A “reading reflection” is a short essay — one or two paragraphs that you should be able to write in about five minutes.
Fraser describes five “kinds of thinking.” Were you surprised at what they are? Are they really about the liberal arts?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
What was the system for evaluating the condition of a new-born that the APGAR score replaced?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
One of the themes in Atul Gawande’s essay, “The Score,” in Better: A Surgeon’s Notes on Performance, is the emergence of the APGAR score as a way to measure birth outcomes. Following the suggestion of former CDC head David Fraser in his New England Journal of Medicine article that “analogic thinking” is an important aspect of epidemiology that can contribute to a liberal education, your assigned task is to invent an APGAR score of your own in an area of your own choosing. Some suggestions:
Be creative! But also be specific about what components would go into the overall score, paying particular attention to the importance of being able to score the components at a glance.
Your answer should consist of a brief description of the problem, followed by a list of the components in your score. Each of these components should have a one- or two-sentence explanation that would make sense to someone familiar with the area of application. For example, in my academic advising score, one of the components is whether the student has decided on a major. Hand in on Moodle
As you read in Epi, you will come across many terms that are either new to you or would be new to someone you are telling about epidemiology. Keep track of these in a Google Doc as the semester goes by.
Create the Google Doc now. Share it with kaplan@macalester.edu. Then go to Moodle and enter the link to that document. You might also want to bookmark it in your browser, so you can easily get back to it.
Over the semester, add to the glossary. When you don't know the meaning of a term, and the definition doesn't make sense to you, just write down the term and come back to it later. You'll learn more if you write the definition in your own words.
One of the goals of this course is to give you insight into how epidemiological data is collected and how epidemiological studies are performed. A great way to do this is for you to perform actual studies on actual populations. But this is impractical in the scope of a one-semester introductory course, to say nothing about the practical difficulties of setting up studies and the ethical difficulties relating to privacy and contact with patients by non-professionals.
Computers to the rescue. Prof. Michael Bulmer, a statistician at the University of Queensland in Brisbane, Australia, has been developing a realistic population simulator: The Island. (Prof. Bulmer spent his sabbatical in Spring/Summer 2010 at Macalester, which was the first site outside Australia to use the simulation.) We'll use this as the substrate for your studies. Of course this means that your results won't be applicable to actual human populations, but on the other hand you'll be able to get much more data in a much shorter time, and even to impose interventions on the people of The Island that would be impractical and unethical on real humans.
Each student has his or her own account, effectively working on his or her own copy of the population on The Island. (When working on a group, you may want to all use the same account.)
Accounts were created for most students based on the enrollment information available at the beginning of the semester. To get your password, follow this link and enter your Macalester email address. Your island password will be mailed to you. If your email is not recognized as a valid account ID, contact Prof. Kaplan who will arrange to have an account set up for you.
Once you have set up your account and received your password, you login here.
Of course, you have no direct way to evaluate the claims made in this article. What do you look for when assessing the reliability or truthfulness of the claims?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
Your group should make a preliminary pan for the collection of data. * How you will sample. * What data you will record. * How you will organize your data.
In class, we'll talk about what's needed to do the necessary calculations. Then you can revise your plans accordingly.
Record your plan in a Google document that's shared with the entire group. Each member of the group should paste in a link to the document on Moodle, here.
What is it about cancer that lends itself to the dubious detection an “outbreak,” whereas for other causes of illness (e.g., food contamination) there doesn't seem to be such a problem?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
Why was Semmelweis ineffective?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
In this reading reflection, consider the ways in which Koch's postulates make sense or not. As a point of reference, here is a recent article on the ecosystem in the gut.
How are Koch's postulates “reductionist”?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
This is a somewhat technical article and it is likely that you will find it difficult or impossible to understand in its entirety. That is a situation that you will find often in your career.
What is “censoring” in the context of survival analysis?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
What is meta-analysis?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
Look at the bicycle helmet page on Wikipedia and see if the information presented there supports the claims made in the article. Also of interest is the listing of fatalities per billion passenger …
Approximately 2/3 of 300 interviewed riders (mostly kids!) say they wear helmets. (See this article in Injury Prevention.) Data from the IIHS shows that in 2008, of 714 bicycle-related deaths in the US, 58 were of riders wearing helmets. Use this information to make an estimate of the odds ratio for death when wearing a helmet and turn this into an attributable fraction. Try to estimate a number needed to treat. (Think of this as a combination reading reflection and estimation problem.)
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
This short essay is intended to probe what you already know about health insurance, before we read about it. A few paragraphs will do nicely. First, give a one- or two-sentence definition of “insurance,” a general category that includes life insurance, unemployment insurance, disability insurance, car insurance, home insurance. Don't look in the dictionary — give your own definition based on your current knowledge.
Second, describe your understanding of how health insurance currently works. Some aspects that you should consider:
Third, say something about how you think health insurance should work:
How does the article square with what we've been reading about PSA testing?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
What's wrong with lifetime risk measures?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
Here is an editorial from the Minneapolis Star Tribune on Aug 11, 2009. Write a couple of paragraphs in the form of a letter to the editor taking on this editorial from an informed epidemiological perspective. Your letter might be supportive or critical of the editorial, but your point of view should be professional.
As you pull together your thoughts in preparation for writing the letter, you might start by summarizing and explaining the arguments made in the editorial that the advantages of screening exceed the disadvantages. Are there any arguments that are rhetorical, mere turns of phrasing rather than careful reasoning?
What are five common risky things that college students do in terms of excess mortality? Estimate how risky each is using years of potential life lost for an individual. Also estimate the prevalence of the risk. Your estimates might be largely guesswork, but try to put reasonable upper and lower bounds on the risk.
For one of the five items, go beyond just guessing. Do a bit of Internet sleuthing and see what you can come up with. Don’t spend more than 30 minutes altogether. It helps if you pick a risk that you don’t expect everyone else in the class to be reporting on.
Many medical treatments in the past strike us today as silly. But they often made sense at the time, emerging logically from a theoretical framework. Pick an example from the reading and explain briefly how the treatment made sense in terms of the theory.
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.
Influenza is the leading cause of death from infectious disease in the US. What aspects of the influenza virus, the human immune system, and the interaction of the two contribute to this?
What is the most important thing you learned from this reading?
If there was anything you found confusing, please describe it.