Epi Tools Everyone Can Use

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Presentation transcript:

Epi Tools Everyone Can Use Emily Mosites, MPH Alice Green, DVM Katie Garman, MPH

Objectives Review concepts from regional outbreak training Line list Resources for outbreaks Demonstrate use of statistical software to develop Epi-curve Symptom profile 2x2 tables (OR, RR) Data management/ analysis tips

Regional Outbreak Training Objectives Provide Regional Health Departments with tools to investigate clusters and outbreaks Today: foodborne diseases Concepts are generalizable Promote collaboration and understanding between epidemiologists/CEDS staff, environmentalists, and laboratorians “Epi-Ready” model

Foodborne illness investigations The “Stool” Foodborne illness investigations Lab Epidemiology Environmental

Foodborne illness investigations Epi Tools Foodborne illness investigations Lab Epidemiology Environmental

Tools Many tools you can use Today’s focus Excel SAS EpiInfo

Compile a Line list: Excel

Data Entry Tips Blank does not equal “No” Single-word variable name Use 1= yes & 0= no OR 1=yes & 3=no Proper alignment to calculate RR

Analysis in Excel

Why Excel? If you don’t want to start having dreams in SAS code If you have never heard of EpiInfo If you find yourself doing analysis in the middle of the woods with only Microsoft ® Office™ USE EXCEL!!!

Overview Summarizing Data with PivotTables RR, OR, and Chi Squares Test Page Incubation period and EpiCurve We will send you an excel workbook with these formulas and explanations!

Why use SAS in an outbreak investigation? It’s powerful Fisher’s exact Easy to screen large numbers of variables It’s subsidized by CDC It’s fun!! Embrace your dorkiness

Fisher’s Exact Test

Meal Date (exposure)

Illness Onset Date

End Illness Date

Why use Epi-Info (Version 3.5.1) Easy Point and click Rapid questionnaire development Simple commands Accessible available anywhere at anytime at www.cdc.gov FREE

www.cdc.gov/epiinfo

Click on analyze data

Click on Read (Import)

Select the correct data format Find your file

Make sure all of your records have been imported

Start looking at your data

Type “=1” to select those who were sick Select your variable

List Select your variable Sick = 1 is selected To unselect click on cancel select

Create symptom profile using frequency command

Frequencies Stratify by sick Select your variables

Symptom Profile

Develop an epi curve using the graph command

Select Bar Graph Choose onset date

Calculating relative risk or odds ratio using the tables command

Remember… In order to calculate RR well 1 ill BBQ 15 20 No BBQ 5 1 ill 1= yes 3= no well 1 ill BBQ 15 20 No BBQ 5 1 ill 3 well BBQ 20 15 No BBQ 5 RR= 15/(15+20) = 0.53 20/(20+5) RR= 20/(20+15) = 2.85 5/(5+20)

Add exposure variable Add outcome variable

BBQ Chicken

Sweet Tea

Resources for Outbreaks

Modifiable gastrointestinal outbreak questionnaires http://health.state.tn.us/ceds/resources.htm Modifiable gastrointestinal outbreak questionnaires Sample databases

Thank you! Connie Robinson and staff Rand Carpenter John Dunn

Questions 615-741-7247 Emily: Emily.Mosites@tn.gov Alice: Alice.Green@tn.gov Katie: Katie.Garman@tn.gov 615-741-7247