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Course, academic year 2024/2025
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Epidemiology and evidence based medicine - DA1106089
Title: Epidemiology and evidence based medicine
Guaranteed by: Department of Epidemiology (13-472)
Faculty: Second Faculty of Medicine
Actual: from 2024
Semester: summer
Points: 3
E-Credits: 3
Examination process: summer s.:
Hours per week, examination: summer s.:14/14, C+Ex [HT]
Extent per academic year: 14 [weeks]
Capacity: unlimited / unlimited (unknown)
Min. number of students: unlimited
4EU+: no
Virtual mobility / capacity: no
Key competences:  
State of the course: taught
Language: English
Teaching methods: full-time
Level:  
Guarantor: doc. MUDr. Pavla Brennan Kearns, Ph.D.
Teacher(s): doc. MUDr. Pavla Brennan Kearns, Ph.D.
Co-requisite : DA1105038
Pre-requisite : DA1103002
Is co-requisite for: DA1105038
Annotation -
The course is intended for students of the 3rd year of General Medicine, takes place in the summer semester and consists of seven lectures and seven practical sessions.
Last update: Brennan Kearns Pavla, doc. MUDr., Ph.D. (12.02.2025)
Course completion requirements -

Participation in practical sessions. It is possible to miss one practical session for a serious reason.

Last update: Brennan Kearns Pavla, doc. MUDr., Ph.D. (12.02.2025)
Literature -

Kenneth J. Rothman, Epidemiology: An Introduction, 2nd edition , Oxford University Press , 2012. The

book can be obtained through this link: https://ebookcentral.proquest.com/lib/cuni/detail.action?docID=5763681

Last update: Brennan Kearns Pavla, doc. MUDr., Ph.D. (12.02.2025)
Requirements to the exam -

The course ends with a written exam that takes place during the exam period. It is necessary to register for the exam via SIS, the dates will be announced during May. Bring an ordinary calculator (not a phone) and a pen

to the exam. The exam tests the achievement of the pre-defined intended learning outcomes and consists of 20 questions with 4 possible answers, only one of which is correct. One point is awarded for each correctly

answered question.

Final grade:

18, 19 and 20 points: 1

16 and 17 points: 2

14 and 15 points: 3

13 or less points: 4 (failed)

In the case of a "failed" result, it is necessary to re-register for the written exam via SIS. In case of failure on the second attempt, a third attempt follows, which will take place as an oral exam. The oral exam will also test achievement of the specified intended learning outcomes.

Quizes:

On Moodle, there are 6 voluntary quizzes available to encourage ongoing study. Each quiz is active during the odd-numbered week from Monday 8:00 AM to Thursday 8:00 PM. The correct answers to the quiz

questions will be displayed on Friday. Each quiz consists of 5 randomly generated questions covering material from the previous week. You have 15 minutes to complete the quiz. Quiz 1 is active in the 3rd

teaching week, Quiz 2 in the 5th week, Quiz 3 in the 7th week, Quiz 4 in the 9th week, Quiz 5 in the 11th week, and Quiz 6 in the 13th week. Each correct answer earns one point, meaning a total of 30 points can be achieved by completing all quizzes. These points can be added as a bonus to your first exam attempt as follows:

29-30 points from quizzes – 3 extra points on the written exam

27-28 points from quizzes – 2 extra points on the written exam

25-26 points from quizzes – 1 extra points on the written exam

Last update: Brennan Kearns Pavla, doc. MUDr., Ph.D. (12.02.2025)
Syllabus -

Lectures:

1) Foundations of epidemiology and evidence-based medicine

Intended learning outcomes: Define the role of epidemiology. Evaluate the credibility of the evidence of individual types of descriptive and analytical studies according to the hierarchy in medical research. Contrast and explain the terms internal validity, external validity, and precision.

2) Association and causality

Intended learning outcomes: Explain the principle of randomization. Interpret the results of “intention-to-treat” and “per protocol” analysis. Contrast the concepts of allocation concealment and blinding. Apply Bradford-Hill criteria to the results of an observational study.

3) Principles of epidemiology of infectious diseases

Intended learning outcomes: Explain the concepts of the epidemic cycle and the process of disease transmission in a population. Define key terms and describe concepts in infectious disease epidemiology (e.g., attack rate, epidemic, pandemic, SIR model, reproductive number). Explain infectious disease surveillance and provide specific examples. List basic epidemiological measures and provide concrete examples of their practical application.

4) Epidemiologist in a healthcare facility

Intended learning outcomes: Explain the role of hygienists and epidemiologists in a healthcare facility. Describe the differences in the epidemic cycle within a hospital setting (e.g., variations in susceptible individuals, differences in hospital microbial flora, modes of transmission). Define healthcare-associated infections and list the most common pathogens, as well as surveillance

methods and epidemiological measures. Outline the role of a physician and the structure of consultations in travel medicine, providing examples of the most common infections addressed in this field.

5) Introduction to social epidemiology and health inequalities

Intended learning outcomes: Define what are social determinants of health using examples and describe multiple mechanisms by which they influence individual and public health. Understand ways of measuring inequalities (absolute vs. relative) and differences between disparity, inequity, and inequality. Explain the concept of natural experiment and quasi-experiment and describe how they may

contribute to establishing causal links in social epidemiology. Debate how social determinants of health may influence quality of care and what clinicians can do to limit their role.

6) Emerging and re-emerging infectious diseases

Intended learning outcomes: Explain the terms emerging and re-emerging infections and provide specific examples. Define risk factors for the occurrence of emerging and re-emerging infections. Using an example, describe methods that can be used to prevent the occurrence and transmission of these infections.

7) What is hot in infectious disease epidemiology

Intended learning outcomes: Describe trends in the incidence of selected infections in the Czech Republic and globally. Assess trends in the incidence of infections for which long-term vaccination programs are in place in the Czech Republic and worldwide. Describe the characteristics of selected infections and outline possible preventive and control

measures.

Practical sessions:

1) Parameters of disease occurrence and death

Intended learning outcomes:

  • Calculate a suitable indicator of the occurrence of a disease (chance, prevalence, risk, incidence rate,

attack rate) and death (mortality, case fatality rate).

  • Reflect on the appropriateness of using cumulative incidence and incidence rate on the example of

specific diseases.

  • Hypothesize a mechanism in the change of incidence / prevalence / mortality / case fatality rate.

2) Association parameters

Intended learning outcomes:

  • Calculate an appropriate relative (risk ratio, incidence rate ratio, odds ratio) or absolute (risk

difference, incidence rate difference, attributable risk, population attributable risk) indicator for the

association between a risk/protective factor and a disease.

  • Interpret the resulting association indicator in terms of its value and statistical significance.

3) Observational analytical studies

Intended learning outcomes:

  • Recognize the type of study and assess the strength of its evidence within the hierarchy.
  • Characterize main advantages and disadvantages of analytical studies.
  • Propose an appropriate analytical study design for a specific research question.
  • Calculate and interpret an appropriate indicator of association (relative risk, odds ratio).

4) Bias

Intended learning outcomes:

  • Determine individual types of bias (confounding, selection bias, information bias) and their effect on

the outcome of the study.

  • Contrast between a confounding factor, a mediator, and an effect modifier.
  • Apply various methods of eliminating confounding factors.

5) Journal Club

Intended learning outcomes:

  • Evaluate the overall quality, validity and precision of an observational study.
  • Interpret study results, including graphical displays (tables, graphs).
  • Recognize bias, its type and the direction, in which it distorts the results.

6) Evidence-based medicine I

Intended learning outcomes:

  • Formulate research and clinical questions using the PICO system.
  • Assess the overall quality, validity and precision of a randomized controlled trial.
  • Interpret result of a randomized controlled trial in terms of clinical and statistical significance.
  • Decide whether it is possible to apply result of a randomized controlled trial to a specific patient.

7) Evidence-based medicine II

Intended learning outcomes:

  • Assign a level of evidence (AD) for a study.
  • Evaluate validity of a systematic review (specificity of the question, search and selection strategy of

studies, evaluation of the risk of bias of primary studies).

  • Interpret a Forrest plot (value, precision, heterogeneity).
  • Assess the risk of publication bias in a systematic review / meta-analysis.
Last update: Brennan Kearns Pavla, doc. MUDr., Ph.D. (12.02.2025)
 
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