Section outline

  • General

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  • Thursday, September 14, 2017; 8:45 AM - 10:15 AM

    Lecture 1: Course overview, the diagnostic process, and measures of interobserver agreement

    Introduction to the course and how we will teach it.

    Evidence-Based Medicine: 1) refining disease probabilities; 2) quantifying  treatment effects. 

    Diagnosis: assigning the right name to a patient's illness versus using test results to guide treatment decisions.

    Inter-rater agreement: concordance, unweighted Kappa, linear and quadratic-weighted Kappa.

    Faculty:  Michael Kohn

    Location:  Mission Hall 1400

  • Thursday, September 14, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 1

    Review of Chapter 1 (Reason for a Diagnosis) problems and "Kappa Game"

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107

  • Thursday, September 21, 2017; 8:45 AM - 10:15 AM

    Lecture 2: Dichotomous Tests
    Sensitivity, specificity, predictive value, prior and posterior probability; 2x2 table method for getting posterior probability; probability and odds;  likelihood ratios, the likelihood ratio slide rule, false-positive and false negative confusion; use of X-graphs to understand testing and treatment thresholds

    Faculty:  Thomas Newman

    Location:  Mission Hall 1400

    • Session Slides:

    • Lec 2 Dichotomous tests 2016-0921 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker
    • 2016 Lecture URL
      Not available unless: You belong to M Laker

    • Required Reading for EBD-2, which hasn't been published yet:

      Chapter 2, Dichotomous Tests (posted below as a Word document)

    • EBD2 Chapter 2 Dichotmous tests 2017-0915.docx File

    • Optional Reading:

    • Testing Threshold Derivations File
    • Cost-Benefit X Graph and calcs for Chapter 3 MAK File

  • Thursday, September 21, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 2

    Review HW-1 (Kappa) Problems

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107

     


      

    • Problem Set #2, Dichotomous Tests, due 9/28/17 at 1:00 PM

    • Epi 204 PSet2.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, September 28, 2017; 8:45 AM - 10:15 AM

    Lecture 3: Multilevel and continuous tests
    ROC Curves, interval likelihood ratios, and the relationship between them; how making multilevel tests dichotomous wastes information; choosing cutoffs, the Walking Man approach to the "non-parametric" ROC curve.

    Faculty:  Michael Kohn

    Location:  Mission Hall 1400

  • Thursday, September 28, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 3

    Review HW-2 (Dichotomous Tests)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Problem Set #3, Multi-level Tests, due 10/5/17 at 1:00 PM

    • Epi 204 PSet3.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, October 5, 2017; 8:45 AM - 10:15 AM

    Lecture 4: Studies of Diagnostic Tests
    Common biases in test accuracy studies: incorporation bias, verification bias, double gold-standard bias, spectrum bias;  Prevalence, spectrum bias, and nonindependence; going beyond checklists and estimating the direction of bias.

    Faculty:  Tom Newman

    Location:  Mission Hall 1400

  • Thursday, October 5, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 4

    Review HW-3 (Multi-level Tests)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Homework assignment #4, Bias in Test Accuracy Studies, due 10/12/17 at 1:00 PM

    • Epi 204 PSet4.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, October 12, 2017; 8:45 AM - 10:15 AM

    Lecture 5: Evaluating Risk Predictions
    Risk predictions: differences from diagnostic tests; calibration and discrimination; comparing predictions; net benefit calculation; decision curves.

    Faculty:  Michael Kohn

    Location:  Mission Hall 1400

    • Session Slides:

    • PrognosticTests10-12-2017withLogarithmsLatest.pptx File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading:

      EBD-1, pages 138-150 on Prognostic Tests (posted below as a pdf)

      Vickers et al. Net benefit approaches to the evaluation of prediction models, molecular markers, and diagnostic tests. BMJ 2016;352:i6.

    • EBD-1_p138-155_PrognosticTests.pdf File
    • Vickers_Net_Benefit_BMJ_2016.pdf File

    • Optional Reading:

    • Vickers 2006 Med Decis Making Decision Curve Analysis File
      Not available unless: You belong to a group in Registered Students Only
    • Steyerberg_2014_Better_Prediction_Models File
      Not available unless: You belong to a group in Registered Students Only
    • Kerr 2015 Decision Curves File

  • Thursday, October 12, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 5

    Review HW-4 (Bias in Test Accuracy Studies)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107

    • Homework assignment #5, Evaluating Risk Predictions, due 10/19/17 at 1:00 PM

    • Epi 204 PSet5.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, October 19, 2017; 8:45 AM - 10:15 AM

    Lecture 6: Combining Tests and Multivariable Decision Rules
    Combining tests/diagnostic models:  Test non-independence conditional on D+/D-; recursive partitioning; logistic regression; importance of validation separate from derivation. 

    Faculty:  Michael Kohn

    Location: Mission Hall 1400

    • Session Slides:

    • CombiningTests10-19-2017.pptx File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading:

      EBD-1, p 156-185, Combining Tests and Multivariable Decision Rules (posted below as a pdf)

    • EBD-1_p156-185 Combining Tests.pdf File

    • Optional Reading:

  • Thursday, October 19, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 6

    Review HW-5 (Prognostic Tests)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Homework Assignment #6, Combining Tests, due 10/26/17 at 1:00 PM

    • Epi 204 PSet6.docx File
    • Optional Expanded Version of Ch07.06.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, October 26, 2017; 8:45 AM - 10:45 AM

    Lecture 7: Quantifying the benefits and harms of treatments using RCTS
    RCT checklist; importance of baseline incidence; measures of effect size: Relative risk (RR), relative risk reduction (RRR), Odds ratio (OR), Absolute risk reduction (ARR), Number needed to treat (NNT);   "Back of the Envelope Cost Effectiveness Analysis" 

    Faculty:  Ben Breyer

    Location:  Mission Hall 1400

    • Session Slides:

    • Session Audio/Video Recording (Access restricted to registered students):

    • Lec 7 RCT Breyer.ppt File
    • Watch (Mediasite version) URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading from Evidence-Based Diagnosis, 2nd Edition (EBD-2), which hasn't been published.

      Chapter 8 (posted below as a Word document)

    • EBD2-Ch8 Quantifying treatment effects 2017-1023 For Posting.docx File
    • PPT SLIDES FOR HowDoWeKnowWhatWeKnow for CTSI 2012-0717 File

    • Optional Reading:

    • LeNoury 2015 BMJ Restoring Study 329 File
      Not available unless: You belong to a group in Registered Students Only
    • Newman 2004 NEJM Antidepressant Perspective File
      Not available unless: You belong to a group in Registered Students Only
    • Stempel 2016 NEJM AUSTRI study Advair v fluticasone alone File
      Not available unless: You belong to a group in Registered Students Only
    • Stolker 2014 Circulation rethinking composite endpoints in clinical trials File
    • Ciani 2013 BMJ Surrogate vs patient relevant outcomes File
    • Miner 2017 Am J Gastro Pecanatide for chronic constipation File

    • Resources:

  • Thursday, October 26, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 7

    Review HW-6 (Combining Tests)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Optional Reading:

    • Homework Assignment #7 (RCTs) Due 1 pm on 11/2/2017

    • PSet7_RCTs.docx File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, November 2, 2017; 8:45 AM - 10:15 AM

    Lecture 8: Screening Tests
    Need for a more critical approach for screening tests, risk factor vs disease screening; biases in observational studies of screening: lead time bias, length time bias, volunteer bias, stage migration bias, pseudodisease; randomized trials of screening

    Faculty:  Martina Steurer-Muller
     
    Location:  Mission Hall 1400

    • Session Slides:

    • Lec 8 Screening (Martina) File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch (Mediasite version) Lec 8 2016 only fair sound quality URL
      Not available unless: You belong to a group in Registered Students Only
    • 2014 Lecture (Watch) URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading:

      EBD-1, p 116-137, Screening Tests (posted below as a pdf)

    • EBD-1 p116-173 Screening.pdf File

    • Optional Reading:

    • Merenstein D. Winners & Losers. JAMA 2004;291:242-5 File
      Not available unless: You belong to a group in Registered Students Only
    • Woloshin et al. Cancer Screening Campaigns — Getting Past Uninformative Persuasion. NEJM 2012; 367:1677-1679 URL
    • Heath 2014 BMJ Role of fear in overdiagnosis File
      Not available unless: You belong to a group in Registered Students Only
    • Heath 2013 BMJ Overdiagnosis When good intentions meet vested interests File
      Not available unless: You belong to a group in Registered Students Only
    • We're #37. (Song celebrating US Healthcare Ranking by Paul Hipp) URL
    • Newman 2016 JAMA IM Lipid screening in children-low value care File
      Not available unless: You belong to a group in Registered Students Only
    • Annas 1995 NEJM Reframing the Debate on Healthcare by replacing Metaphors File
    • Tilman 2014 Nature Global diets link environmental sustainability and human health File
      Not available unless: You belong to a group in Registered Students Only

  • Thursday, November 2, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 8

    Review HW-7 (RCTs)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Homework Assignment #8, Screening, Due 11/9/2017 1 pm: 

    • PSet8 Screening File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, November 9, 2017; 8:45 AM - 10:15 AM

    Lecture 9: P-Values and Confidence Intervals / Alternatives to RCTs

    Faculty:  Thomas Newman

    Location:      Mission Hall 1400

    • Session Slides:

    • Lec 8 Alternatives To RCTs and P-values 2017-1108 File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch (Mediasite version) URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading:

      EBD-2, Ch 9 Alternatives to Randomized Trials for Estimating Treatment Effects (posted below as a Word document)

      EBD-1, Ch 11 P-Values and Confidence Intervals (posted below as a pdf)

    • EBD-2 Chapter 9 2017-1108 File
    • EBD-1 Chapter 11 p220-238.pdf File
    • Goodman S 2008 Seminars Hematol Dirty Dozen P Value fallacies File

    • Optional Reading:

    • Laptook 2017 JAMA Effect of therapeutic hypothermia after 6 hours Bayesian example File
    • Quintana 2017 JAMA Bayesian analysis. Using prior information to interpret results of clinical trials File
    • Browner WS, Newman TB. Are all significant P-values created equal? The analogy between diagnostic tests and clinical research. JAMA 1987;257:2459-63 File
      Not available unless: You belong to a group in Registered Students Only
    • Goodman, S. Toward evidence-based medical statistics. 1: The P value fallacy. Annals of Internal Medicine 1999; 130: 995-1004 File
      Not available unless: You belong to a group in Registered Students Only
    • Goodman, S. Toward evidence-based medical statistics. 2: The Bayes factor. Annals of Internal Medicine 1999; 130: 1005-1013 File
      Not available unless: You belong to a group in Registered Students Only
    • Newman, T. If almost nothing goes wrong, is almost everything all right? JAMA 1995; 274: 1013 File
      Not available unless: You belong to a group in Registered Students Only
    • Goodman S 2013 Circulation Are we there yet File

  • Thursday, November 9, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)

    Small Group Discussion Section 9

    Review HW-8 Screening

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2108, Rodriguez MH-2106, Cage MH-2105, Peyvandi MH-2107


    • Homework Assignment #9:  Due November 16, 2017 at the beginning of Small Group Section

    • PSet9 PValuesAndMore File

    • Assignment Answer Key (Access restricted to registered students):

  • Thursday, November 16, 2017; 8:45 AM - 10:15 AM

    Lecture 10: Cognitive Biases / Course Review

    Faculty:  Michael Kohn

    Location:  Mission Hall 1400

    • Session Slides:

    • Lecture10CognitiveBiasCourseReview File

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch (Mediasite versiion) URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Required Reading:

      EBD, Chapter 12

    • EBD-2 Ch 12 CognitiveBiasesForPosting 2017.1116 File

    • Optional Reading:

    • Rosenbaum 2014 NEJM Invisible risks File
      Not available unless: Your ID number contains 02
    • Newman, TB. The Power of Stories over Statistics.BMJ. 2003;327(7429):1424-7 File
      Not available unless: Your ID number contains 02
    • Newman TB, Maisels, MJ. Less Aggressive Treatment of Neonatal Jaundice and Reports of Kernicterus: Lessons About Practice Guidelines. Pediatrics 2000;105:242 File
      Not available unless: Your ID number contains 02
    • Newman TB, Johnston BD, Grossman DC. Effects and costs of requiring child-restraint systems for young children traveling on commercial airplanes.Arch Pediatr Adolesc Med. 2003 Oct;157(10):969-74 File
      Not available unless: Your ID number contains 02
    • Bishai D. Hearts and Minds and Child Restraints on Airplanes. Arch Peds Adol Med 2003;157:953 File
      Not available unless: Your ID number contains 02
    • Healy B. Who Says Whats Best? US News World Rept URL
    • Newman TB. Universal Bilirubin Screening, Guidelines and Evidence. Pediatrics 2009 File
      Not available unless: Your ID number contains 02

  • Thursday, November 16, 2017; 1:00 PM - 2:30 PM (Times and dates for online sessions may differ)


    Small Group Discussion Section 10

    Review HW-9 (P-Values, Confidence Intervals)

    Faculty:  Kevin Selby, Luis Rodriguez, Tene Cage, Shabnam Peyvandi, Benjamin Breyer, Martina Steurer-Mueller, Tom Newman, Michael Kohn,
     
    Location:  Selby MH-2106, Rodriguez MH-2107, Cage MH-2105, Peyvandi MH-2108

  • Thursday, November 23 - No Class - Thanksgiving Holiday

  • Thursday, November 30, 2017; 8:45 AM - 10:15 AM

    Lecture 11: Final Exam Review
     
    Faculty:  Michael Kohn

    Location: Mission Hall 1400

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch (Mediasite version) URL
      Not available unless: You belong to a group in Registered Students Only
    • .mp4 URL
      Not available unless: You belong to M Laker

    • Assignment: TAKE-HOME FINAL EXAM DUE THURS 11/30 8:45 AM

    • Final EXAM epi 204 2017-11-20 File

    • Note: I may post clarifications in response to forum posts!

    • EPI 204 Final Exam - upload PDF here if you are unable to attend class Assignment

      Please use this option if you are unable to attend this session.  Please upload as a .pdf such that all your formatting will be preserved.

    • Final Examination Answer Key (Access restricted to registered students):

  • Thursday, November 30, 2017; 1:00 PM

    No Small Group