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Epidemiology and Biostatistics

Epidemiology and Biostatistics

Rationale, description and objectives of the course

This course outline has been prepared primarily for the postgraduate students and fellows in the National Center for Diabetes, Endocrinology, and Genetics, Jordan. However, the course may be of benefit for the entire spectrum of people working in the field of health sciences including medicine, public health, nursing, and allied health sciences.

 


Although textbooks in epidemiology and in biostatistics are widely available, they are often highly specialized and therefore difficult to use by a wide range of health researchers and scientists. This course is intended to be simple and practical avoiding unnecessary scientific jargon and responding to the actual needs of students and researchers in the field of health sciences. Despite the increasing availability of computers and statistical software, most available books, if not all, still ignore these facts and make little use of the available technology. In this course, we will try to bridge this gap and explain how to use the computer to perform the needed statistical analysis. Practical training on two of the commonly used statistical packages, Epi Info and SPSS, should be considered an essential part of the course.

At the end of this course we expect that the student will have the basic knowledge and skills to:

  1. Formulate research question/questions.
  2. Propose an appropriate research design.
  3. Select appropriate data collection methods.
  4. Plan and perform the necessary statistical analysis.
  5. Present his data in tables, graphs, and charts as appropriate.
  6. Interpret his findings and draw valid conclusions.

In addition, a major goal for the course is to strengthen the ability of students to critically read the literature and identify possible pitfalls.

Methods of Instruction:

  1. lectures
  2. Computer sessions closely linked to the lectures.
  3. Practical exercises.

Reading Material:

In addition to the course material, we recommend the following textbook: Charles H. Hennekens, Julie E. Buring. Epidemiology in medicine, first edition, 1987, Little, Brown and Company, Boston, Toronto.

 

Course content

Introduction:

  • Definition of epidemiology
  • Types of epidemiology: descriptive versus analytic epidemiology
  • Scope of epidemiology and its uses
  • Meaning of statistical analysis

Measurement of morbidity:

  • Incidence and incidence density
  • Prevalence

 

Measurement of mortality:

  1. Crude death rate
  2. Specific mortality rates
  3. Proportionate mortality rate
  4. Case fatality rate

Study design: Clinical case series

  • Basic design
  • Analysis
  • Strengths and limitations
  • Example

 

Study design: cross sectional studies

  • Basic design
  • Sampling methods:
    • Techniques
    • Strengths and weaknesses
    • Sampling error
    • Sampling bias
    • Sample size
  • Analysis
  • Strengths and limitations
  • Example

 

Study design: Case control studies

  • Unmatched case control studies:
    • Basic design
    • Selection of cases .
    • Selection of controls
    • Analysis
    • Strengths and limitations
    • Sample size
    • Example
  • Matched case control studies:
    • Matching factors
    • Types of matching
    • Analysis
  • Strengths and limitations
  • Alternatives to matching
  • Example

 

Study design: Cohort studies

  • Concurrent prospective studies:
    • Basic design
    • Analysis
    • Strengths and limitations
    • Sample size
  • Example
  • Historical cohort studies:
    • Basic design
    • Strengths and limitations
    • Example
  • Nested case control studies and case cohort studies:
    • Design
    • Strengths and limitations

 

Study design: Clinical trials

  • Basic design
  • Essential differences from observational studies
  • Masking (blinding)
  • Randomization
  • Placebo control
  • Analysis
  • Strengths and limitations
  • Sample size

 

Data collection and presentation:

  • Types of data
  • Methods of data collection:
    • Questionnaires:
  • Face to face interviews
  • Mailed questionnaires
  • Telephone interviews
    • Clinical data:
  • Physical examination
  • Laboratory data
  • Radiological data and other interventions
  • Data presentation:
  • Tables
  • Barcharts
  • Histograms
  • Curves
  • Pie charts

Assessment of diagnostic tests

  • Validity
  • Reliability
  • Predictive value
  • Setting normal values

 

Survival analysis

  • Actuarial life table method
  • Kaplan Meier product limit
  • The Cox proportional hazard regression

 

Selected statistical techniques

  • Mean, standard deviation, and standard error
  • Confidence limits
  • The Mantel Haenzel technique for dealing with confounding
  • The t test: paired and unpaired
  • The F test
  • The chisquare test

 

Correlation and regression

  • Correlation:
    • The Pearson's coefficient
    • Assumptions
    • Interpretation
  • Regression:
    • Linear regression:
  • Technique
  • Interpretation
  • Presentation
    • Logistic regression
  • Technique
  • Interpretation
  • Presentation