Department of Epidemiology School of Public Health University of California, Los Angeles
Course EPI 100 Session Lect 1
INTRODUCTION TO EPIDEMIOLOGY
I. Introduction A. Course 1. EPI 100 – Principles of Epidemiology, Summer Session A, 2009 B. Handouts to be printed and brought to class by students 1. Course outline 2. Lecture outline – Introduction to Epidemiology (Lecture 1) 3. Lecture outline – History of Epidemiology (Lecture 2) C. Description of Course 1. Introduction to the study of the distribution and determinants of disease and injury in human populations, including measures of disease occurrence, research designs, and causation criteria D. Administrative details 1. Instructors a. Ralph R. Frerichs, DVM, DrPH, Professor, UCLA Dept. of Epidemiology (1) Email: frerichs@ucla.edu b. Nguyen Nguyen, M.D., Ph.D. (candidate) (1) Email: nguyennihe@ucla.edu (2) Available for discussion, T-W-Th from 5-6 pm in Rm. 23-105 CHS 2. Lectures a. 21 lectures in six weeks – see Course Outline 3. Book a. Required (1) Gordis, L. Epidemiology, Elsevier-Sanders, Philadelphia, 4th Ed., 2008. b. Recommended (1) Porta, M. (Ed.), A Dictionary of Epidemiology, Oxford, New York, 2008 4. Format a. All material will be presented, but not handed out, in class (1) Students must bring their handouts (printed from the internet) and their book (a) There will be no in-class handouts b. Course guidelines and material are posted on the internet (1) http://www.ph.ucla.edu/epi/epi10009s.html (a) Course description (background, grading, sources for book, etc.) (b) Course material i) Course outline (Adobe Acrobat reader) ii) Session outlines (Adobe Acrobat reader) a) Available for printing on Saturday or Sunday preceding the week of class b) Pages will be numbered in chronological order for the total set of session outlines iii) Lecture animated slides with embedded sound a) Requires Microsoft Internet Explorer b) Available for review the following day (usually by early -4-
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afternoon), but at latest by Saturday following the week of class MP3 sound files of each lecture a) Available at the same time as the animated slides
5. Grading a. Declaration of option (1) Preliminary declaration date – June 25, 2009 (end of first week) (2) Final declaration time/date – Noon, July 29, 2009 (day before Final Exam) b. Option One (to be declared; see above) (1) Five quizzes, one on each Tuesday from 6:00 to 6:30 pm (a) Drop the lowest quiz (b) Remaining four quizzes account for 20% of course grade (c) Quizzes will focus only on the Gordis (2008 ed.) book (2) Final Examination, Thursday, July 30, 2009, from 6:00 to 8:30 pm (a) The Final Examination will be given only at UCLA on July 30, 2009 i) The examination will not be given in a different location, nor at an earlier or later date ii) For those missing the Final Examination, the make-up examination will not be administered until Saturday morning of either December 5, 2009 or December 12, 2009 (i.e., at the end of the Fall Quarter, 2009). (b) Final examination focuses only on the Gordis (2008 ed.) book and Frerichs lectures, but not the discussion sessions (c) Accounts for 80% of grade c. Option Two (to be declared; see above) (1) Final Examination, Thursday, July 30, 2009, from 6:00 to 9:00 pm (a) Note comments about the examination under “Option One” above (b) Accounts for 100% of grade II. Definitions and Objectives "The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems" (“broader definition,” Gordis, p. 3) A. Key Words: health-related states specified populations control of health problems B. Reveal and diagnose 1. Individual level a. patient reveals and physician makes diagnosis of disease in individual 2. Population level a. surveys reveal and epidemiologist makes diagnosis of disease patterns in community C. Objective of epidemiology 1. Etiology a. Cause of disease b. Cause of disease risk factors -5-
2. Occurrence a. Incidence (new disease cases) b. Prevalence (existing disease cases) 3. Natural history a. Prognosis of disease 4. Evaluation a. Preventive actions b. Therapeutic actions III. Patterns of Health Conditions A. Evolving over time 1. Epidemiological transition from infectious diseases to chronic diseases 2. Increase in life expectancy B. Related to prevention 1. Primary 2. Secondary 3. Tertiary C. Importance to the clinician 1. Need to know the epidemiological distribution of disease agents in the community of their patients IV. The Epidemiologic Approach A. Look for associations 1. Patterns in the community 2. Stimulate etiological hypotheses B. Encourage experimentation 1. Investigators (to be presented later) 2. Communities a. Positive experimentation (1) People respond to reports in the media and are willing to try new things that are beneficial (a) A common community evaluation design (pretest, posttest, control)
where O1 and O2 are observations before and after the intervention (shown as X) in the intervention area and O3 and O4 are the observations before and after in a comparable non-intervention (i.e., control) area. b. Negative experimentation (1) People also react to fear or mis-information and move in harmful directions (a) Support or deny epidemiological hypotheses (b) Considered ethical to investigate if people voluntarily created the potentially negative change V. Conclusion -6-
A. Epidemiology is an invaluable tool for... 1. the rational basis on which effective prevention programs can be planned and implemented a. Public health function 2. conducting clinical investigations that contribute to the control of disease and to the amelioration of the human suffering associated with it a. Medical care function
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