will be taught through specific themes for example, a life course approach or injury prevention.

Requisites


Prerequisite: POPLHLTH 111, 202 and 15 points from STATS 101, 102, 108

Key course objectives


By the end of the course, each participant will be expected to:

  • Be familiar with the main epidemiological study designs, their applications, strength and weaknesses.

  • Be familiar with the methods of calculating main study effect measures and confidence intervals.

  • Have developed skills using EpiInfo software, a free public-domain software package, which allows users to analyse data.

  • Have a greater insight into how epidemiological studies contribute to medical and public health practice.

  • Be able to assess and critically evaluate epidemiological studies, such as those published as government reports or in the peer-reviewed literature, especially in areas close to your own interests. 

Course structure


There are two one hour lectures and one hour tutorial each week

The course focuses on the principles of epidemiology applied to the measurement and surveillance of disease and the assessment of cause-and-effect relationships. The objective is to give you the skills to understand reports and published new studies in health areas that use epidemiological methods, which includes studies of the frequency of disease, the causes of diseases, and the effects of treatment and health care interventions. It includes ‘hands on’ experience with the analysis and interpretation of data from real studies.

Lecture schedule


Week

Session

Lecturer

Title

Content

1

1

M Elwood

Introduction.

Epidemiology: causes or coincidence?

Purposes: measurement; assessing causality. Types of causation. Example of a randomised trial

1

2

M Elwood

Study designs to show causation 

Trials, cohort, casecontrol, survey designs. Relative risk and odds ratio.

2

3

M Elwood

Case-control studies 

Design, choice of controls. Results: odds ratio. 

2

4

Visitor RS

Example: a case-control study (NZ cot death study)

An important case-control study: design, results, and implications

3

5

M Elwood

Cohort and trial designs

Cohort studies. Relative risk, risk difference, attributable risk. 

3

6

Visitor SA

Example: a cohort study

Doing and interpreting cohort studies

4

7

M Elwood

Review: study designs and measures of disease frequency

Incidence, prevalence, cumulative incidence; randomised trials, results, relative and attributable risk

4

8

M Elwood

Age standardisation

Age standardisation as an introduction to confounding

5

No session: Easter

 

 

5

No session: Easter

 

 

6

9

M Elwood

Introduction to critical appraisal. Observation bias

Assessment of causation: first steps. Measured outcomes: effects of definition, error, and bias. Examples

6

10

M Elwood

Confounding: concepts and effects

Confounding. Concepts, effects, examples using cohort/trial designs

7

11

M Elwood

Confounding: ways to adjust for it; stratification 1

Restriction. Stratification. Standardisation.

7

12

M Elwood

Confounding: ways to adjust for it; stratification 2

Mantel-Haenszel adjusted RR.

 

Semester break

 

 

 

 

8

13

M Elwood

Confounding: ways to adjust for it

Confounding in casecontrol designs. M-H odds ratio. Matching.

8

14

Visitor NW

Designing and doing randomised trials

Important randomised trials in real life.

9

15

M Elwood

Assignment 3 classroom exercise

 

9

16

M Elwood

Assignment 3 classroom exercise

 

10

17

M Elwood

Multivariate analysis

Multivariate analysis. Coping with many confounders.

10

18

M Elwood

Review: control of confounding

 

11

19

M Elwood

Critical appraisal 2

Bradford-Hill guidelines.

11

20

visitor VJ

Systematic reviews: and the Cochrane collaboration 

Meta-analysis in practice

12

21

M Elwood

Meta-analysis

Systematic reviews and meta-analysis. Weighted RR or OR methods

12

22

M Elwood

Reviewing a study

Example

13

23

M Elwood Assessing a study: review

How to assess a study: review and examples

13

24

M Elwood Assessing a study: review 

How to assess a study: review and examples

In period June 11 to June 29     Examination  

Tutorial schedule


Week

Topic

1

No tutorial

2

Introduction to EpiInfo

3

Risk Ratios and attributable risks

4

No tutorial 

5

Easter – no session

Stratification – confounding 

7

Stratification – effect modification

 

Semester break

8

No tutorial

9

Logistic regression – confounding

10

Logistic regression – effect modification

11

Linear regression

12

Meta-analysis (with Revman)

13

No tutorial

Course assessment


  • Assignment one: 10%

  • Assignment two: 10%

  • Assignment three: 20%             

  • Final exam: 60%                  

Readings or recommended textbooks


A list of recommended readings from textbooks is given for each session. These will amplify and reinforce material covered in the lectures and tutorials and help greatly with your assignment and examinations work. Some topics will not be covered fully in the lectures, and text book readings for these will be essential, and emphasised in the lectures. 

Recent and new issues may be covered in the course, and other important readings may be assigned or recommended. These will usually be available on the internet.  

There are two recommended texts. We will assume you have at least one of these. 

Essential Epidemiology: This is a basic book that gives you most, but not all, the topics covered, but is adequate in addition to the taught sessions. It is easily obtained ($83 at Ubiq book store) and we chose it because you may have used this text in earlier courses. The authors are at the University of Queensland. 

Webb, P and Bain, C  Essential Epidemiology, 2nd edition 2011; Cambridge University Press.  

The other is a more advanced text, written by Professor Elwood:

Elwood, JM Critical Appraisal of Epidemiological Studies and Clinical Trials, 3rd edition, 2008, Oxford University Press.

This covers more than you need for this course. Many of the examples used come from this text. It will be particularly useful if you go on to do further courses, or a research project in epidemiology. It can be obtained through the library or sources such as Amazon. A new edition has been developed, likely to appear in late 2016. 

Course Director