Course Description | Course Objectives | Course Format | Assignments | Policy for Late Submissions | Interaction | Course Materials | Grading Policy | Examinations | Proctored Exam Guidelines | Contact Information | Help | Schedule | Course Topics | Exercises | Recommended Reading | Evaluation | Ethical Conduct

Quantitative Methods introduces the basic concepts of biostatistics and epidemiology as applied to public health problems. Emphasis is placed on the principles and methods of epidemiologic investigation, appropriate summaries and displays of data, and the use of classical statistical approaches to describe the health of populations. Topics include the dynamic behavior of disease; usage of rates, ratios and proportions; methods of direct and indirect adjustment, and types of life tables which measure and describe the extent of disease problems. Various epidemiologic study designs for investigating associations between risk factors and disease outcomes are also introduced, culminating with criteria for causal inferences. The application of these disciplines in the areas of health services, screening, genetics, and environment policy are presented. The influence of epidemiology and biostatistics on legal and ethical issues are also discussed.

After completion of this course, students will be able to apply principles of epidemiology and biostatistics to the prevention of disease and the improvement of health. 

In order to obtain the course objectives, the student will:

• Distinguish the roles and relationships between epidemiology and biostatistics in the prevention of disease and the improvement of health.
• Compute basic descriptive statistics and explore data analytic methods.
• Demonstrate a basic understanding of epidemiologic methods and study design.
• Combine appropriate epidemiological concepts and statistical methods.

After completing this course, the student will be able to demonstrate the following competencies:

• Perform exploratory data analysis using descriptive statistics.
• Evaluate morbidity and mortality using ratios, proportions, and rates. 
• Perform direct and indirect methods of adjustment of overall rates. 
• Construct life tables in vital statistics and epidemiologic studies. 
• Recognize the assumptions associated with construction of a life table.
• Calculate probabilities and conditional probabilities of health-related events.
• Calculate sensitivity, specificity, and predictive values. 
• Recognize and describe the elements in the design and conduct of a randomized clinical trial, a cohort study, a case-control study, and a cross-sectional study. 
• Calculate measures of association in identifying risk factors of diseases. 
• Calculate a chi-square statistic to test the significance of a measure of association and interpret it using probability concepts.
• Identify biases and their consequences in published literature.
• Describe criteria for characterizing the causality of associations.
• Recognize the presence of effect modifiers.
• Explain the use of epidemiology in the genetics application.
• Explain the use of epidemiology in the evaluation of screening process.
• Describe the impact of epidemiology on national and local policy.
• Describe the influence of epidemiology on ethical and professional issues.

Modules
The content of this course is divided into nine separate modules (see Course Topics). The first module will become available on the first day of class and subsequent modules will become available every two weeks thereafter. In each module, you'll find lecture sections, exercises, and review questions.

Lectures
The lecture sections are presented sequentially and should be completed in that order. Each of these lectures combines audio presentation and slides. You may return to any previous lecture at any point in time and review its contents at your convenience. In each lecture, you will find objectives, links to the lecture materials, a listing of reading assignments, frequently asked questions, and links to Web resources.

Exercises
The exercise for each module corresponds to the concepts, principles, and methods covered in the lecture sections. Please note that Exercise 6/7 will cover the materials from Modules 6 and 7 (see Exercises).

While working on the exercises, you should review the materials from the lecture sections and the textbooks. You should work on the problems on your own and then discuss the answer with members from your assigned groups (see below). To facilitate the discussion, you may use the DigiChat software, email, DED Messenger, the LiveTalk area, or some other third party software program. (Please note that the Distance Education Division does not support third party software; if you encounter problems, you'll need to contact the manufacturer for support.)

If your group still has difficulties with the answer, post the question and your observation or comments on the Bulletin Board. Others may also have similar questions and will be able to give their own input.

• Group Summary Questions (GSQ)
• Bulletin Board Exercises
• Homework Assignments

Group Summary Questions: Before beginning this course, you will be assigned to a working group. Your working group will work together to discuss the answers to the group summary question (GSQ). Please review these important details regarding group dynamics and expectations of group performance in online collaboration. For each module, each group must submit written answers for the GSQ to qmmail@jhsph.edu. (See also Submitting GSQ.)

Bulletin Board Exercises: For modules 2, 4, 6, and 8, there will be an assignment in the Bulletin Board area under "BBS Exercise Forums." Each thread in the forums refers to an assignment that must be completed by each individual by the deadline noted in the schedule. These exercises involve a discussion of current/relevant events or an Internet search to find pertinent information. Bulletin Board exercises are required work for the course. Each student will complete the work without assistance from others. Answers will be scored and some representative responses will be posted to the master forum (a public area of the Bulletin Board exercise forums) for everyone to view.

The Bulletin Board exercise forums will be grouped alphabetically by the first character of your last name. Please look for the appropriate folder and submit your answers ONLY in that forum.

Homework Assignments: This is also an individual work to be completed without assistance. Homework assignments will be posted in the Online Library the day after the Instructor Discussion Session (LiveTalk). The homework will cover topics from the exercise and the corresponding lecture sections and should be emailed to qmmail@jhsph.edu. (Please check the Schedule for due dates.) The answers should be submitted as a Microsoft Word document. If printed, the answers must fit on NO MORE THAN TWO printed pages using a 12-point font size (or otherwise stated in the homework). (See also Submitting GSQ.)

Optional Review Questions: Please note that in addition to the aforementioned assignments, you will also have a set of review questions at the end of each module. The review questions are an excellent way for you to check your understanding and comprehension of the material covered in each module. These questions are wholly optional, can be completed and reviewed at your convenience, and you can access them as often as you like.

Optional Online Quiz: Prior to the proctored midterm and final examinations, an online quiz will be available for you to familiarize yourself with taking an exam under a time constraint. The questions are taken mostly from the review question sets. Quiz 1 includes questions from review questions 1, 2, 3, and 4. Quiz 2 includes questions from all review question sets. You may take the exam multiple times. The quiz scores do not contribute to the final course grade.

Submitting GSQ and Homework Assignments When submitting GSQ and homework assignments via email to qmmail@jhsph.edu, please use the following subject headers. Do not insert any spaces between characters in the headers. For GSQ, type: GSQ1, GSQ2, GSQ3, etc. For Homework, type: Homework1, Homework2, Homework3, etc. Using these specific headers will facilitate the forwarding of your mail to its appropriate mailbox. File-naming guidelines Files should be prepared in Microsoft Word. For the GSQ, please use the following convention: GSQ#_group#.doc. For example, the filename GSQ1_group5.doc would be acceptable. The group number should also be on the first page of the submitted assignment. For homework files, please use the following naming: homework#_your name.doc. For example, homework1_Jane_Doe.doc. Please also type your name and email address on the first page of the submitted homework. IMPORTANT: After the second module, any submission of assignments that does not follow the email subject header and/or file-naming guidelines will be returned to the sender for resubmission. Thank you for your cooperation!

The policy for late submissions of homework assignments and Bulletin Board exercises is as follows: For each day that the assignment is late, 10% of the total possible score for that assignment will be deducted.

Instructor LiveTalks: At the end of each two week period for a module, the instructors will hold a LiveTalk on the issues and concepts encountered while working on the exercise. The dates of these sessions, which will always be at 7:00 PM (EDT or EST), can be found on the course Schedule.

TA sessions: TAs will hold regular sessions to discuss any questions that remain after the LiveTalk discussion of a module. The sessions will utilize DigiChat, which is the chat software part of the LiveTalk system. (To join a TA session, just go to the LiveTalk room on the date and time listed on the Schedule.) To help the TAs prepare for a session, you should post your questions in the "Questions for TA Session" thread of the module-specific forum at least two hours before a session begins. Please refer to the schedule for specific dates and times.

This course has two required textbooks:

1. Gordis, L. (2004). Epidemiology. Third edition. Philadelphia: Elsevier Saunders. (The second edition is also acceptable.) 
2. Pagano, M. and Gauvreau, K. (2000). Principles of Biostatistics. Belmont, CA: Wadsworth. 

You can buy the textbooks from an online bookseller such as Amazon, or through the Matthews Johns Hopkins Medical Book Center:

Matthews Johns Hopkins Medical Book Center
1830 East Monument Street
Baltimore, MD 21205 U.S.
410-955-3931
800-266-5725
410-955-0576 Fax
http://www.cbamatthews.com/jhmedbook/

Reading assignments are provided on the introductory Web page of each lecture section. The lecture sections and the textbook readings complement each other and reinforce your learning of the materials. For a list of recommended reading, see the Recommended Reading section in the right-hand column of this syllabus.

Grades will be determined in Quantitative Methods using the following percentages:

• Proctored final examination: 35%
• Proctored midterm examination: 25%
• Homework: 25%
• GSQ: 10%
• BBS exercises: 5%
• Group collaboration and class participation will also be factored into the final grades.

Grades will be determined as A, B, C, D, and F. The distribution of the final course scores will be used to determine the cutpoints for the grades.

This course contains a midterm and a final examination. The examinations will be the same as those taken in a classroom; you will work on the examination alone without aids. A proctor system will be used to administer the examinations. You are asked to identify a proctor who will receive the examination by mail, proctor your examination session, and return the examination by mail to the Office of Distance Education. The proctor may be your employer or supervisor, a librarian, a clergyman, or another person identified by you and the faculty. This person cannot be related to you in any way. The proctor will follow an established procedure in administering the exam, keeping track of time, and collecting the exam. He or she will be asked to sign an ethical conduct statement on proctoring off-site examinations. The conduct of the examination is to follow the Johns Hopkins University Academic Ethics in the Policy and Procedures Memorandum. Failure to follow the ethical guidelines will result in failing the course.

Examinations will only cover content from the textbooks, lectures, exercises, and review questions. Information from the Web links scattered throughout the course is not testable material. These links are offered to improve your understanding of the concepts, to provide examples relevant to the materials covered in the course, to present the concepts in more details, and for your enjoyment.

Concerns Contact Concerns about course topics and assignments For course-related questions, please email qmmail@jhsph.edu. Technical concerns about the functionality and operation of course Web pages (before emailing, please make sure that you can replicate the problem) DEHelp, the central help system for all tech support inquiries related to DED courses Technical help on weekends JHSPH User Support: 410-955-3781 Concerns about your Internet connection Your Internet service provider (e.g., AT&T, Erols, etc.) Concerns about your personal software Your software vendor

• Start dates of each module
• Due dates for group summary questions, Bulletin Board exercises, and homework assignments
• Dates of the midterm and final examinations
• Dates and times for instructor discussion sessions via LiveTalk

• Definitions and uses of quantitative skills in public health
• Disease transmission
• Exploratory data analysis 

Module 2: Quantifying and Comparing Public Health Measures

• Summary measures (ratio, proportion, rate)
• Indices of morbidity and mortality
• Direct and indirect methods of adjustment of rates 

Module 3: Quantifying the Natural History of Disease

• Cohort and current life tables
• Clinical life tables
• Natural history of disease 

Module 4: Probability Concepts and their Use in Evaluation of Diagnostic and Screening Tests

• Probability concepts
• Screening tests, sensitivity, and specificity

Module 5: Epidemiologic Study Designs

• Randomized clinical trials 
• Cohort, case-control, and cross-sectional studies

Module 6: Estimating Risk

• Measures of association
• Use of chi-square statistics 

Module 7: Interpretation of Data from Epidemiologic Studies

• Design and analysis issues
• Bias and confounding
• Interaction
• Causal inferences

Module 8: Applying Epidemiology to Evaluation

• Evaluation of health services
• Evaluation of screening programs

Module 9: Roles of Genetic Factors and Epidemiology and Public Policy

• Roles of genetic and environmental factors in disease causation
• Epidemiology and public policy, ethical and professional issues

Module 10: Summary of Course Concepts

Exercise 1: An Outbreak of Foodborne Illness Following a Charity Luncheon

Exercise 2: Calculation of Adjusted Rates

Exercise 3: Life Tables and Quantifying the Natural History of Disease

Exercise 4: Probability Concepts and Applications in Assessing the Validity of Diagnostic and Screening Tests

Exercise 5: Field Evaluation of Vaccine Effectiveness

Exercise 6/7: Cancer of the Lung and Cigarette Smoking

Exercise 8: Effectiveness of Coronary Care Units on In-Hospital Case-Fatality Rates from Myocardial Infarctions

Exercise 9: Analyzing Published Papers: Silicone Breast Implants and Connective Tissue Disease

In the exercises, you will encounter questions in one of the three general formats: Numerical calculations, multiple-choice problems, and open-ended discussion questions.

• Numerical calculations: You will be asked to calculate values and key the answers into the appropriate boxes. You will be able to check your answers immediately. Correct answers will allow you to proceed to the next boxes.An alert box will inform you of the wrong answer, and you will not be able to proceed further in some situations. You should review the materials from the lecture sections or the textbooks and try again. If you still have difficulties and cannot proceed, you should email other members in your working group or post a query on the Bulletin Board discussion module. The problems may be simply resolved. If you still have questions, contact one of the teaching assistants or sign up for a TA office hour.
• Multiple-choice problems: You will either simply click on the answer icon or select one of the choices. Usually, there will be an immediate response or answer to your selection.
• Open-ended discussion questions: You will encounter either the "Answer" icon, which will provide an immediate response, such as hints or formulas, or the "Delayed Answer" icon, which signifies that the answer will not be immediately available. The answers, however, will be available approximately one week later.

Lecture and instructor evaluation: We value your input in evaluating this course. An online evaluation form is attached to each lecture page for you to complete. This information will be given serious attention in future updates to the course.

The academic ethics code, as discussed in the Policy and Procedure Memorandum for Students, March 31, 2002, will be adhered to in this class.

If you are a student with a documented disability who requires an academic accommodation, please contact Betty H. Addison in the Office of Career Services and Disability Support: dss@jhsph.edu, 410-955-3034, or Room E-1140.