Medical Epidemiology

Code:

M324

Acronym:

EM

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2024/2025 - 2S (of 17-02-2025 to 13-06-2025)

Active?	Yes
Responsible unit:	Population Studies
Course/CS Responsible:	Integrated Masters Degree in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIM	167	Official Study Plan	3	-	3	28	81

Teaching language

Portuguese
Obs.: Português - Suitable for English-speaking students

Objectives

The Curricular Unit intends to apply the principles of epidemiology to the study of groups of patients. At the end of the curricular unit, the student should be able to assess the effect of diagnostic, preventive and therapeutic interventions on clinical outcomes, study the determinants and effects of clinical decisions, incorporate the results of medical epidemiological research into decision-making processes.

It is intended that the student understands the importance of epidemiology for the quality of health care and patient safety. It uses an approach based on examples of the use of epidemiology in the real world of a doctor's activity and intends to be the continuation of the teachings of other previous Curricular Units and allow the development of critical capacity for a better understanding of the main challenges in public health.

Learning outcomes and competences

• It is intended to provide future physicians with the ability to critically assess the available evidence to inform their decisions, as well as conceptualize medical research studies to answer questions of the same nature.

Working method

Presencial

Program

● Efficacy/effectiveness and safety of interventions (prevention, diagnosis and therapies)
● Prognosis – measures, outcomes, generalizability
● Risk assessment
● Instruments for clinical prediction and clinical decision rules – development, validation, calibration
● Using medical epidemiology to assess and promote the quality of healthcare and patient safety
● Epidemiological surveillance


Preparation for practical classes

Teachers' role
● Ensure groups are organized
● They prepare the script about the objective/depth of each topic/session
● They do a theoretical contextualization of the class, according to what is established in the program
● Before class, ensure everyone has read the assignments and understood the lesson objectives
● Foster discussion – brainstorming or name identification techniques to ensure participation of all elements and encourage creative thinking
● They ensure that students focus on the objectives of the lesson and remember, whenever necessary, the different steps of the lesson in order to guarantee that there is no dispersion
● End the class with a brief summary of the most relevant concepts

role of students
● Review the subject and class objectives (always made available a week in advance)
● View the class support material, available on moodle
● They prepare the class in advance – the case studies, articles, protocols used in the class will be distributed in advance, as well as the guide for the same.
● During class they actively participate
● As a group they prepare a protocol for a systematic review


Composition of groups
Each group has between 5 and 6 students


Theoretical-practical classes


Date Topic Objectives
week 1

Introduction to the Course Unit

● Introduction to the curricular unit, objectives, methodology and evaluation
● Formation of groups with 5/6 students
● Introduction to Medical Epidemiology


Group work with class discussion:
● Identification of the theme that will be prepared as a group (systematic review protocol)
● Bibliographical research

Week 2 Systematic review

A systematic review must be able to synthesize all relevant information.

Methodology: Lecture by the teacher with presentation and discussion of examples
Goals:
• What is a systematic review
• Identification, evaluation and selection of articles
• Graphic presentation of results
• Assessment of heterogeneity
• Evaluate the quality of a systematic review

Week 3 Diagnosis

Proper diagnosis is the first step towards therapeutic optimization and prognosis prediction.

Methodology: Reading, interpretation and discussion of articles, case studies
Goals:
• The choice of diagnostic tests (sensitivity, specificity, likelihood ratios, ROC curve)
• Classification of diseases
• Agreement between tests

Week 4 and 5 Prognosis

Predicting the course of an illness and trying to improve the prognosis is the goal of medical activity.

Methodology: Reading, interpretation and discussion of articles, case studies
Goals:
• Prognostic evaluation studies
• Survival analyzes – interpretation
• Identification of prognostic factors
• Bias
• Sensitivity analysis
• Cost-benefit, cost-effectiveness, cost-utility studies
• Personalized medicine – the stratification of therapeutic decisions

Week 6, 7 and 8 Interventions

After diagnosis, intervention is the responsibility of the clinician.

Methodology: Reading, interpretation and discussion of articles, case studies
Goals:

● Treatment efficacy studies
● Clinical trials
● Analysis according to intention to treat vs analysis according to treatment received
● Superiority, equivalence and non-inferiority
● From clinical trial to individual treatment
● Alternatives to randomized controlled trials
● Observational intervention studies

Week 9 Safety

Adverse effects, quality of care and adherence to the prescribed intervention have an important effect on the prognosis of the disease.

Methodology: Reading, interpretation and discussion of articles, case studies
Goals:
• Patient safety
• Pharmacovigilance
• Strategies according to the context
• The importance of involving patients and survivors of the disease
• Critical analysis of a problem and identification of improvement strategies

Week 10
qualitative studies

Qualitative studies are important tools.

Methodology: Reading, interpretation and discussion of articles, case studies
Goals:
• Structured and unstructured observational studies
• Interview – sample selection, process, analysis and presentation
• Focus group
• Mixed methods

Week 11 Protocol Protocol presentation and discussion

Week 12 Clinical Guidelines

Medical activity follows what is identified as best practice, based on evidence. These good practices are usually identified in clinical guidelines.

Methodology: Reading, interpretation and discussion of articles, case studies
Objectives:

Methodology for developing guidelines
How to critically analyze guidelines

Week 13

Consensus methods

There are situations in which proposals are based on consensus between experts in certain areas. These consensuses also have an appropriate methodology.

Methodology: Reading, interpretation and discussion of articles, case studies

Objectives:

Methods for reaching consensus
The Delphi technique
The analysis

Week 14

Presenting the results

Presenting results is a fundamental step in research.

Class discussion - presenting, writing and publishing

Critical analysis of the course and self-evaluation process

Mandatory literature

Dabiv D. Celentano; Gordis epidemiology. ISBN: 978-0-323-55229-5

Comments from the literature

More information is available on SIGARRA in the Guidelines, which includes more detailed information about the study unit including the main references we will be using as well as additional ones.

Teaching methods and learning activities

During the theoretical-practical classes, group work will be done with the stimulation of discussions based on scientific articles, study protocols, case-studies, audiovisual materials.

Evaluation Type

Distributed evaluation with final exam

Assessment Components

Designation	Weight (%)
Exame	70,00
Trabalho escrito	30,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	43,00
Frequência das aulas	28,00
Trabalho escrito	5,00
Apresentação/discussão de um trabalho científico	5,00
Total:	81,00

Eligibility for exams

Assistance to at least 75% of the theoretical-practical sessions
Minimum evaluation of 7 values in each of the components, with a total equal to or greater than 9.5.

Calculation formula of final grade

Distributed evaluation with final exam

Assessment Components

• Exam 70%
• Laboratory work 30%

Special assessment (TE, DA, ...)

If the distributed evaluation is not possible, as is the case of student workers, students in this situation must notify the person responsible for the UC within 3 weeks after the beginning of the academic year to evaluate an alternative evaluation methodology.

Classification improvement

The improvement of classification will be carried out through the component corresponding to the final exam (with group work).
Validity of the written work: current and subsequent academic year (two years).