Prof Elias Mossialos COW.4.08

This course is available on the MSc in Global Health. This course is available with permission as an outside option to students on other programmes where regulations permit.

An optional course for students taking MSc Global Health and available to other students taking relevant MSc programmes, particularly Health, Population and Society and Health and Population Development

The course provides students with an understanding of key epidemiological concepts, including: (a) tools for descriptive epidemiology (incidence, prevalence and survival); (b) measures of association (relative and absolute measures); (c) effect modification, interaction and mediation; and (d) confounding, information bias and selection bias. The course introduces the concepts of population health and the Global Burden of Disease, including estimation of the Population Attributable Fraction (PAF) and the Population Impact Fraction (PIF). It also introduces students to the principals of causal inference and mediation in epidemiology, based on the counterfactual approach and causal diagrams (Directed Acyclical Graphs). The course introduces students to key fundamentals of epidemiologic data analysis, including regression modelling, bias analysis and stratified analysis.

Teaching is structured in the form of lectures and seminars. Lectures introduce students to key epidemiological concepts and methods. This is complemented by seminars whereby published papers in epidemiology are discussed. Students are expected to read in advance on a specific application of the concepts and methods discussed during the lecture. An article will be assigned to each student in advance of each class, and students will be expected to prepare a short critical review of the article and lead the discussion in class based on an accompanying set of questions on the design and validity of the studies discussed. Students will first address and discuss the questions for each article in small groups. This will be followed by a plenary session whereby articles and related questions are discussed in the whole group.

Summative assessment is based on an examination to assess student’s understanding of epidemiological concepts and their ability to interpret epidemiological data. Summative assessment includes also a research proposal in which students are expected to apply the basic principles of epidemiology in the context of a well-defined research question. By the end of the course, students will deliver a 3,000-word research project paper.

10 hours of lectures and 10 hours of seminars in the LT. 3 hours of help sessions in the ST.

Ten one-hour lectures and five two-hour seminars, plus a three-hour revision seminar in the ST.   

Students will be expected to produce 1 project in the LT.

One non-assessed project paper (2,000 words) in week 5.

Students are expected to deliver a first research plan of their proposed project. The proposed plan should address a specific epidemiological question of relevance to Global Health. The research project will follow a structure: First, it will identify an epidemiological research question to be addressed, including a justification of the relevance of this question to global health. Second, students will shortly summarize key literature, and identify gaps in knowledge. Students will then propose a concrete epidemiological study design to address the research question. Finally, they will outline an approach to address the proposed question, including the epidemiological methods they will use to address that question. They will discuss the threads to internal validity and causal inference in their approach. Students will receive feedback on this paper, which will serve as basis for the development of the final proposed project paper.

Rothman KJ, Greenland S, Lash TL. Modern epidemiology. 3rd, thoroughly rev. and updated. Ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.

Hernan M, Robins J. Causal Inference. London: Chapman & Hall / CRC; 2014.

Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. Dec 15 2012;380(9859):2224-2260.

Sims M, Maxwell R, Bauld L, Gilmore A. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. British Medical Journal.340(jun08 1):c2161.

VanderWeele, T. and S. Vansteelandt (2009). "Conceptual issues concerning mediation, interventions and composition." Statistics and Its Interface 2: 457-468.

Cole SR, Hernán MA. Fallibility in estimating direct effects. International Journal of Epidemiology. 2002;31(1):163-165.

Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol. Jan 2003;2(1):43-53.

Murray CJ, Richards MA, Newton JN, et al. UK health performance: findings of the Global Burden of Disease Study 2010. Lancet. Mar 23 2013;381(9871):997-1020.

Exam (75%, duration: 2 hours) in the main exam period.
Project (25%, 3000 words) in the LT.

An assessed research project paper of 3,000 words (25%) to be submitted at the end of the LT and a two-hour written examination in the ST (75%).