The HMS Clinical Epidemiology and Population Health (CEPH) course is a required first year course for all medical and dental students. CEPH combines teaching of core skills of clinical epidemiology (biostatistics, study design, and critical reasoning) as they apply to the care of individuals and populations with an introduction to key public and population health topics. An overarching goal is to provide students with an appreciation of the health and wellbeing of individual patients and those of populations as a continuum; and to understand that improving health may involve interventions by clinicians, public health authorities, and other sectors with impact on health. With this goal in mind, the course is designed to complement the Ethics, Social Medicine, and Health Policy courses, as well as the basic biomedical sciences and the Patient-Doctor sequence.
In studying clinical epidemiology, we focus on interpreting and applying evidence about the occurrence and natural history of disease and on comparing the relative benefits and risks of different methods of prevention and treatment. Studying statistical principles helps us to understand how uncertainty affects our interpretation of data and clinical decisions. These skills are essential as consumers of the medical literature for patient care and for creating effective public health policies. We also seek to help students gain specific skills to foster critical thinking. These include probabilistic thinking, assessing the evidence for casual connections on the basis of available data, effective use of (always imperfect) screening and diagnostic information, and understanding cognitive biases that affect reasoning.
Objectives
Specific learning objectives include developing skills to understand:
- The strengths and weaknesses of different kinds of medical evidence, including commonly used study designs and statistical approaches;
- Factors that often distort medical evidence: chance, bias, and confounding;
- Assessment of casual relationships based on available data;
- Critical issues in the interpretation of evidence to inform the care of patients, including the rational use of diagnostic tests and technologies;
- Modern methods for monitoring events in populations, such as patterns of disease and adverse effects of the medicines we prescribe;
- Strategies to alter health-related patient behaviors at an individual and population level;
- How physicians, public health officials, and policy-makers use information (including effectiveness and cost) to make decisions about patients and groups of patients;
- The role of the public health system in promoting health of populations, and in responding to specific individual- and population-level threats.