Statistics, epidemiology and history of the healthcare services

A.Y. 2020/2021
7
Max ECTS
56
Overall hours
SSD
MED/01 MED/02 MED/42
Language
Italian
Learning objectives
The course aims to provide students with the basics to:
· acquire advanced knowledge of the historical dimension of medicine, in order to better understand the evolution of the professional figures of the health professional and the doctor-surgeon; ù
· acquire knowledge to reflect on "human facts", generally considered as "past", to attempt the encounter between two levels of humanity: the time lived by men of the past and the present in which it develops the effort to recall this past, so that the man of the future will benefit from it;
· acquire the statistical knowledge necessary to be able to process a set of data and draw up a reporting document indicating the analyzes carried out and the results achieved for the purpose of research and / or planning of management activities of a health facility;
· demonstrate and understand the aims of the Epidemiology, the methods of investigation, and the related fields of application.
Expected learning outcomes
Undefined
Course syllabus and organization

Single session

Responsible
Lectures will still take place in classrooms; if students can't reach the buildings we might consider alternative ways.
Prerequisites for admission
Basic algebra and elements of geometry.
Assessment methods and Criteria
Written examination with a combination of multiple-choice questions (1 right, 4 wrong answers) and small problems or toy examples with a series of questions to reply. Every question has its mark indicated in the written examination. Students who gain a final mark higher than 30 will receive a mark of 30 cum laude. A calculator and the tables of the probability distributions found in Ariel are necessary to solve the written examination. Students are allowed to fill in a form with all the formulas to keep during the examination. Results will be provided to the students via Ariel.
Medical statistics
Course syllabus
Reliability of a measure
∙ Reliability and its components
∙ Systematic error and casual error
Variability
Between-subjects and within-subjects variability
Descriptive statistics
∙ Graphs
∙ Location, scale, and shape of a frequency distribution
∙ Measures of location and scale
∙ Accuracy and precision of a measure
∙ Quantiles and reference limits
∙ Correlation coefficient and Kappa statistic
Gaussian model
∙ Probability of events on the population within the Gaussian model
∙ How to model the error with a Gaussian model
Screening programs
∙ Events
∙ Probability: concept
∙ Probability of an event: algebra
∙ Basics of probability
∙ Screening programs: why
∙ True and false positives, true and false negatives
∙ Sensitivity and specificity of a diagnostic tool
∙ Positive (negative) predictive values
∙ Likelihood ratio: positive and negative
∙ Pre-test and post-test probabilities
∙ Bayes theorem
Inference
∙ Sampling variability
∙ Population and sample
∙ Estimate of a population parameter with sampling quantities
Sampling distribution
∙ The central limit theorem and the distribution of a sampling quantity
∙ Standard error
Confidence interval
∙ Definition and meaning
∙ Formulas
Hypothesis testing
∙ First type and second type errors and power of a test
∙ Sample size calculation
∙ Clinical statistics and clinical relevance
∙ Hypothesis testing on a population mean
Deterministic and probabilistic models
∙ Deterministic and probabilistic models: differences
∙ Simple linear regression model: interpretation and parameters
∙ Hypothesis testing on the parameters of a simple linear regression model
Teaching methods
Teaching through slides and blackboard use with a problem-solving approach; practical sessions of exercises; slides and exercises available from Ariel for additional homeworks.
Teaching Resources
M. Pagano and K. Gauvreau Principles of Biostatistics, Chapman and Hall/CRC;
M. Bland An Introduction to Medical Statistics (English Edition) 4th Edition, Oxford University Press;
Elmore - Wild - Nelson - Katz Jekel's Epidemiology, Biostatistics, Preventive Medicine, and Public Health, Elsevier - Health Sciences Division, 2020 (in press);
Medical history
Course syllabus
- The origins and meaning of Medicine and the History of Medicine
- Study and research sources: Medicine in ancient Greece and Rome. Medieval Medicine; Knowing the body:
Renaissance and Animated Anatomy. Iatrophysics and Iatrochemistry. Microscopic anatomy.
- Enlightenment and public health: occupational diseases, hygiene and preventive medicine, vaccine prophylaxis,
orthopedics, humanitarian treatment of the mentally ill persons.
- The birth of Clinics and its tools: semeiotics, diagnostics and therapy; Surgery problems and their solution:
analgesia, anesthesia, asepsis and antisepsis. Cell theory and microbiology.
- The 20th century: new concepts, tools and therapies; Evolution and transformation of hospitals.
- Elements of the history of public health in Lombardy
Teaching methods
The teaching is provided through frontal classroom lessons
Teaching Resources
. Porro A., Franchini A.F., Cristini C., Galimberti P.M. Lorusso L., Falconi B., Lezioni Di Storia Della Medicina. Gli Strumenti 3, Rudiano, Gam, 2013.
- Porro A., Cristini C., Falconi B., Franchini A.F., Galimberti P.M., Lorusso L., Lezioni Di Storia Della Medicina 2, -Rudiano, Gam, 2011.
- Porro A., Falconi B., Franchini A.F. Lezioni Di Storia Della Medicina 1, Rudiano, Gam Editrice, 2009.
Porro A., Storia Della Medicina 1 (Fino Al Xix Secolo). In Appendice: Storia Dell'odontoiatria, Rudiano, Gam Editrice, 2009.
- Belloni L., Per La Storia Della Medicina, Sala Bolognese, Forni, 1990.
Hygiene and public health
Course syllabus
. Meaning and use of the epidemiological method: from data analysis to programming and evaluation within the health system.

2. Use of current health data in epidemiology.
- Characteristics of current data sources.
- Main sources of health data.
- The indicators: meaning and use.
- Methodological aspects related to the use of administrative data for planning and research.
- Guided analysis of current health data.

3. Frequency measures: ratios, proportions, rates;
- Concept of prevalence, incidence, density of incidence, cumulative incidence standardization of rates

4. Study plans and their application for need assessment, analysis of care problems, assessment of the quality of care.
- Ecological (or correlation) studies and their application: the search for differences.
- Prevalence studies and their application.
- Incidence studies and their application. Case control studies and their application. Experimental studies.

5. Association and impact measures: relative risk, odds ratio, risk attributable as absolute measure and as relative measure

6. Random and systematic error in Epidemiology. The confusion

7. Studies to evaluate the quality of health care
- The assessment of needs.
- Assessment of organizational aspects in the delivery of health care services.
- Evaluation of the results.
Teaching methods
The teaching is provided through frontal classroom lessons, scheduled according to a timetable published on the ARIEL website of the course of study.
Teaching Resources
Signorelli C.: Elementi di metodologia epidemiologica. SEU Roma
Hygiene and public health
MED/42 - HYGIENE AND PUBLIC HEALTH - University credits: 2
Lessons: 16 hours
Professor: Amendola Antonella
Medical history
MED/02 - MEDICAL HISTORY - University credits: 2
Lessons: 16 hours
Professor: Porro Alessandro
Medical statistics
MED/01 - MEDICAL STATISTICS - University credits: 3
Lessons: 24 hours
Professor(s)
Reception:
For meetings, please write an email.
Campus Cascina Rosa, via A. Vanzetti, 5, 20133 Milano - room number 3 - 4
Reception:
previo appuntamento e-mail
Padiglione Centro Ipertensione - Ospedale maggiore Policlinico - 1* p.