University of Pennsylvania Graduate Program in Public Health MPH Degree Program Course Syllabus Spring 2012



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University of Pennsylvania Graduate Program in Public Health MPH Degree Program Course Syllabus Spring 2012 Title: PUBH 502 (NURS 500) - Introduction to the Principles and Methods of Epidemiology Course Units: 1.0 c.u. Course Description: Epidemiology is a combination of a subject matter science and research methodology. Introduction to Principles and Methods of Epidemiology focuses on the latter component. The course introduces the study designs applied to human populations, including randomized trials and four types of observational studies (cohort, case-control, cross-sectional, ecological). Because cause-and-effect relations are at the heart of epidemiologic research, numerous related topics are taught, including causal inference, and bias. Placement / Room Assignment: Monday, 5:00 8:00 PM Lecture Biomedical Research Building, Room 252 Course Director: Kathryn H. Schmitz, PhD, MPH Associate Professor schmitz@mail.med.upenn.edu *** best way to reach me is email *** 2 office locations: 3401 Market St., Suite 202 and 144 Anatomy Chemistry Building. When making an appt, please be sure you are clear WHERE our meeting will occur. Phone: 215-898-6604 Office Hours: By Appointment Course Co-Director: Anne Marie McCarthy, ScM Instructor University of Pennsylvania MPH Program amccarth@jhsph.edu P: 267-934-2540 PhD Candidate Cancer Epidemiology Johns Hopkins Bloomberg School of Public Health Office Hours: by appt.

Teaching Assistant: Brian S. Finkelman MD/PhD Student Division of Epidemiology Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine University of Pennsylvania (484) 459-4966 bfin@mail.med.upenn.edu Office hours: Thursdays 12-1 pm, location 107 Blockley Hall Pre-requisites: Introductory Statistics, 80% or better on math pretest (Epidemiology is a quantitative subject) Course Overview: This course will provide an introduction to the principles and methods of epidemiology as a research science. Co-requisites: None. Course Objectives: By the end of the course, students will be able to: 1) Design basic epidemiologic studies. 2) Analyze epidemiologic data using tabular methods. 3) Critically review epidemiologic papers. Public Health Core Competencies Covered by this course: 1. Apply the public health paradigm which recognizes a social ecological framework to understanding health events including: social, ethnic, demographic, economic, and environmental determinants of health and health disparities. 2. Apply biostatistical and epidemiological methods and technologies including to interpret data, identify and assess health risks, and present data in a meaningful way to at-risk communities. 3. Apply principles and science of environmental health to determining causation of occupational and environmental hazards. 4. Incorporate qualitative and quantitative skills into innovative research and systems approaches to health problems. 5. Assess the public health needs of communities and make evidence-based decisions to evaluate the delivery of health services and programs. 6. Communicate public health information effectively to government, scientific, organizational, family and community groups and individuals. Teaching Methods: Most of the instruction will be through lectures and class discussion. Some class time will be devoted to critical review of articles or in-class exercises. Work Expectations: Students are expected to come to class having read the assigned readings and reviewed the notes for the class. Students are expected to turn in assignments on time and take tests at the scheduled times as well.

Evaluation Methods: 35% Midterm Exam 35% Final Exam 24% Homeworks 6% Class Participation. COURSE REQUIREMENTS: HOMEWORK: There will be SIX homework assignments. The homework due dates are clearly noted in the class schedule students are expected to arrive at class with the homework ready to turn in at the start of the class associated with the homework due date. The exercises will be reviewed in class and are meant to illuminate the concepts covered in the class and in the readings. They will count for 24% of the final grade. (EACH HOMEWORK COUNTS 4 POINTS TOWARD THE FINAL GRADE.) MIDTERM AND FINAL EXAM: There will be a midterm exam in class on October 31st which will count for 35% of the final grade. The final exam will count for 35% and will be given in class on Thursday December 15 from 3-5 pm. ONLY ONE MAKE-UP SESSION WILL BE SCHEDULED FOR EITHER EXAM. IF YOU CANNOT MAKE THE REGULARLY SCHEDULED EXAME OR THE MAKE-UP TIME, YOU WILL RECEIVE A ZERO FOR THE EXAM. CLASS PARTICIPATION: Class attendance and participation will count for the remaining 5% of your grade for the course. You are expected to come to class with the assigned readings and the homeworks completed. There are a total of 15 class sessions. You will receive the full 5 points toward your final grade by attending and participating fully in at least 13 of these sessions. After 2 absences, each absence will result in a full point off of your final grade. YOU ARE RESPONSIBLE FOR SIGNING IN AT EVERY CLASS SESSION. IF YOU DO NOT SIGN IN, EVEN IF I REMEMBER YOU BEING IN CLASS, YOU WILL NOT RECEIVE CREDIT FOR ATTENDING. The course director has a teaching policy of not providing additional work for students who need to make up points due to absences, poorly done homework, or low grades on exams, out of fairness to the other students. You will be asked to sign a statement that you have read and understand these course requirements. Homework Assignments: 1. Homework #1: Epidemiologic Investigations of Cholera John Snow 2. Homework #2: Measures of Disease Frequency 3. Homework #3: Cohort Studies 4. Homework #4: Case Control Studies 5. Homework #5: Measures of Association and Impact 6. Homework #6: Effect Measure Modification Out-of-Class Communication: Email will be the main method for out-of-class communication. You are expected to check your email regularly. The course director will read email from students one time per day. Anticipate that it will take 24 hours (or slightly more) to get an email reply Monday through Friday. No promises are made regarding email replies over the weekend.

Course Web Site: Students access Blackboard course sites via a web browser such as Netscape or Internet Explorer. Assigned Readings: Epidemiologcy, 4 th Edition. Leon Gordis. Saunders Elsevier, Philadelphia PA, 2009. This book will NOT be available in the Penn bookstore. Purchase through online vendors. Weekly reading assignments will be given in the text and additional readings will be posted on the course blackboard site. Academic Integrity: Students are expected to adhere to the University s Code of Academic Integrity. Care should be taken to avoid academic integrity violations, including: plagiarism, fabrication of information, and multiple submissions. Students who engage in any of these actions will be referred to the Office of Academic Integrity, which investigates and decides on sanctions in cases of academic dishonesty. See link for more information: http://www.upenn.edu/academicintegrity/index.html MPH Academic Standing Policy/Academic Probation: According to University policy, a graduate student must maintain a B average or better to be considered in good academic standing. A student who does not meet the University policy of a B /3.0 average will be reviewed by the MPH Program Director, the Associate Director and the Academic Progressions Committee. A student may be put on academic probation for a period of 1 semester to improve his/her overall average may be put on academic probation for a period of 1 semester to improve his/her overall average. Any course in which the student receives a grade below a B- will not be applied toward the Master of Public Health degree. The record of any student who receives an unsatisfactory grade (less than a B- ) in a course or who does not meet the University policy of a B /3.0 average will be reviewed by the MPH Program Director, the Associate Director and the Academic Progressions Committee. A student may be put on academic probation for a period of 1 semester to improve his/her overall average Students may continue to take other courses during the probation period and the student must make arrangements with the course director to remediate any grades lower than a B-. These arrangements must be approved by the MPH Program Director with input from the Academic Progressions Committee as needed. Any student who is on academic probation for a period greater than 1 semester will be referred to the Academic Progressions Committee for review and recommendation. This committee is authorized to dismiss the student or allow the student to remain in the program on a probationary basis. A return to good academic standing is contingent on receiving an acceptable grade (B or higher) in all remaining courses. The MPH grading policy is at the discretion of the individual course instructors. Please find below the generally used grading scale for the MPH Program. A+ 97-100 B+ 87-89 C+ 77-79 A 93-96 B 83-86 C 73-76 A- 90-92 B- 80-82 C- 70-72 F 0-69 Please note that an A+ carries the same weight (4.0) as an A.

Incomplete Grade: It is expected that a matriculated Master of Public Health student shall complete the work of a course during the semester in which that course is taken. A student who fails to complete a course within the prescribed period shall receive at the instructor s discretion either a grade of I (incomplete) or F (failure). If the incomplete is given, the instructor may permit an extension of time up to one year for the completion of the course. In such cases, any course which is still incomplete after one calendar year from its official ending must remain as incomplete on the student s record and shall not be credited toward the MPH degree. Students who receive two or more incompletes within a semester may not register for the subsequent semester(s) without the permission of the Department. For additional information on academic policies, please refer to the corresponding sections in the Student Handbook.

Course Outline / Assignments: Class Date Class Topics Readings & Homework Due 1 1/16 MLK Day of Service Observed 2 1/23 OUTLINE OF COURSE REQUIREMENTS, HISTORY OF EPIDEMIOLOGY, DEFINITIONS, OUTBREAK INVESTIGATION Gordis Chap. 1 and Chap. 2: pp 19-29 & 32-36 3 1/30 MEASURES OF DISEASE FREQUENCY Gordis Chap. 3 : pp 37-52, Chap. 4: pp 57-73 Homework 1 due 4 2/6 DESCRIPTIVE EPIDEMIOLOGY, RELIABILITY/VALIDITY, SCREENING Gordis Chap. 3: pp. 29-32 & Chap. 5, Chap. 18 Homework 2 due 5 2/13 EXPERIMENTAL STUDIES Gordis Chap. 7 & 8 6 2/20 COHORT STUDIES, CRITICAL REVIEW OF Gordis Chap. 9 EPIDEMIOLOGIC LITERATURE 7 2/27 CASE CONTROL STUDIES Gordis Chap 10: pp. 177-195, Chap. 13 Homework 3 due 8 3/12 MIDTERM EXAM 9 3/19 MEASURES OF ASSOCIATION Gordis Chap. 11 Homework 4 due 10 3/26 MEASURES OF IMPACT Gordis Chap. 12 11 4/2 CROSS-SECTIONAL AND ECOLOGIC STUDIES, CAUSALITY Gordis Chap. 10: pp. 195-198, Chap. 14 Homework 5 due 12 4/9 BIAS, PART 1 Gordis Chap. 15 13 4/16 BIAS, PART 2; STATISTICAL Gordis Chap. 15 SIGNIFICANCE 14 4/19 EPIDEMIOLOGY, HEALTH SERVICES & Gordis Chap. 17 & 19 PUBLIC POLICY Homework 6 due 15 4/23 FINAL EXAM 3-5 pm

FURTHER READINGS IN EPIDEMIOLOGY This course can only give an introduction to the field of epidemiology. To those with more extensive interest, the following books are recommended: 1. McMahon B, Trichopoulos D. Epidemiology: Principles and Methods. (Boston: Little, Brown, 1996) This is a major textbook in the field, is clearly written and has a superb bibliography for epidemiologic studies. 2. Morris, JN. Uses of Epidemiology. (Churchill Livingstone, 1975) This is less textbook-like and has some more illustrations of the ways epidemiology can be used to understand disease and improve health. 3. Hulley S, Cummings SR. Designing Clinical Research. (Williams & Wilkins, 1988) 4. Rothman K, Greenland, S. Modern Epidemiology. (Lippincott, William, and Wilkins, 2008) 5. Epidemiologic Methods: Studying the Occurrence of Disease. T.D. Koepsell, N.S. Weiss. Oxford University Press, 2003.