Professional Development Workshop Day 2 Teach Epidemiology Professional Development Workshop Centers for Disease Control and Prevention David J. Sencer CDC Museum Tom Harkin Global Communications Center June 4-8, 2012

Teach Epidemiology Teach Epidemiology

http://www.npr.org/blogs/health/2012/02/07/146519243/disease-sleuths-surf-for-outbreaks-online

Time Check 8:15 AM

Teach Epidemiology Teach Epidemiology

Time Check 8:45 AM

Teach Epidemiology Teach Epidemiology

Teachers Team-Teaching Teachers (TTTT) 1 Existing Lesson   Team leads other workshop participants in a portion of a selected existing epidemiological lesson. Teach Epidemiology

Epi – Grades 6-12 Metacognition They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Teach Epidemiology

Enduring Epidemiological Understandings Teach Epidemiology

Time Check 9:30 AM

Teach Epidemiology Teach Epidemiology

Teachers Team-Teaching Teachers (TTTT) 2 Existing Lesson   Team leads other workshop participants in a portion of a selected existing epidemiological lesson. Teach Epidemiology

Epi – Grades 6-12 Metacognition They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Teach Epidemiology

Enduring Epidemiological Understandings Teach Epidemiology

Time Check 10:30 AM

Teach Epidemiology Teach Epidemiology

Time Check 10:45 AM

Teach Epidemiology Teach Epidemiology

Teachers Team-Teaching Teachers (TTTT) 3 Existing Lesson   Team leads other workshop participants in a portion of a selected existing epidemiological lesson. Teach Epidemiology

Epi – Grades 6-12 Metacognition They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Teach Epidemiology

Enduring Epidemiological Understandings Teach Epidemiology

Time Check 11:30 AM

Teach Epidemiology Teach Epidemiology

Time Check 12:30 PM

Teach Epidemiology Teach Epidemiology

Teachers Team-Teaching Teachers (TTTT) 4 News Item   Team leads other workshop participants in the analysis of a news item from an epidemiological perspective. Teach Epidemiology

Epi – Grades 6-12 Metacognition They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas. They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question. Ken Bain, What the Best College Teachers Do Teach Epidemiology

Enduring Epidemiological Understandings Teach Epidemiology

Time Check 1:15 PM

Teach Epidemiology Teach Epidemiology

Detectives in the Classroom - Investigation 1-3: What’s My Hypothesis? PPT Sheet Detectives in the Classroom - Investigation 1-3: What’s My Hypothesis? Investigation 1-3

Enduring Epidemiological Understandings Teach Epidemiology

Time Check 2:00 PM

Teach Epidemiology Teach Epidemiology

Teach Epidemiology Workshop—Day 2 Diane Marie M. St. George, PhD University of MD School of Medicine

Back to EU 2 and 3 Why study patterns of disease? Why is a description of the person, place, and time elements of a disease distribution important?

Epidemiologic Studies Descriptive epidemiology Describes patterns of disease Suggests hypotheses about relationships between “exposures” and “health-related conditions” Analytic epidemiology Tests hypotheses Evaluates relationships Always in a search for causality Knowing causation helps us to prevent and treat disease and promote health

Enduring Understandings 4. A hypothesis can be tested by comparing the frequency of disease in selected groups of people with and without an exposure to determine if the exposure and the disease are associated. 5. When an exposure is hypothesized to have a beneficial effect, studies can be designed in which a group of people is intentionally exposed to the hypothesized cause and compared to a group that is not exposed. 6. When an exposure is hypothesized to have a detrimental effect, it is not ethical to intentionally expose a group of people. In these circumstances, studies can be designed that observe groups of free-living people with and without the exposure.

Boys are more likely than girls to want to go to this field trip. What are we comparing? Proportion of girls who will want to go on the trip to proportion of boys who will want to go on the trip. What is the causal inference? Gender  Wanting to attend the field trip This “Teach Epi” thing…it will work better for Ms. Smith’s kids than mine. Proportion of Smith’s students who will engage with epidemiology to proportion of my students who will engage with epidemiology. Class  Engagement with the science of epidemiology

Breast Cancer Descriptive epidemiology showed the following patterns: Long-term trend of increasing incidence of breast cancer Higher incidence in industrialized nations Breast cancer incidence is higher among older women than younger women What is your hypothesis?

Testing hypotheses about BrCA Hypothesis: High dietary fat intake increases risk of BrCA. How might you go about evaluating this hypothesis?

Testing hypotheses about BrCA Hypothesis: High dietary fat intake increases risk of BrCA. Evaluate the hypothesis using an: Ecologic study

Ecologic study of diet and BrCA Exposure is dietary fat Measured as dietary fat consumption per capita Outcome is BrCA Measured as a rate per 100,000 Plot data on a graph What might you expect to see?

Ecologic Study 55

Ecologic Study Key element Quantify relationships Advantages Group-level estimates Quantify relationships Graphical displays Correlation coefficient Advantages Study group-level variables, e.g. policies, laws, community socioeconomic status Use existing data sources Use fewer resources (time, money, subject burden) Disadvantage Ecologic fallacy

Testing hypotheses about BrCA Hypothesis: High dietary fat intake increases risk of BrCA. Evaluate the hypothesis using a: Cross-sectional study

Cross-sectional study of dietary fat exposure and BrCA Exposure is dietary fat Measured as dietary fat intake Outcome is BrCA Measured as yes or no Count responses What might you expect to see?

Diet and BrCA BrCA+ BrCA- High fat Low fat 200

So, is dietary fat associated with BrCA? Diet and BrCA BrCA+ BrCA- High fat 60 90 150 Low fat 10 40 50 70 130 200 So, is dietary fat associated with BrCA?

Diet and BrCA BrCA+ BrCA- High fat 60 90 150 Low fat 10 40 50 70 130 200 What is the prevalence of BrCA? What is the prevalence of BrCA among high fat consumers? What is the prevalence of BrCA among those with low dietary fat?

What is the prevalence of BrCA? 70/200 = 35% Diet and BrCA BrCA+ BrCA- High fat 60 90 150 Low fat 10 40 50 70 130 200 What is the prevalence of BrCA? 70/200 = 35% What is the prevalence of BrCA among those with high fat intake? = 60/150 = 40% What is the prevalence of BrCA among those with low fat intake? = 10/50 = 20%

Cross-sectional Study Key element Snapshot of one point in time Quantify association Prevalence ratio Advantages Individual data Quick, cheap Disadvantages Difficult to assess temporality because measure E and D simultaneously Inefficient for E or D that are rare Inefficient for D that are rapidly fatal or of short duration

Time Check 2:45 PM

Teach Epidemiology Teach Epidemiology

Time Check 3:00 PM

Teach Epidemiology Teach Epidemiology

Emergency Operation Center Tours Emergency Operation Center Teach Epidemiology

Time Check 4:00 PM