Epidemiology: Concepts and Methodological Approaches

By the end of the course, the candidate should demonstrate the following:

Advanced knowledge about:

• Epidemiologic thinking and hypothesis generating
• Measuring disease occurrence at population level
• Association and causal relationships between exposures and health outcomes
• Research methods in epidemiology
• Observational studies and intervention trials
• Validity in epidemiologic research

Skills:

• Ability to outline the core principles in epidemiologic research
• Ability to develop epidemiologic hypothesis considering the existing knowledge in a health topic
• Ability to distinguish and apply measures of occurrence and association of diseases
• Ability to explain, apply, and critique the different types of epidemiologic study designs
• Ability to demonstrate awareness of how to minimize bias and confounding in epidemiologic research

General competence:

• Ability to reflect on the importance of epidemiologic studies to tackle relevant public health problems
• Ability to critically evaluate the different types of epidemiologic studies in terms of their strengths and weaknesses
• Ability to recognize the challenges and limits of epidemiologic research to support clinical interventions and evidence-based public health actions
• Ability to engage in scientific discussions involving epidemiologic research
• Ability to contribute to the planning and conducting epidemiologic studies in your area of expertise

The course outlines the general principles of epidemiology as a core science of public health. The course addresses the fundamental epidemiologic concepts encompassing the different types of research designs. The course also highlights the critical aspects of using epidemiologic research to describe the occurrence of diseases at population level as well as to identify the causes of diseases and to assess the efficacy of treatment and preventive regimens.

1. Introduction to the principles and foundations of epidemiology

• Pioneers in epidemiology and history of causal thinking in public health
• Basic epidemiologic concepts concerning the definitions of population, types of research, hypothesis, association, causal link, types of variables, exposure, outcome, bias and confounder
• Epidemiologic thinking and the rationale of moving from population data observation into developing and testing epidemiologic hypothesis

2. Measures of disease frequency and measures of association

• Measures of incidence and prevalence and the related types of events
• Measures of effect, association and impact between exposures and outcomes

3. Causal relationships

• Theoretical causal mechanisms involving sufficient cause and component cause model
• Causal criteria proposed by Hill: understanding their strengths and limits

4. Types of epidemiologic studies

• Observational studies: cross-sectional, ecological, case-control studies and cohort studies
• Intervention trials: quasi-experimental trials, randomized clinical trials, community intervention trials

5. Validity

• Evaluation of bias and strategies to mitigate bias in epidemiologic studies
• Assessment of confounding and approaches to handle confounders
• Identification and interpretation of interaction (effect modification)

6. Epidemiology in clinical settings

• Studies of diagnostic and screening tests