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Introduction to epidemiology
Epidemiology studies people, patients and populations, and their diseases: their incidence, causes
and consequences and possible control. It is a fundamental discipline for clinical medicine and
public health. It may, together with basic science and clinical research, provide tools to learn about
the aetiology and consequences of diseases, the possibilities for prevention and treatment and the
risk profiles of individuals and populations. Epidemiology plays an integral role in the application
of medical research to populations, interacting with almost every other specialism. Using
advanced - predominantly quantitative - methods such as statistical analyses, field research and
complex laboratory techniques, epidemiologists map various elements of a disease and the ways
they are related.
Students will acquire skills in the critical interpretation of the epidemiologic literature;
methodology of estimating measures of disease frequency and effect and common measures of
potential impact; evaluation of study design; analysis of bias, confounding and effect
modification; and options for control of extraneous factors.
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Ⅰ Disease frequency 15
The teaching of Theory 3
(1) Master the definition of health and disease.
(2) Master the definition, formula and the infecting factors of prevalence rate and incidence rate,
and the differences between them.
(3) Master the definition and formula of mortality rate and fatality rate, and the differences
between them.
(4) Know well the indexes of measuring disease frequency, such as incidence rate, attack rate,
prevalence rate, infection rate, secondary rate, disability rate, mortality rate, fatality rate, survival
rate, cumulative incidence(mortality) rate, etc.
(5) Know well standardized rates.
(6) Understand the definition of life expectancy, and the measures of it, such as PYLL, DALY.
(7) Understand the methods of comparing disease occurrence.
Emphasis: the definition of health and disease, the contents of prevalence rate, incidence rate,
mortality rate and fatality rate.
Difficulty: the infecting factors of prevalence rate and incidence rate, standardized rates, and how
to compare disease occurrence.
The teaching of Practice 3
Emphasis:
(1) Master the definition of health and disease.
(2) Master the definition, formula and the infecting factors of prevalence rate and incidene rate,
and the differences between them.
(3) Master the definition and formula of mortality rate and fatality rate, and the differences
between them.
(4) Know well the indexes of measuring disease frequency, such as incidence rate, attack rate,
prevalence rate, infection rate, secondary rate, disability rate, mortality rate, fatality rate, survival
rate, cumulative incidence(mortality) rate, etc.
(5) Know well standardized rates.
(6) Understand the definition of life expectancy, and the measures of it, such as PYLL, DALY.
(7) Understand the methods of comparing disease occurrence.
Contents of practice:
(1) Calculate the indexes of measuring disease frequency.
(2) Exercise the methods of standardized rates.
Homework:
(1) What are differences between prevalence rate and incidene rate?
(2) What are differences between mortality rate and fatality rate?
(3) Why should we use standardized rates when compare the frequency of disease in population?
Study by oneself 9
Ⅱ Disease distribution 9
The teaching of Theory 3
(1) Master the three forms of disease distribution: time, place, and person.
(2) Master the principles of migrant epidemiology.
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(3) Master the types epidemic intensity of disease.
(4) Know well the two methods of analyzing age distribution.
(5) Know well four time trends(secular trends, short-term trends, cyclic trends and seasonal
trends) used in epidemiology.
(6) Understand the effect of time, place, and person on the study and control of disease in
populations.
(7) Understand the importance of the facets and aspects of the elements of time, place, and person
on epidemiological study and analysis.
Emphasis: the three forms of disease distribution, the principles of migrant epidemiology.
Difficulty: the two methods of analyzing age distribution, cross sectional analysis and birth cohort
analysis.
The teaching of Practice 0
Emphasis:
(1) Master the three forms of disease distribution: time, place, and person.
(2) Master the principles of migrant epidemiology.
(3) Master the types epidemic intensity of disease.
(4) Know well the two methods of analyzing age distribution.
(5) Know well four time trends(secular trends, short-term trends, cyclic trends and seasonal
trends) used in epidemiology.
(6) Understand the effect of time, place, and person on the study and control of disease in
populations.
(7) Understand the importance of the facets and aspects of the elements of time, place, and person
on epidemiological study and analysis.
Contents of practice:
(1) Exercise the descriptive methods of diseases based on time, place, and person.
(2) Understand the distribution forms and characteristics of diseases in population.
Homework:
(1) What are the principles of migrant epidemiology?
(2) What are the two methods of analyzing age distribution? What are differences between them?
Study by oneself 6
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design.
The teaching of practice 3
Emphasis:
(1) Master the principle of the cross-sectional studies
(2) Master the design and analysis of the cross-sectional studies.
(3) Know well the characteristics and types of the cross-sectional studies.
(4) Know well the types of sampling schemes to use.
(5) Know well the advantages and the limitations.
(6) Know well the important types of bias and how to prevent the biases in cross-sectional studies
design.
Contents of practice:
(1) Practise the design and analysis of the cross-sectional studies.
(2) Exercise the different methods of sampling schemes.
Homework:
(1) What are the applications of cross-sectional studies?
(2) Outline the design of a cross-sectional study?
(3) What are the advantages and limitations of the cross-sectional studies?
Study by oneself 6
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Emphasis:
(1) Master the principle, the characteristics, and the applications of case-control studies.
(2) Master the selection of cases and controls.
(3) Master the calculation of the odds ratio(OR) and the implication of OR.
(4) Master the advantages and limitations of case-control studies.
(5) Know well the factors affecting the sample size.
(6) Know well the basic case-control study design.
(7) Know well the important types of bias and how to prevent the biases in case-control studies.
Contents of practice:
(1) Evaluate the case-control design and analysis of the case-control data.
(2) Exercise the calculation of the odds ratio(OR) and the implication of OR.
Homework:
(1) What are the characteristics and applications of case-control studies?
(2) Outline the design of a case-control study?
(3) What are the advantages and disadvantages of case-control studies?
Study by oneself 9
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(1) What are the characteristics and applications of cohort studies?
(2) Outline the design of a cohort study?
(3) What are the advantages and disadvantages of cohort studies?
Study by oneself 9
Ⅴ Experimental epidemiology 12
The teaching of Theory 3
(1) Master the principles and the characteristics of experimental epidemiology.
(2) Master the essential of a randomized controlled trial design.
(3) Know well the three forms of experimental epidemiology.
(4) Know well the limitations of experimental studies.
(5) Understand the indexes of analyzing in experimental epidemiology.
Emphasis: The principle and the characteristics of experimental epidemiology. The essential of a
randomized controlled trial design.
Difficulty: The essential of a randomized controlled trial design.
The teaching of practice 3
Emphasis:
(1) Master the principles and the characteristics of experimental epidemiology.
(2) Master the essential of a randomized controlled trial design.
(3) Know well the three forms of experimental epidemiology.
(4) Know well the limitations of experimental studies.
(5) Understand the indexes of analyzing in experimental epidemiology.
Contents of practice:
(1) Practise how to design a randomized controlled trial and how to analyze the RCT data.
(2) Calculate indexes of analyzing in experimental epidemiology.
Homework:
(1) What are the characteristics and principles of experimental epidemiology?
(2) Outline the design of experimental epidemiology?
(3) What are the advantages and disadvantages of experimental epidemiology?
Study by oneself 6
Emphasis: the important sources of error in epidemiology studies and the concepts of selection
bias, measurement bias and confounding.
Difficulty: Criteria for a confounding factor.
The teaching of practice 0
Emphasis:
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(1) Master the important sources of error in epidemiological studies.
(2) Master the concepts of selection bias, measurement bias and confounding.
(3) Know well the difference between bias and confounding.
(4) Know well strategies for enhancing accuracy.
(5) Understand the examples of different bias.
Contents of practice:
(1) Discuss the biases of particular concern in case-control studies.
(2) Discuss the strategies for enhancing accuracy.
Homework:
(1) What is random error and how can it be reduced?
(2) What are the main types of systematic error in epidemiological studies and how can their
effects be reduced?
Study by oneself 12
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(4) Evaluate relationship between two variables.
Homework:
(1) Why do the mean and median have different values?
(2) What is confidence intervals?
(3) In a study to investigate the therapeutic effects of high and low doses of antidepressant
medication, patients were randomly assigned to a low-dosage or high-dosageregimen. They were
assessed initially and after 14 and 18 days using standardized rating scales. In comparing the two
dosage groups, should one-tailed or two-tailed tests be used? Give reasons.
Study by oneself 15
Ⅰ Prevention 6
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The teaching of Theory 3
(1) Master levels of prevention, including primordial prevention, primary prevention, secondary
prevention and tertiary prevention.
(2) Know well the aims of each level of prevention.
(3) Understand the scope of prevention.
Emphasis: four levels of prevention.
Difficulty: the aims of each level of prevention.
The teaching of Practice 0
Study by oneself 3
Ⅱ Screening 15
The teaching of Theory 3
(1) Master the concept of screening.
(2) Master how to evaluate a screening programme, including validity, reliability, predictive value,
yield, etc.
(3) Know well the types of screening.
(4) Know well associated screening tests.
(5) Know well the criteria for instituting a screening programme.
Emphasis: the concept of screening, how to evaluate a screening programme, including validity,
reliability, predictive value, yield, etc.
Difficulty: how to evaluate a screening programme, including validity, reliability, predictive
value, yield, etc.
The teaching of Practice 3
Emphasis:
(1) Master the concept of screening.
(2) Master how to evaluate a screening programme, including validity, reliability, predictive value,
yield, etc.
(3) Know well the types of screening.
(4) Know well associated screening tests.
(5) Know well the criteria for instituting a screening programme.
Contents of practice:
(1) Evaluate a screening programme, including validity, reliability, predictive value, yield, etc.
(2) Evaluate associated screening tests, understand the outcome of parallel test and serial test.
Homework:
(1) What characteristics of a disease would indicate its suitability for screening?
(2) What epidemiological study designs can be used to evaluate a screening programme?
Study by oneself 9
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(5) Know well how to draw, interpret, and describe the value of an epidemic curve.
(6) Know well the main steps in the investigation of an outbreak.
(7) Understand the ways of surveillance.
Emphasis: The roles of infectious agent, transmission, host, and environment; he control
measures of an epidemic.
Difficulty: The control measures of an epidemic.
The teaching of practice 0
Emphasis:
(1) Master the roles of infectious agent, transmission, host, and environment.
(2) Master the control measures of an epidemic.
(3) Know well how to define the terms “outbreak,” and “epidemic.”
(4) Know well definition of an endemic disease.
(5) Know well how to draw, interpret, and describe the value of an epidemic curve.
(6) Know well the main steps in the investigation of an outbreak.
(7) Understand the ways of surveillance.
Contents of practice:
(1) Practise how to draw, interpret, and describe the value of an epidemic curve.
(2) Exercise how to investigate an outbreak.
Homework:
(1) If you were a district health officer, how you would you monitor the occurrence of measles and
detect an epidemic in your district?
(2) Describe the chain of infection for foodborne disease caused by salmonella?
Study by oneself 12
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(2) Practise how to distinguish between normality and abnormality.
Homework:
(1) Why has the term “clinical epidemiology” been described as a contradiction in terms?
(2) What determines the positive predictive value of a screening test?
Study by oneself 6
Reference Books:
1. Howard Strasberg, Principles of Epidemiology, the Health Sciences Consortium.
2. Kenneth J. Rothman & Sander Greenland, Modern Epidemiology, Maple Press.
3. Last, J. M, A dictionary of epidemiology, Oxford University Press.
4. David S. moore, Statistics, W. H. Freeman and Company.
5. Thomas C. Timmregk, An Introduction to Epidemiology, Jones and Bartlett Publishers.
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