Learning outcomes of the course unit
The student will be expected to: know and understand the most common veterinary problems using epidemiological methods; allow to acquire the basic principles and the most commonly applied epidemiological techniques of veterinary medicine; apply a quantitative reasoning method, focusing particularly on disease frequency estimates, test assessments and risk factor assessment.
Course contents summary
Study of the methods applied to the understanding of the epidemiology of diseases of veterinary interest
1. Introduction to the study of epidemiology. Historical considerations and basic concepts. Differences between epidemiology and other diagnostic disciplines. The concept of disease determinant. Primary determinants. Secondary determinants. The concept of "population". Levels of populations.
2. Tasks and aims of epidemiology. Tasks of veterinary epidemiology. Prevention, control and eradication of diseases. The aims of epidemiological studies. Observational and experimental studies.
3. From association to causality. Demonstration of causality in observational studies. Statistical significance and causality. Chi-square test for comparing two percentages. Statistical significance tests. Association and causality: types of association. General model of causal and non-causal associations. Examples of causal and non-causal associations.
4. The epidemiological approach to the causes of disease. Henle-Koch's postulates. Evans's postulates. The Rules of John Stuart Mill. Demonstration of causality. Criteria of causality. Prospective and retrospective studies for demonstrating causality. Prevalence rate, relative risk and odds ratio.
5. Biological variability: basic concepts in epidemiology. Frequency distribution. Cumulative, median and centile frequencies. Central tendency indices. Variation indices.
6. Sampling in veterinary practice. Aims of sampling. Characteristics of a good sample. Sampling errors. Sampling methods. The variability of an estimate and confidence limits. Sample size.
7. Measuring disease frequency. General concepts. Morbidity and mortality. Survival and lethality. Prevalence and incidence. Attack rate. Relationship between incidence and prevalence. Epidemic, endemic and sporadic diseases. Other methods for measuring disease frequency. Standardisation of measures.
8. Screening tests for sub-clinical diseases. Population screening. Test performance assessment. Sensitivity, specificity, positive and negative predictive value. Methods for improving the predictive value of a test. Multiple tests: use of 2 tests simultaneously or in succession; serial or parallel interpretation. Concordance index between two tests.
9. Transmission and maintenance of infectious diseases Transmissible diseases. The cycle of a transmissible disease. Latent infection and carrier status. Horizontal and vertical, direct and indirect transmission. Host types. Mechanical and biological vectors. Factors associated with the spread of infections. The spread of infections and host characteristics: receptiveness and contagiousness. The spread of infections and agent characteristics. The spread of infections and contact efficiency. Routes of infection. Transmission modes. Long distance transmission of disease agents. Vertical transmission of disease. Maintenance and survival strategies of the agent.
10. Disease patterns. Epidemic curves. Kendall’s threshold theorem. Epidemic trends. Common source and propagation epidemics.
11. Models in epidemiology. Model types and functions. A classic model: the Reed & Frost model. Bovine Neospora caninum Infection: example of a mathematical model.
PRACTICAL LEARNING ACTIVITIES. With the aid of the computer and preparation of spreadsheets, students will consolidate the concepts acquired by solving problems relative to: demonstration of cause-effect relationship (case-control and cohort studies), sampling, measuring disease frequency, critical interpretation of screening tests.
According to guidelines of the European Association of Establishment for Veterinary Education, students will learn principles on finding technical-scientific informations via Internet using public online databases (OPAC SBN, PUBMED etc.).
BOTTARELLI E.: Quaderno di Epidemiologia Veterinaria. http://www.quadernodiepidemiologia.it.
TESTI DI CONSULTAZIONE
AHLBOM A., NORELL S.: Epidemiologia moderna. Il Pensiero Scientifico Editore, Roma, 1993
BEAGLEHOLE R., BONITA R., KJELLSTROM: Epidemiologia di base. Edizione italiana a cura di G. Agazzotti, Editoriale Fernando Folini, Casalnoceto, 1997.
LOPALCO P.L., TOZZI A.E. (2003) Epidemiologia facile. Il Pensiero Scientifico Editore, Roma.
PFEIFFER D.U., Veterinary Epidemiology - An Introduction. Institute of Veterinary, Animal and Biomedical Sciences, Massey University, New Zealand. Disponibile online (al 25/9/2009) all'indirizzo: http://www2.vetmed.wisc.edu/education/courses/epi/Pfeiffer.pdf
Signorelli C. (2000) Elementi di metodologia epidemiologica. Società Editrice Universo, Roma, V ed.
During the lessons will be taught the principles of epidemiology adding to theoretical classes practical examples relating to veterinary medical applications.
Along with the practical lessons, the student will have to deal with computer simulations of epidemiological applications (one computer for each student).
Assessment methods and criteria
The assessment of the objectives of the course involves a written examination, with 6 open questions related to the topics covered during the course.