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Course, academic year 2023/2024
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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 2023 to 2023
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, Czech
Teaching methods: full-time
Teaching methods: full-time
Level:  
Additional information: https://dl1.cuni.cz/course/view.php?id=15858
Guarantor: doc. MUDr. Pavla Brennan Kearns, Ph.D.
Co-requisite : DA1105038
Pre-requisite : DA1103002
Annotation -
Last update: doc. MUDr. Pavla Brennan Kearns, Ph.D. (16.02.2024)
The course is intended for students of the 3rd year of General Medicine, takes place in the summer semester and consists of six lectures and seven practical sessions. Lectures and practical sessions have specific intended learning outcomes (see the syllabus on the following pages).
Course completion requirements -
Last update: doc. MUDr. Pavla Brennan Kearns, Ph.D. (16.02.2024)

Participation in practical sessions: It is possible to miss one practical session for a serious reason, please let your teacher know.

● Successful completion of the online course "Vaccination - from Theory to Practice and Beyond” by 24.5.2024. The course is available on moodle: https://dl1.cuni.cz/course/view.php?id=4434. To successfully complete the course, you must achieve

at least 15 points in the self-test. You have 3 attempts.
Literature -
Last update: doc. MUDr. Pavla Brennan Kearns, Ph.D. (16.02.2024)

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

Presentations from lectures and practical sessions and other study materials are available on moodle at this

link: https://dl1.cuni.cz/course/view.php?id=15858
Requirements to the exam -
Last update: doc. MUDr. Pavla Brennan Kearns, Ph.D. (16.02.2024)

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.
Syllabus -
Last update: doc. MUDr. Pavla Brennan Kearns, Ph.D. (16.02.2024)

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.
  • Apply Bradford-Hill criteria to the results of an observational study.

3) Principles of epidemiology of infectious diseases

Intended learning outcomes:

  • Define and characterize basic concepts (epidemic, pandemic, epidemiological triangle, surveillance,

herd immunity, incubation period, latent period, infectious period, basic reproductive number,

effective reproductive number).

  • Differentiate between direct and indirect type of transmission and list relevant examples.
  • Explain the SIR (susceptible-infectious-removed) framework.
  • Calculate the potential necessary vaccine coverage for a given disease based on vaccine efficacy and

basic reproductive number.

4) Epidemiology of non-communicable diseases

Intended learning outcomes:

  • Describe trends in the occurrence of non-communicable diseases (cardiovascular, mental,

neurological, oncological diseases and diabetes mellitus).

  • List and explain the role of risk factors in the development of non-communicable diseases.
  • Propose effective measures to promote prevention of non-communicable diseases.

5) An 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 biological mechanisms for the emergence and re-emergence of infectious diseases.
  • Assess the risk of emerging and re-emerging infections, interpret trends in their occurrence and

identify risk factors for their occurrence and spread.

  • Specify social causes for the emergence and re-emergence of infectious diseases.

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.
 
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