Epidemiologi

Session 1 Overview and History of Epidemiology in Term of Public Health Policy

Lecturer : Riris Andono Ahmad, dr, MPH, PhD

Learning Objectives

By the end of this session, students will be able to :

  • Define and discuss the goal of public health (policy, management and finance as a tools for public health practice)
  • Define epidemiology and explain its objectives
  • Discuss the key components of epidemiology
  • Discuss the history of epidemiology and important modern studies
  • Discuss the current activities and challenges of modern epidemiology
  • Describe the epidemiological framework for the delivery of health care services

Reading

  1. Aschengrau & Seage’s Essentials of Epidemiology in Public Health, Third Edition, Jones and Bartlett Publishers, 2014. Chapter 1
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 1
  3. Denise M. Oleske, Epidemiology and the Delivery of Health Care Services, Methods and Applications, Springer-Verlag US, 2010. Chapter 1

Assignment : None


Session Application of Epidemiology in Public Health Practice 

Lecturer : Riris Andono Ahmad, dr, MPH, PhD

Learning Objectives

By the end of this session, students will be able to :

  • Define and provide examples of application of epidemiology in assessing health status of population (surveillance) and delivery of health services (surveillance in health care services)
  • Define application of epidemiology to identify disease etiology (outbreak investigation)
  • Define application of epidemiology in disease control and prevention activities (screening and disease prevention in health care services)
  • Define application of epidemiology and the impact to public health policy

Reading

  1. Friis RH, Sellers T. Epidemiology for Public Health Practice. Jones and Bartlett Publishers 5th Ed; Chapter 2
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 1
  3. Carr S, Unwin Nigel, Mulloli TP, 2nd, An Introduction to Public Health and Epidemiology, McGrawHill, 2007; Chapter 9: Health need analysis

Assignment : None


Session Measuring and Comparing Disease Frequency for Public Health Policy

Lecturer : Prof. dr. Hari Kusnanto, DrPH

Learning Objectives

By the end of this session, students will be able to :

  • Define and provide examples of a population
  • Distinguish between fixed and dynamic population
  • Discuss case definition and its role in comparing disease frequency
  • Discuss key aspects of measuring disease occurrence
  • Discuss burden of disease (morbidity (cumulative incidence, incidence rate and prevalence), mortality, DALY measurement and mathematical relationship between measures of disease frequency) in context of priority setting, planning, program evaluation
  • Describe the concept and  purpose of standardization

Reading

  1. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 2
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 3
  3. Denise M. Oleske, Epidemiology and the Delivery of Health Care Services, Methods and Applications, Springer-Verlag US, 2010

Assignment : homework will be delivered in the website and should be submitted to Gamel before tutorial session


Session Natural History of Disease and Level of Prevention for Public Health Policy

Lecturer : Riris Andono Ahmad, dr, MPH, PhD

Learning Objectives

By the end of this session, students will be able to :

  • Describe the natural history of disease as a way to explain disease process
  • Discuss how natural history influence disease control strategy (example: malaria, TB, HIV strategy in global health policy)
  • Demonstrate how different disease’s natural history shape different disease control strategy

Reading

  1. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 2 and Chapter 6

Assignment : None


Session 5 Dynamic of Disease Transmission and Reproductive Rate

Lecturer : Riris Andono Ahmad, dr, MPH, PhD

Learning Objectives

By the end of this session, students will be able to :

  • Define and explain the epidemiology triad as a basis of understanding disease occurrence
  • Define and explain herd immunity, population heterogeneity and reproductive rate
  • Define and explain the role of different mode of transmission influence transmission dynamic
  • Discuss application of herd immunity, population heterogeneity, reproductive rate and mode of transmission in disease control (example: strategy and policy on immunization program)

Reading

  1. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 2

Assignment : None


Session Epidemiology Approach to Association and Causation for Public Health Policy

Lecturer : Prof. dr. M. Hakimi, SpOG(K), PhD

Learning Objectives

By the end of this session, students will be able to :

  • Define and state the importance characteristic of a cause
  • Describe the historical development of disease causation theories, including the germ theory and the web causation
  • Describe key elements of the sufficient-component cause model
  • Discuss the causal guidelines proposed by Hill, including the limitation
  • Describe and distinguish between a risk factor and cause
  • Demonstrate measures of association (absolute risk, relative risk, risk difference and attributable risk fraction)

Reading

  1. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 15: The Epidemiologic Approach to Causation
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 14: From Association to Causation: Deriving Inference from Epidemiologic Studies

Assignment : None


Session 7, 8 and 9 – Epidemiology Study Design : Introduction, Observational and Experimental Design in Healthcare Setting

Lecturer : Prof. dr. Hari Kusnanto, DrPH

Learning Objectives

By the end of this session, students will be able to :

  • Distinguish between experimental and observational studies
  • Describe characteristic of cohort, case-control, cross sectional and ecological studies
  • Describe the key features of conducting observational studies: cohort, case-control and cross sectional
  • Discuss the strength and limitation across the observational design
  • Identify design of particular study
  • Describe characteristic of experimental studies regarding subject selection, data collection and analysis
  • Distinguish between the type of experimental studies, including individual versus community trial, preventive versus therapeutic trials, parallel versus crossover trial, simple versus factorial trials
  • Describe key features of conducting experimental studies

Reading

  1. David G. Kleinbaum Kevin M. Sullivan Nancy D. Barker, A Pocket Guide to Epidemiology. Chapter 3: How to set things up? Study design
  2. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 6: Overview of Epidemiologic Study Design
  3. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 7: Experimental Design
  4. Gordis L, Epidemology, 3rd Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 7 & 8: Assesing the Efficacy of Preventive and Randomized Trials and Randomized Trials: Some Furthur Issues
  5. Denise M. Oleske, Epidemiology and the Delivery of Health Care Services, Methods and Applications, Springer-Verlag US, 2010. Chapter 4

Assignment :  None


Session 10 Bias and Confounding

Lecturer : Prof. dr. Hari Kusnanto, DrPH

Learning Objectives

By the end of this session, students will be able to :

  • Define and illustrate bias, confounding
  • Distinguish bias and confounding
  • Identify bias and way to deal with it
  • Describe methods for assessing the presence of confounding
  • Describe methods for controlling confounding
  • Describe how the bias and confounding can impact the public health policy

Reading

  1. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 10: Bias and Chapter 11: Confounding
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 15: More on Causal Inference: Bias, Confounding and Interaction.

Assignment : None


Session 11 Effect Measures Modification

Lecturer : Prof. dr. Hari Kusnanto, DrPH

Learning Objectives

By the end of this session, students will be able to :

  • Define and describe examples of effect measure modification (synergism and antagonism)
  • Distinguish between confounding and effect measures modification
  • Describe the methods for evaluating effect measures modification
  • State relationship between the measures association and effect measures modification

Reading

  1. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 13: Effect Measures Modification
  2. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 15: More on Causal Inference: Bias, Confounding and Interaction

Assignment : None


Session 12 Diagnostic and Screening for Public Health Policy

Lecturer : dr. M. Bayu Sasongko, Sp.M, M.Epid, PhD

Learning Objectives

By the end of this session, students will be able to :

  • Discuss role of diagnostic and screening in different level of prevention
  • List key characteristics of disease appropriate for diagnostic and screening
  • Describe important feature of a diagnostic and screening
  • Define sensitivity, specificity, negative predictive value and positive predictive value (example: deciding the best screening tool for procurement policy)
  • Discuss the outcome measures and study design for evaluating of effectiveness diagnostic and screening program
  • Describe the impact of screening on cancer mortality

Reading

  1. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 18: The Epidemiologic Approach to the Evaluation of Screening Program
  2. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 16: Screening in Public Health

Assignment : None


Session 13 Reading Epidemiological Papers (Critical Appraisal)

Lecturer : Prof. dr. M. Hakimi, SpOG(K), PhD

Learning Objectives

By the end of this session, students will be able to :

  • Appraise epidemiology related reports using STROBE and CONSORT

Reading

  1. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. PLoS Med 4(10): e296. doi:10.1371/journal.pmed.0040296
  2. Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 Statement: Updated Guidelines for Reporting Parallel Group Randomised Trials. PLoS Med 7(3): e1000251. doi:10.1371/journal.pmed.1000251

Assignment : None


Session 14 Ethical and Professionals Issues in Epidemiology

Lecturer : Prof. dr. M. Hakimi, SpOG(K), PhD

Learning Objectives

By the end of this session, students will be able to :

  • Discuss issues that relate to the actual conduct of epidemiology studies
  • Discuss issues that relate to broader societal issues beyond the epidemiology studies it self
  • Describe historical events that have shaped current guideline and regulation for ethical conduct of epidemiologic research involving human subjects

Reading

  1. Gordis L, Epidemology, 3rd Ed. Philadelphia, PA. Elsevier Saunders: 2004. Update edition is preferable. Chapter 20: Ethical and Professional Issues in Epidemiology
  2. Aschengrau A, Seage GR. Essentials of Epidemiology in Public Health 2nd Edition. Sudbury, Massachusetts. Jones and Bartlett Publishers; Chapter 17: Ethics in Research Involving Human Participant
  3. Council for International Organization of Medical Science. 2002. International Ethical Guidelines for Biomedical Research Involving Human Subjects. Available from : http://www.cioms.ch/publications/ layout_guide2002.pdf

Assignment : None