Medical Epidemiology
Upon completion of the theoretical and practical teaching activities, the student will be able to:
Evidence-Based Medicine (EBM)
Upon completion of the theoretical and practical teaching activities, the student will be able to:
Based on a pragmatic approach, this course aims to enable the student to integrate the key concepts and tools of medical epidemiology, pharmacoepidemiology and evidence-based medicine.
The aim is to make the student capable of a critical analysis of the scientific bases underlying his/her future practice as a student and health professional.
Medical Epidemiology
1. Introduction
1.a. Causality and chance
1.b. Statistical inference and hypothesis testing
2. Formulating a question of clinical epidemiology or pharmacoepidemiology
3. Measures of frequency, association, impact, and prediction
3.a. Frequency: Prevalence; Incidence; Rates (Birth, Fertility, Mortality, Case Fatality, etc.); Life Expectancy; Attack Rate; Basic Reproduction Rate
3.b. Association: Risk Ratio, Absolute Risk Difference; Odds Ratio; Standardized Mortality Ratio
3.c. Impact: Attributable Risk; Number Needed to Treat; Number Needed to Harm
3.d. Prediction: Positive/Negative Predictive Value of a Test; Strength of Evidence/Exclusion; Fagan Nomogram; ROC Curves; Net Reclassification Index
4. Bias and confounding factors
5. Study types, strengths and limitations, and assessment of internal and external validity:
5.a. Observational studies (cross-Sectional, case-control, cohort)
5.b. Quasi-experimental studies
5.c. Clinical studies: randomized, double-blind controlled trials (Phase I-II-III)
5.d. Post-marketing Drug Surveillance and Evaluation (Phase IV)
5.e. Diagnostic and prognostic Studies
6. Quality analysis of epidemiological studies:
6.a. Non-randomized intervention studies: ROBINS; SIGN Scales; Newcastle-Ottawa Scale
6.b. Diagnostic studies: QUADAS-2
6.c. Randomized clinical trials: Cochrane Risk of Bias Tool; RoB 2
Evidence-Based Medicine (EBM)
1. Components of EBM
2. Identification and extraction of relevant scientific data concerning a specific clinical question:
2.a. Bibliographic databases: MEDLINE, Embase, Cochrane Library, etc.
2.b. Other sources: INAHTA, CRD, GIN, EBMPracticenet, etc.
3. Systematic literature reviews
3.a. Methodology and interpretation of meta-analyses
3.b. Quality analysis of systematic literature reviews: AMSTAR-2
4. Assessment of the quality of evidence on a specific clinical question:
4.a. Heterogeneity of results
4.b. Imprecision of results
4.c. Indirectness of evidence
4.d. Publication bias and other biases
5. Development of good clinical practice guidelines:
5.a. Clinical Guidelines Quality Assessment: AGREE
5.b. Recommendation development: GRADE
6.Shared decision making in clinical practice
The practical work allows the student to concretely grasp the relevance of the main concepts and tools covered during the course. Five 2-hour sessions are dedicated to medical epidemiology, and an additional 5 hours to EBM. The 7 sessions are essentially focused on the critical reading of recent scientific articles and related questions illustrating the epidemiological and EBM approach. Participation in the practical work is strongly recommended.
This course is based on a resolutely pragmatic approach, i.e. it is based on the resolution, step by step, session after session, of clinical questions (for example: "What is the efficacy and safety of the monoclonal antibody nirsevimab in the prevention of respiratory syncytial virus infections in infants?"; "What is the place of the S-100 β protein assay in the assessment of mild traumatic brain injuries?"). The student will be invited to prepare in advance the theory of the session based on the course summaries. At the beginning of each session, time will be allocated to answering questions relating to the theory. The rest of the session will be dedicated to solving, together, concrete exercises. Participation in the practical sessions is strongly recommended.
The assessment for each module (Medical Epidemiology, EBM) is based on a written exam with multiple-choice questions. These questions are primarily practical exercises related to recent scientific advances. Some questions will be based on summaries of scientific articles, some of which may be in English.
Please note that students must successfully complete both modules (minimum 10/20) to successfully complete the course. If students fail either module, the grade for the module passed will be carried over to the next exam session.
The presentations and discussions during the sessions, as well as the exercises completed during the practical exercises, constitute the course framework. The PPT presentations cover most of the theoretical material, but require supplementation during exercises and discussions during lectures and practical sessions.
These books can be useful as study aids (no purchase necessary):
| Training | Study programme | Block | Credits | Mandatory |
|---|---|---|---|---|
| Bachelor in Medicine | Standard | 0 | 3 | |
| Bachelor in Medicine | Standard | 2 | 3 |