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Graduate Summer Session in Epidemiology

1-Week Courses

EPID 703 Topics in Infectious Diseases
(1 credit hour) Philip S. Brachman and Jan E. Patterson
This course will focus on current topics and new concepts in infectious disease epidemiology.  We will discuss factors and issues of diseases most currently prevalent in the world, their status, epidemiology, and methods of control and prevention and barriers to their successful applications.  The diseases to be discussed include but are not limited to:  diarrheal diseases, HIV/AIDS, tuberculosis, vaccine preventable diseases, avian influenza, emerging infections, West Nile virus, hemorrhagic fevers, zoonoses, hospital infections including multiple resistant staphylococcus and antibiotic resistance of other organisms.  The class format will include lectures, discussions, and critical review of assigned reading material.  Prerequisite:  Basic knowledge of epidemiology and microbiology.

EPID 705 Epidemiology and Health Policy
(1 credit hour) Hal Morgenstern
This course deals with selected applications of epidemiologic methods and findings to health-services research, population health planning and evaluation, risk assessment and health policy. The major objective is to provide a framework for integrating causal inference with decision making, thereby bridging the gap between science and practice. Emphasis is given to important conceptual and methodologic issues that confront public-health and clinical researchers, policy analysts, health planners, attorneys, and decision makers. Prerequisites: Introductory level courses in epidemiology and biostatistics.

EPID 710 Intermediate Epidemiologic Methods
(1 credit hour) Hal Morgenstern
This course expands on the concepts, principles and methods covered in Epid 709 and focuses on the investigation of disease etiology and other causal relations in public health and medicine.  Class topics include types of research strategies (experiments, quasi experiments, observational studies), concepts of causation (counterfactuals, sufficient-cause model, effect measures), principles of analysis in observational studies (frequency, association, impact measures; confidence intervals, p values), error in effect estimation (precision; selection bias, misclassification bias, confounding), and methods for dealing with covariates (stratified analysis, matching and matched analysis; effect modification).  Prerequisites:  Basic courses in epidemiology (e.g., Epid 709) and linear regression (e.g., Epid 743, which can be taken concurrently).

EPID 711 Epidemiology of Injury and Violence
(1 credit hour) Not offered in 2009

EPID 716 Clinical Epidemiology and Evidence-Based Decision Making
(1 credit hour) Mitchell A.H. Levine
 With the increasing demand for an evidence-based approach in the delivery of health care services and the economic pressures for a more rational and efficient use of limited health care resources, practitioners and administrators in the health care field need to develop clinical measurement and evaluative skills in order to conduct their work optimally. Clinical Epidemiology and Evidence-Based Decision Making identifies and teaches these skills. The course will cover the basic concepts of clinical epidemiology in the context of appraising the recent medical literature pertaining to issues of causation, diagnosis, management, and economic evaluation. The format will include problem-based learning. Course materials will be provided in advance of the sessions, and should be reviewed before the course begins in order to obtain the maximum benefit from enrollment in the course. All health professionals (clinicians and administrators) who rely on the medical literature to guide their activities are invited to attend the course. No prerequisite.

EPID 717 Design and Conduct of Clinical Trials 
(1 credit hour) Stan Shapiro
 The theoretical and practical challenges to be considered in designing and conducting a randomized clinical trial will be presented. Topics to be discussed include the specification of a primary objective, adherence to accepted ethical guidelines, the role of randomization and the means of its implementation, the choice of design strategy and design strengthening features, considerations involved in sample size determination and patient recruitment and standards for reporting clinical trials. Detailed analytic issues will be considered in the complementary one-week course that follows. Prerequisite: Introductory level course in epidemiology.

EPID 718 Analysis of Clinical Trials
(1 credit hour) Stephen J. Farish
 Methods of analysis appropriate to various designs, such as cross-over designs, nested designs, factorial designs, and designs with repeated measures will be presented. The use of GLM techniques for analysis will also be illustrated. Topics will include estimation of survival functions, survival comparison between groups of subjects, identification of important covariates, adjustment for covariates, testing for interaction, and understanding the difference between confounding and interaction. Specific tools to be discussed include the Kaplan-Meier estimators, the log-rank (Mantel-Haenszel) statistics, and the Cox proportional hazards model. Instruction will focus on empirical use of methodologies rather than formal algebraic knowledge. Practical applications of manual and software-based analysis will illustrate specific procedures and interpretation of results. Students receive a disk with the data and analysis programs for all examples in the course. Students are advised to bring a scientific calculator. Prerequisite: Introductory level course in biostatistics.

EPID 719 Genetics in Epidemiology
(1 credit hour) Not offered in 2009

EPID 720 Planning, Delivery, and Evaluation of Community Based Interventions for Behavioral and Social Change
(1 credit hour) Kathleen R. Miner
Community-based interventions comprise the vast majority of the public health efforts to reduce the morbidity and mortality in populations.   This survey course covers the life stage of these interventions from their inception, implementation, evaluation, and sustainability.  This course has as its core the theoretical concepts from the social and behavioral sciences, health education, and health communication and their application to population health. With these concepts as the base, the course will integrate the development and use of logic models, the basic principles of prevention effectiveness, and the utility of quantitative and qualitative evaluation methods in measuring the effects of program activities. Using the lessons from the literature and current events, students will have the opportunity to discuss and critique the information learned in class as they apply to specific community-based interventions. This course can serve as a foundation for EPID 783 Methods of Community-Based Participatory Research for Health.  No prerequisite.

EPID 722 Pharmacoepidemiology and Risk Management
(1 credit hour) Judith K. Jones
This course will cover the application of epidemiologic methods to study the use and effects of pharmaceuticals, biologics and other medical products.  In particular, it will cover methods of detecting adverse and beneficial drug effects, including spontaneous reporting systems, ad hoc epidemiologic studies, and the growing use of automated databases.  Emphasis will be placed on the need to quantify the frequency of drug effects and risk factors for these drug effects, rather than simply documenting causation.  We will also address the renewed interest in adverse events as a major public health problem and how it will impact the health care system through the more recent implementation of pharmaceutical risk management plans or Risk Evaluation and Mitigation Strategies, or REMS.  Other topics to be covered include measuring the frequency of drug use, the quality of prescribing, and new developments in pharmacoepidemiology methods.  Teaching methods will include lectures and workshops, as well as  development of a study protocol.  Prerequisite:  Introductory-level course in epidemiology.

EPID 723 Environmental and Occupational Epidemiology
(1 credit hour) Leslie Stayner
This course will cover the fundamental concepts and methods used in Occupational and Environmental Epidemiology. Designs and methods used for the analyses of occupational cohort, nested and population based case-control, cross-sectional and longitudinal studies will be reviewed.   Methodological issues such as exposure misclassification and common sources of bias such as the healthy worker survivor effect will be discussed.   Qualitative and quantitative methods (e.g. meta-analysis) for the review of occupational and environmental epidemiologic studies, and the use of risk assessment methods will also be reviewed. Case studies on a variety of environmental and occupational hazards will be used to illustrate these issues. Prerequisites: Introductory Epidemiology.  

EPID 742 Introduction to Logistic and Poisson Models
(1 credit hour) Alan E. Hubbard
The vast majority of epidemiologic data involve either binary or count data. Logistic (binary data) and Poisson (count data) regression analyses are two important analytic approaches that frequently provide valuable insights into collected data. Both techniques will be presented in a practical and an applied fashion. The discussed material begins with the simplest case with the goal of understanding the fundamental properties of each model. Once these properties are established, more advanced topics such as collinearity, variable selection, non-linear explanatory variables and goodness-of-fit will be described and applied to several multivariable epidemiologic data sets. These two analytic approaches not only provide simple and effective ways to explore complex relationships but illustrate the general process of using a linear model to draw conclusions from the analysis of epidemiologic data. Prerequisites: Introductory level courses in epidemiology and biostatistics.

EPID 743 Applied Linear Regression
(1 credit hour) Brenda Gillespie
 This course discusses the applications of linear regression models to medical research and public health data. We will focus on the two major goals of linear models: (1) explanation, the estimation of associations using linear regression models, and (2) prediction, the use of linear regression models to predict subject outcomes, as with diagnostic tests and nomograms. Specific topics include graphical exploratory data analysis, assumptions behind simple and multivariate linear models, the use of categorical explanatory variables, identifying when transformations of explanatory and/or outcome variables are needed, assessing the presence of predictor/outcome associations through hypothesis testing, identifying when confounding and effect modification are present, assessing model fit, and model selection techniques. Prerequisite: Targeted audience members include researchers and health professionals with some basic knowledge of statistics and epidemiology who desire some in-depth exposure to the concepts and principles of linear regression models. This course will include a computer lab where students will gain experience with regression analysis using statisical software.

EPID 747 Successful Scientific Writing
(1 credit hour) Paul Z. Siegel
This course takes an active, participatory approach to help public health and health care professionals learn how to communicate the findings of their research and investigations more effectively and expedite publication of their manuscripts. Working in small groups, students spend much of their class time critiquing actual published and unpublished manuscripts, including their own, and solving a wide range of exercises that exemplify the real-world challenges that authors face. Free-form in-class discussions make it possible for class members to learn from one another's experiences. Major components of the course include the following: basic sections of a scientific article: the purpose, elements and organization of each section; principles of style for writing in public health and epidemiology; systematic approaches to the process of writing and publishing an article in a peer-review journal; and effective strategies for dealing with requests of journal editors and reviewers. No prerequisite.

**Important Notice**

CANCER EPIDEMIOLOGY COURSES - EPID 750 and EPID 751
EPID 750 will be offered during Week 1, July 13-17 at the Graduate Summer Session Campus in Ann Arbor, Michigan. EPID 750 (July 20-24) and EPID 751 (July 27-31) will be offered at an international location (Egypt or Cyprus). International details will be provided upon request to Dr. Amr Soliman at asoliman@umich.edu, (734) 764-5469 or Mohsina Qadr at mqadr@umich.edu, (734) 763-1340. Applications for international courses must be submitted as per the instructions on the application to Jody Gray.

EPID 750 Cancer Epidemiology I: Illustrating the Etiologic Evidence for Cancer Prevention
(1 credit hours) Amr Soliman
This course will review advances in cancer epidemiology that illustrate causal mechanisms and the basis for cancer prevention. The syllabus will include lectures on the global burden of cancer; environmental and lifestyle factors; and the possible role of hormones in human carcinogenesis.  Topics related to cancer pathways and biomarkers of exposures and susceptibility will be also discussed.  Prerequisite: Introductory-level course in epidemiology. 

EPID 751  Cancer Epidemiology II:  Applications for Research and Cancer Prevention
(1 credit hour)  Amr Soliman
This course will stimulate cancer epidemiology research by improving knowledge and skills of applied cancer epidemiology among researchers and clinicians.  Students will discuss opportunities for improving the quality of data from cancer registries; collection, processing, and use of biologic specimens in cancer epidemiology research; and examples of epidemiologic and prevention research using cancer registry data.  Students will also be asked to apply the knowledge gained to a problem related to current and/or future research projects. The course format includes lectures complemented by seminars devoted to exercises and discussion of current examples of epidemiologic studies. Prerequisite:  Basic course in cancer epidemiology (e.g. Epid 750 or 621). 

EPID 755 Emerging and Re-Emerging Infections
(1 credit hour) Philip Brachman
Emerging and re-emerging infectious diseases continue to represent a major worldwide public health problem.  Naturally occurring and bioterrorist introduced agents can result in disease and death. Societal, technological and environmental factors have a significant effect on infectious diseases facilitating the emergence of new diseases and the re-emergence of old ones.  Recent occurrences that underscore the public health concerns include viral infections, such as HIV, SARS, NIPAH virus, dengue, SLE, West Nile virus and bacterial infections, such as Helicobacter pylori, E. coli 0157: H7, and antibiotic resistant organisms including tubercle bacilli, staphylococci, streptococci, and gram negative rods.  The role of infectious agents as causative factors of malignancies will be reviewed.  We will discuss the general factors that have influenced the occurrence of these diseases and the programs promoted by the Centers for Disease Control and Prevention, the World Health Organization, and other professional organizations, to combat these infectious diseases.  The major emerging and re-emerging infections will be discussed emphasizing their identification, epidemiology, recommended control and prevention measures, and their current unresolved problems.  We will also discuss the threat of bioterrorism in reintroducing an infectious agent.  The format will include lectures, discussions, and a critical review of assigned reading materials.  Prerequisite: Basic knowledge of epidemiology and microbiology.

EPID 757 Introduction to Systematic Reviews and Meta-Analysis
(1 credit hour) Not offered in 2009

EPID 759 Introduction to SAS
(1 credit hour) Kathleen B. Welch
This course will present SAS at an introductory level for public health professionals. The overall objective of the course is to enable students to develop the ability to use SAS for basic statistical analyses, and to prepare for more advanced uses of SAS. Students in the course will learn how to navigate SAS in the Windows environment, create and submit command files, print output, do simple troubleshooting, create and manipulate SAS data sets, recode and transform variables, and do simple statistical analyses using SAS. Data management tasks, such as merging data sets to add variables, and adding cases to a data set will also be covered, as will information on how to import/export data between SAS and other programs, such as Excel, SPSS, and Epi Info. SAS/INSIGHT will be introduced for examining the distributions of variables and checking statistical assumption, and using interactive graphics. The class will be taught as a lab, with lectures and demonstrations. Prerequisites: Introductory level courses in epidemiology and biostatistics; experience in the use of Windows-based microcomputers.

EPID 761 Social Epidemiology
(1 credit hour) Not offered in 2009

EPID 766 Analysis of Longitudinal Data from Epidemiologic Studies
(1 credit hour) Daowen Zhang
 It has been popular in epidemiology to conduct longitudinal studies where study participants are followed over time and repeated measurements of interest are obtained. Compared to traditional cross-sectional or case-control studies, longitudinal studies can be more efficient to detect difference of interest, offer more evidence for possible causal inference, etc. However, longitudinal data are likely to be correlated, which presents substantial challenge in analyzing such data. This course will address 1) epidemiologic methods for the design and interpretation of longitudinal studies involving repeated measures and 2) statistical methods appropriate for longitudinal data including generalized estimating equations (GEEs), linear mixed models and generalized linear mixed models. A series of studies will be used to illustrate the major design issues and statistical approaches. Relevant procedures in statistical package SAS will be introduced and appropriate interpretation of results will be emphasized. Prerequisite: Introductory level courses in epidemiology and biostatistics and courses in linear regression, logistic regression and statistical inference.

EPID 768 Global Health Issues, Crises and Solutions (Myron E. Wegman Memorial Course in International Health)
(1 credit hour) Jose R. Teruel
Many of the world’s developing countries are plagued by unemployment, poor housing, low education, high infant mortality, malnutrition, communicable and parasitic diseases, and disability due to injury and occupational hazards. They are also affected by natural or manmade disasters, wars and conflicts that produce situations of emergency with a high impact in the life of exposed population groups. Developed countries also face some of these problems, as well as worldwide issues like emerging diseases, violence and drug trafficking. We define GLOBAL HEALTH as a “new dynamic approach of international health that should be based on the analysis of the existing diversity and trends in the health and living conditions of people and nations, including the political and socioeconomic forces that influence them and the use of this knowledge for the solution of the identified problems”.  It is essential for the health professional to be aware of the health conditions in the various countries of the world and how international health activities, both from bilateral and multilateral agencies are organized to face them and to understand the strategies for transition and international cooperation to rebuild damaged infrastructures and improve health  conditions for the normal development of the populations affected.  This course will review the present knowledge and approaches to these issues through presentations, videotapes and special exercises.  No prerequisite.

EPID 770 Environmental Determinants of Infectious Diseases
(1 credit hour) Mark L. Wilson
This course will explore the diverse associations and processes underlying a broad range of environmental influences that affect the transmission of infectious disease agents. The fundamental mechanisms of transport and colonization will be addressed in their ecological and evolutionary contexts. Various anthroponotic and zoonotic diseases in the U.S. and abroad will be compared by considering how different environmental factors shape their distributions, maintenance, intensity, and epidemic potential. The role of ecological changes such as dams, irrigation, agricultural intensification, urbanization, deforestation, and reforestation will be considered for a variety of water-, vector-, and airborne diseases. Possible effects of global climate change and species introductions on these infectious diseases, as well as new analytic tools for their study, also will be explored. No prerequisite.

EPID 777 Geographic Information Systems for Epidemiology
(1 credit hour) Danielle Gwinn
Geographic Information Systems (GIS) are used for displaying and analyzing spatial data. Data from a variety of sources may be compared utilizing overlay analysis and spatial statistics. Modern tools permit novice GIS users to perform spatial analysis without extensive training. This course will introduce students to ArcGIS, the world's leading GIS analysis package. Examples of epidemiological applications will give students the opportunity to see and use this powerful tool. Some of the topics to be covered are data import/export, layering, data table management, classification, labeling, spatial and attribute queries, and buffer analysis. No prerequisite.

EPID 781 Molecular Epidemiology of Cancer
(1 credit hour) Robert C. Millikan
The objectives of this course are a) to introduce students to basic concepts in molecular epidemiology of cancer, design considerations for gene-environment interaction, and statistical methods for analyzing haplotype data; b) to discuss practical issues such as biologic specimen collection, processing and banking of samples, and quality control in the laboratory; c) to understand methodologic issues related to the major categories of biologic markers (exposure, susceptibility, and early biologic response); and d) to review current research in the molecular epidemiology of cancer. The course will explore concepts and issues found at the interface of the basic sciences and cancer epidemiology, including discovery of new biomarkers, whole genome association studies, expression profiling and proteomics, and development of new technologies for cancer screening. Students will be asked to apply the knowledge gained to a particular problem in cancer epidemiology. The course will incorporate lecture and discussion. Prerequisite: Introductory-level course in epidemiology.

EPID 783 Methods in Community-Based Participatory Research for Health
(1 credit hour) Barbara A. Israel (co-taught by other faculty and community partners involved in the Detroit Community-Academic Urban Research Center (www.sph.umich.edu/urc) and its affiliated CBPR projects)
There is increasing recognition and support for more comprehensive and participatory approaches to research and interventions in order to address the complex set of determinants associated with public health problems that affect populations generally, as well as those factors associated with racial and ethnic disparities in health more specifically. Community-based participatory research (CBPR) is one such partnership approach that equitably involves all partners in all aspects of the research and intervention process, aimed at both increasing knowledge and understanding and linking the knowledge gained with interventions and policy change to enhance the health and quality of life of community members. This course will provide an introduction to some of the core principles, concepts and methods involved in using a CBPR approach. Organized along the phases of CBPR, this course will focus on describing and understanding partnership formation, maintenance and evaluation; the use of quantitative and qualitative methods (e.g., survey, focus group interview, observational checklist) for the purposes of community assessment, examining basic research questions, and developing and evaluating interventions; and feedback, interpretation, dissemination and application of research results. The course will examine the rationale for, benefits of and challenges associated with using a community-academic partnership approach to research and interventions. Class format includes lectures, discussions, case studies, and small group exercises. No prerequisite.

EPID 784 Survival Analysis Applied to Epidemiologic and Medical Data
( 1 credit hour) Jack Kalbfleisch
The primary goal of this course is to give a general introduction to survival analysis using only elementary mathematics and relying heavily on examples and intuitive explanations. The mathematical level is completely accessible with knowledge of high school algebra, one semester of calculus, and a one-year course in basic statistical methods. With this background, participants should be able to appreciate the methods and apply these methods using standard statistical software. Examples will be chosen from various epidemiological and medical applications.  The topics covered will be:  an introduction to survival probability models, hazard rates and survivor functions; xponential and Weibull survival models; right censoring and left truncation; life tables and the Kaplan-Meier Estimate; two sample and k sample nonparametric tests; log rank and censored data Wilcoxon tests; parametric methods for analyzing survival data: the Weibull regression model; semi parametric methods: Cox proportional hazard model.  The statistical techniques will be illustrated using various medical and epidemiological studies. Students will be challenged with some applied (non-computer) problems to illustrate the main ideas of survival analysis and to solidify the concepts. There will also be a number of exercises that will utilize computer software to analyze data.  Prerequisite: Introductory level course in statistics including an introduction to regression methods.

EPID 785 Public Health Surveillance
(1 credit hour) Philip S. Brachman
Public health surveillance is an integral ingredient of any efficient and effective disease control and prevention program. Public health professionals must have information concerning the parameters of a disease’s occurrence in order to be able to develop and maintain a program to reduce the occurrence of that disease. This course will provide a strong background in all aspects of public health surveillance. Discussions will cover its history, purposes and uses, and the elements involved in a public health surveillance program, surveillance data sources, data analysis, preparation of reports, program evaluation, and ethical and legal issues. Discussions will include surveillance of infectious and non-infectious diseases. Newer concepts of public health surveillance will also be discussed such as syndromic surveillance. Surveillance at local, state, and federal levels as well as as practiced in other countries will also be discussed. Several case exercises will be worked on in the classroom. Prerequisite: Basic knowledge of epidemiology and descriptive statistics.

EPID 787 An Introduction to Multilevel Analysis in Public Health
(1 credit hour) Not offered in 2009

 EPID 788 Evolutionary Epidemiology
(1 credit hour) Betsy Foxman and Randolph Nesse
New applications of evolutionary theory to medicine are growing and helping to explain apparent paradoxes, such as rapidly increasing rates of breast cancer, increased asthma vulnerability in certain populations and the metabolic syndrome (For details see The Evolution Network at  http://evolutionandmedicine.org).   Epidemiologists have begun to apply these principles and ask new questions, such as do genes that vary by latitude explain hypertension, and how might public health interventions for infectious disease be 'evolution-proofed' (see discussion of the American College of Epidemiology 2008 meeting: Dawn of Evolutionary Epidemiology (http://acepidemiology.org/meetings/2008Tuscon/08AMSpeakerHandouts.asp).  This course will explore how epidemiologists and other public health workers can make use of these advances in their own work.  Applying evolutionary theory can sharpen research questions, raise new possible explanations for observed phenomena and identify new types of exposure and outcome measures.  Pre-requisite:  No prior training in evolutionary biology is assumed.

**Important Notice**

EPID 789 (July 27-31) will be offered at an international location (Egypt). International details will be provided upon request to Dr. Amr Soliman at asoliman@umich.edu, (734) 764-5469 or Mohsina Qadr at mqadr@umich.edu, (734) 763-1340. Applications for international courses must be submitted as per the instructions on the application to Jody Gray.

EPID 789 Infection and Nutrition in Developing Countries
(1 credit hour) Arnold Monto
This course will emphasize practical approaches to evaluation of infectious disease and nutritional problems.  Practical issues involving both topics will be broadly addressed; their intersections occur mainly in developing countries, which will be a major focus.  The course will mainly be intended for public health practitioners who will already understand the basic approaches to infectious disease investigation and nutritional deficiencies, particularly those of women and children.  Classroom material will feature description of past studies of the combined effect of protein-calories and micronutrient deficiencies and common infectious diseases on the health and development of various risk groups in the population.  Special emphasis will also be given to emerging issues, including zoomatic diseases such as avian influenza.  The application of standard epidemiologic tools will be emphasized as well as practical examples.  The internet is becoming an important method for surveillance and disease investigation in the developing world and it’s use will form a key element in investigational approaches to be considered.