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The curriculum outline of basic epidemiology

Tatal period: 180 Theory: 117 Practice: 63

Chapter Contents Total period Theory Practice study by


oneself
Chapter one What is epidemiology 6 3 0 3
Chapter two Measuring health and disease 24 6 3 15
Chapter three Types of study 72 15 12 45
Chapter four Basic statistics 18 3 0 15
Chapter five Causation in epidemiology 12 3 0 9
Chapter six Epidemiology and prevention 21 3 3 15
Chapter seven Communicable disease epidemiology 18 6 0 12
Chapter eight Clinical epidemiology 9 3 0 6
Total 180 42 18 120

Introduction to epidemiology
Epidemiology studies people, patients and populations, and their diseases: their incidence, causes
and consequences and possible control. It is a fundamental discipline for clinical medicine and
public health. It may, together with basic science and clinical research, provide tools to learn about
the aetiology and consequences of diseases, the possibilities for prevention and treatment and the
risk profiles of individuals and populations. Epidemiology plays an integral role in the application
of medical research to populations, interacting with almost every other specialism. Using
advanced - predominantly quantitative - methods such as statistical analyses, field research and
complex laboratory techniques, epidemiologists map various elements of a disease and the ways
they are related.
Students will acquire skills in the critical interpretation of the epidemiologic literature;
methodology of estimating measures of disease frequency and effect and common measures of
potential impact; evaluation of study design; analysis of bias, confounding and effect
modification; and options for control of extraneous factors.

Chapter 1 What is epidemiology 6


The teaching of Theory 3
(1) Master the definition of epidemiology and the characteristics of it.
(2) Know well the scope, principles, and uses of epidemiology.
(3) Understand how epidemiology has contributed to advances in medicine and public health.
Emphasis: the definition of epidemiology and the characteristics of it.
Difficulty: the definition of epidemiology and the principles of it.
The teaching of Practice 0
Study by oneself 3

Chapter 2 Measuring health and disease 24

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Ⅰ Disease frequency 15
The teaching of Theory 3
(1) Master the definition of health and disease.
(2) Master the definition, formula and the infecting factors of prevalence rate and incidence rate,
and the differences between them.
(3) Master the definition and formula of mortality rate and fatality rate, and the differences
between them.
(4) Know well the indexes of measuring disease frequency, such as incidence rate, attack rate,
prevalence rate, infection rate, secondary rate, disability rate, mortality rate, fatality rate, survival
rate, cumulative incidence(mortality) rate, etc.
(5) Know well standardized rates.
(6) Understand the definition of life expectancy, and the measures of it, such as PYLL, DALY.
(7) Understand the methods of comparing disease occurrence.
Emphasis: the definition of health and disease, the contents of prevalence rate, incidence rate,
mortality rate and fatality rate.
Difficulty: the infecting factors of prevalence rate and incidence rate, standardized rates, and how
to compare disease occurrence.
The teaching of Practice 3
Emphasis:
(1) Master the definition of health and disease.
(2) Master the definition, formula and the infecting factors of prevalence rate and incidene rate,
and the differences between them.
(3) Master the definition and formula of mortality rate and fatality rate, and the differences
between them.
(4) Know well the indexes of measuring disease frequency, such as incidence rate, attack rate,
prevalence rate, infection rate, secondary rate, disability rate, mortality rate, fatality rate, survival
rate, cumulative incidence(mortality) rate, etc.
(5) Know well standardized rates.
(6) Understand the definition of life expectancy, and the measures of it, such as PYLL, DALY.
(7) Understand the methods of comparing disease occurrence.
Contents of practice:
(1) Calculate the indexes of measuring disease frequency.
(2) Exercise the methods of standardized rates.
Homework:
(1) What are differences between prevalence rate and incidene rate?
(2) What are differences between mortality rate and fatality rate?
(3) Why should we use standardized rates when compare the frequency of disease in population?
Study by oneself 9

Ⅱ Disease distribution 9
The teaching of Theory 3
(1) Master the three forms of disease distribution: time, place, and person.
(2) Master the principles of migrant epidemiology.

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(3) Master the types epidemic intensity of disease.
(4) Know well the two methods of analyzing age distribution.
(5) Know well four time trends(secular trends, short-term trends, cyclic trends and seasonal
trends) used in epidemiology.
(6) Understand the effect of time, place, and person on the study and control of disease in
populations.
(7) Understand the importance of the facets and aspects of the elements of time, place, and person
on epidemiological study and analysis.
Emphasis: the three forms of disease distribution, the principles of migrant epidemiology.
Difficulty: the two methods of analyzing age distribution, cross sectional analysis and birth cohort
analysis.
The teaching of Practice 0
Emphasis:
(1) Master the three forms of disease distribution: time, place, and person.
(2) Master the principles of migrant epidemiology.
(3) Master the types epidemic intensity of disease.
(4) Know well the two methods of analyzing age distribution.
(5) Know well four time trends(secular trends, short-term trends, cyclic trends and seasonal
trends) used in epidemiology.
(6) Understand the effect of time, place, and person on the study and control of disease in
populations.
(7) Understand the importance of the facets and aspects of the elements of time, place, and person
on epidemiological study and analysis.
Contents of practice:
(1) Exercise the descriptive methods of diseases based on time, place, and person.
(2) Understand the distribution forms and characteristics of diseases in population.
Homework:
(1) What are the principles of migrant epidemiology?
(2) What are the two methods of analyzing age distribution? What are differences between them?
Study by oneself 6

Chapter3 Types of study 72

Ⅰ Descriptive epidemiology-Cross-sectional studies 12


The teaching of Theory 3
(1) Master the principle of the cross-sectional studies
(2) Master the design and analysis of the cross-sectional studies.
(3) Know well the characteristics and types of the cross-sectional studies.
(4) Know well the types of sampling schemes to use.
(5) Know well the advantages and the limitations.
(6) Know well the important types of bias and how to prevent the biases in cross-sectional studies
design.
Emphasis: The principle, the design, and analysis of the cross-sectional studies.
Difficulty: The important types of bias and how to prevent the biases in cross-sectional studies

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design.
The teaching of practice 3
Emphasis:
(1) Master the principle of the cross-sectional studies
(2) Master the design and analysis of the cross-sectional studies.
(3) Know well the characteristics and types of the cross-sectional studies.
(4) Know well the types of sampling schemes to use.
(5) Know well the advantages and the limitations.
(6) Know well the important types of bias and how to prevent the biases in cross-sectional studies
design.
Contents of practice:
(1) Practise the design and analysis of the cross-sectional studies.
(2) Exercise the different methods of sampling schemes.
Homework:
(1) What are the applications of cross-sectional studies?
(2) Outline the design of a cross-sectional study?
(3) What are the advantages and limitations of the cross-sectional studies?
Study by oneself 6

Ⅱ Descriptive epidemiology-Ecological studies 3


The teaching of Theory 0
(1) Know well the roles of the ecological studies in epidemiological process.
(2) Know well the characteristics of the ecological studies.
(3) Know well the ecological fallacy or bias.
(4) Understand the examples of ecological studies
Emphasis: The ecological fallacy or bias.
Difficulty: The interpretation of ecological studies.
The teaching of practice 0
Study by oneself 3

Ⅲ Analytical epidemiology-Case-control studies 15


The teaching of Theory 3
(1) Master the principle, the characteristics, and the applications of case-control studies.
(2) Master the selection of cases and controls.
(3) Master the calculation of the odds ratio(OR) and the implication of OR.
(4) Master the advantages and limitations of case-control studies.
(5) Know well the factors affecting the sample size.
(6) Know well the basic case-control study design.
(7) Know well the important types of bias and how to prevent the biases in case-control studies.
Emphasis: The principle, the characteristics, and the applications of case-control studies. The
selection of cases and controls. The calculation of the odds ratio(OR) and the implication of OR.
The advantages and limitations of case-control studies.
Difficulty: The selection of cases and controls.
The teaching of practice 3

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Emphasis:
(1) Master the principle, the characteristics, and the applications of case-control studies.
(2) Master the selection of cases and controls.
(3) Master the calculation of the odds ratio(OR) and the implication of OR.
(4) Master the advantages and limitations of case-control studies.
(5) Know well the factors affecting the sample size.
(6) Know well the basic case-control study design.
(7) Know well the important types of bias and how to prevent the biases in case-control studies.
Contents of practice:
(1) Evaluate the case-control design and analysis of the case-control data.
(2) Exercise the calculation of the odds ratio(OR) and the implication of OR.
Homework:
(1) What are the characteristics and applications of case-control studies?
(2) Outline the design of a case-control study?
(3) What are the advantages and disadvantages of case-control studies?
Study by oneself 9

Ⅳ Analytical epidemiology-Cohort studies 15


The teaching of Theory 3
(1) Master the definition of cohorts and exposure groups.
(2) Master the calculation and interpretation of relative risk, attributable risk and population
attributable risk.
(3) Master the advantages and limitations of cohort study design.
(4) Know well the important types of bias and how to address these in cohort study design.
(5) Understand the tracing of subjects in cohort studies.
(6) Understand the expense of cohort studies.
Emphasis: the definition of cohorts and exposure groups. the advantages and limitations of cohort
study design. the calculation and interpretation of relative risk , attributable risk and population
attributable risk.
Difficulty: The definition of cohorts and exposure groups.
The teaching of practice 3
Emphasis:
(1) Master the definition of cohorts and exposure groups.
(2) Master the advantages and limitations of cohort study design.
(3) Master the calculation and interpretation of relative risk, attributable risk and population
attributable risk.
(4) Know well the important types of bias and how to address these in cohort study design.
(5) Understand the tracing of subjects in cohort studies.
(6) Understand the expense of cohort studies.
Contents of practice:
(1) Evaluate the cohort study design and calculate the indexes, including RR, AR, PAR etc.
(2) Calculate and interpret the indices of relative risk, attributable risk and population attributable
risk.
Homework:

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(1) What are the characteristics and applications of cohort studies?
(2) Outline the design of a cohort study?
(3) What are the advantages and disadvantages of cohort studies?
Study by oneself 9

Ⅴ Experimental epidemiology 12
The teaching of Theory 3
(1) Master the principles and the characteristics of experimental epidemiology.
(2) Master the essential of a randomized controlled trial design.
(3) Know well the three forms of experimental epidemiology.
(4) Know well the limitations of experimental studies.
(5) Understand the indexes of analyzing in experimental epidemiology.
Emphasis: The principle and the characteristics of experimental epidemiology. The essential of a
randomized controlled trial design.
Difficulty: The essential of a randomized controlled trial design.
The teaching of practice 3
Emphasis:
(1) Master the principles and the characteristics of experimental epidemiology.
(2) Master the essential of a randomized controlled trial design.
(3) Know well the three forms of experimental epidemiology.
(4) Know well the limitations of experimental studies.
(5) Understand the indexes of analyzing in experimental epidemiology.
Contents of practice:
(1) Practise how to design a randomized controlled trial and how to analyze the RCT data.
(2) Calculate indexes of analyzing in experimental epidemiology.
Homework:
(1) What are the characteristics and principles of experimental epidemiology?
(2) Outline the design of experimental epidemiology?
(3) What are the advantages and disadvantages of experimental epidemiology?
Study by oneself 6

Ⅵ Potential errors in epidemiological studies 15


The teaching of Theory 3
(1) Master the important sources of error in epidemiology studies.
(2) Master the concepts of selection bias, measurement bias and confounding.
(3) Know well the difference between bias and confounding.
(4) Know well strategies for enhancing accuracy.
(5) Understand the examples of different bias.

Emphasis: the important sources of error in epidemiology studies and the concepts of selection
bias, measurement bias and confounding.
Difficulty: Criteria for a confounding factor.
The teaching of practice 0
Emphasis:

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(1) Master the important sources of error in epidemiological studies.
(2) Master the concepts of selection bias, measurement bias and confounding.
(3) Know well the difference between bias and confounding.
(4) Know well strategies for enhancing accuracy.
(5) Understand the examples of different bias.

Contents of practice:
(1) Discuss the biases of particular concern in case-control studies.
(2) Discuss the strategies for enhancing accuracy.
Homework:
(1) What is random error and how can it be reduced?
(2) What are the main types of systematic error in epidemiological studies and how can their
effects be reduced?
Study by oneself 12

Chapter4 Basic statistics 18


The teaching of Theory 3
(1) Master the measures of central tendency, measures of variability.
(2) Master the concept of population and sample, the standard error.
(3) Master the meaning of confidence intervals, and how to calculate confidence intervals.
(4) Master the meaning of typeⅠand typeⅡerrors.
(5) Know well the methods of hypothesis testing.
(6) Know well how to evaluate relationship between two variables, such as chi-squared test,
correlation, and regression.
(7) Understand differences between statistical, clinical and public health significance.
Emphasis: the measures of central tendency, measures of variability, concept of population and
sample, the standard error, the meaning of confidence intervals, the meaning of typeⅠand
typeⅡerrors.
Difficulty: the meaning of typeⅠand typeⅡerrors, differences between statistical, clinical and
public health significance.
The teaching of Practice 0
Emphasis:
(1) Master the measures of central tendency, measures of variability.
(2) Master the concept of population and sample, the standard error.
(3) Master the meaning of confidence intervals, and how to calculate confidence intervals.
(4) Master the meaning of typeⅠand typeⅡerrors.
(5) Know well the methods of hypothesis testing.
(6) Know well how to evaluate relationship between two variables, such as chi-squared test,
correlation, and regression.
(7) Understand differences between statistical, clinical and public health significance.
Contents of practice:
(1) Practice the measures of central tendency, measures of variability,
(2) Calculate confidence intervals.
(3) Do exercises about hypothesis testing.

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(4) Evaluate relationship between two variables.
Homework:
(1) Why do the mean and median have different values?
(2) What is confidence intervals?
(3) In a study to investigate the therapeutic effects of high and low doses of antidepressant
medication, patients were randomly assigned to a low-dosage or high-dosageregimen. They were
assessed initially and after 14 and 18 days using standardized rating scales. In comparing the two
dosage groups, should one-tailed or two-tailed tests be used? Give reasons.
Study by oneself 15

Chapter5 Causation in epidemiology 12


The teaching of Theory 3
(1) Master the concept of cause.
(2) Master the guidelines for causal inference, including temporal relationship, plausibility,
consistency, strength, dose-response relationship, reversibility, study design, jugging the evidence.
(3) Know well the steps in assessing the nature of the relationship between a possible cause and
outcome.
(4) Understand Koch’s rules for determining causation.
(5) Understand factors in causation and interaction.
Emphasis: the concept of cause, the guidelines for causal inference.
Difficulty: the guidelines for causal inference, the steps in assessing the nature of the relationship
between a possible cause and outcome.
The teaching of Practice 0
Emphasis:
(1) Master the concept of cause.
(2) Master the guidelines for causal inference, including temporal relationship, plausibility,
consistency, strength, dose-response relationship, reversibility, study design, jugging the evidence.
(3) Know well the steps in assessing the nature of the relationship between a possible cause and
outcome.
(4) Understand Koch’s rules for determining causation.
(5) Understand factors in causation and interaction.
Contents of practice:
(1) Do exercises about the steps of causation study.
(2) Consider the criteria for causality.
Homework:
(1) What is causal inference?
(2) Comment on the statement: " Epidemiology is the only scientific discipline essential to causal
inference."
(3) List the criteria commonly used to assess the causal nature of observed associations.
Study by oneself 9

Chapter6 Epidemiology and prevention 21

Ⅰ Prevention 6

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The teaching of Theory 3
(1) Master levels of prevention, including primordial prevention, primary prevention, secondary
prevention and tertiary prevention.
(2) Know well the aims of each level of prevention.
(3) Understand the scope of prevention.
Emphasis: four levels of prevention.
Difficulty: the aims of each level of prevention.
The teaching of Practice 0
Study by oneself 3

Ⅱ Screening 15
The teaching of Theory 3
(1) Master the concept of screening.
(2) Master how to evaluate a screening programme, including validity, reliability, predictive value,
yield, etc.
(3) Know well the types of screening.
(4) Know well associated screening tests.
(5) Know well the criteria for instituting a screening programme.
Emphasis: the concept of screening, how to evaluate a screening programme, including validity,
reliability, predictive value, yield, etc.
Difficulty: how to evaluate a screening programme, including validity, reliability, predictive
value, yield, etc.
The teaching of Practice 3
Emphasis:
(1) Master the concept of screening.
(2) Master how to evaluate a screening programme, including validity, reliability, predictive value,
yield, etc.
(3) Know well the types of screening.
(4) Know well associated screening tests.
(5) Know well the criteria for instituting a screening programme.
Contents of practice:
(1) Evaluate a screening programme, including validity, reliability, predictive value, yield, etc.
(2) Evaluate associated screening tests, understand the outcome of parallel test and serial test.
Homework:
(1) What characteristics of a disease would indicate its suitability for screening?
(2) What epidemiological study designs can be used to evaluate a screening programme?
Study by oneself 9

Chapter7 Communicable disease epidemiology 18


The teaching of Theory 6
(1) Master the roles of infectious agent, transmission, host, and environment.
(2) Master the control measures of an epidemic.
(3) Know well how to define the terms “outbreak,” and “epidemic.”
(4) Know well definition of an endemic disease.

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(5) Know well how to draw, interpret, and describe the value of an epidemic curve.
(6) Know well the main steps in the investigation of an outbreak.
(7) Understand the ways of surveillance.
Emphasis: The roles of infectious agent, transmission, host, and environment; he control
measures of an epidemic.
Difficulty: The control measures of an epidemic.
The teaching of practice 0
Emphasis:
(1) Master the roles of infectious agent, transmission, host, and environment.
(2) Master the control measures of an epidemic.
(3) Know well how to define the terms “outbreak,” and “epidemic.”
(4) Know well definition of an endemic disease.
(5) Know well how to draw, interpret, and describe the value of an epidemic curve.
(6) Know well the main steps in the investigation of an outbreak.
(7) Understand the ways of surveillance.
Contents of practice:
(1) Practise how to draw, interpret, and describe the value of an epidemic curve.
(2) Exercise how to investigate an outbreak.
Homework:
(1) If you were a district health officer, how you would you monitor the occurrence of measles and
detect an epidemic in your district?
(2) Describe the chain of infection for foodborne disease caused by salmonella?
Study by oneself 12

Chapter8 Clinical epidemiology 9


The teaching of Theory 3
(1) Master how to value of a diagnostic test.
(2) Know well the definitions of normality and abnormality, and how to distinguish between
normality and abnormality.
(3) Know well the methods for measuring efficacy and effectiveness.
(4) Understand the natural history and prognosis of disease.
(5) Understand prevention in clinical practice.
Emphasis: how to value of a diagnostic test.
Difficulty: how to distinguish between normality and abnormality.
The teaching of Practice 0
Emphasis:
(1) Master how to value of a diagnostic test.
(2) Know well the definitions of normality and abnormality, and how to distinguish between
normality and abnormality.
(3) Know well the methods for measuring efficacy and effectiveness.
(4) Understand the natural history and prognosis of disease.
(5) Understand prevention in clinical practice..
Contents of practice:
(1) Value of a diagnostic test.

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(2) Practise how to distinguish between normality and abnormality.
Homework:
(1) Why has the term “clinical epidemiology” been described as a contradiction in terms?
(2) What determines the positive predictive value of a screening test?
Study by oneself 6

Reference Books:
1. Howard Strasberg, Principles of Epidemiology, the Health Sciences Consortium.
2. Kenneth J. Rothman & Sander Greenland, Modern Epidemiology, Maple Press.
3. Last, J. M, A dictionary of epidemiology, Oxford University Press.
4. David S. moore, Statistics, W. H. Freeman and Company.
5. Thomas C. Timmregk, An Introduction to Epidemiology, Jones and Bartlett Publishers.

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