Beruflich Dokumente
Kultur Dokumente
(EC05)
Module: EPM301 Epidemiology of Communicable Diseases
Course: PG Diploma/ MSc Epidemiology
This document contains a copy of the study material located within the
computer assisted learning (CAL) session. The first three columns designate
which page, card and screen position the text refers to.
If you have any questions regarding this document or your course, please
contact DLsupport via DLsupport@lshtm.ac.uk.
Important note: this document does not replace the CAL material found on
your module CDROM. When studying this session, please ensure you work
through the CDROM material first. This document can then be used for
revision purposes to refer back to specific sessions.
These study materials have been prepared by the London School of Hygiene & Tropical Medicine as
part of the PG Diploma/MSc Epidemiology distance learning course. This material is not licensed either
for resale or further copying.
London School of Hygiene & Tropical Medicine September 2013 v2.0
Objectives
By the end of this exercise you should:
This session should take you between 45 mins and 1h30 mins to complete.
The only prerequisite is that you have completed sessions 1 4 of this unit
before starting the exercise. Session EC04 gives information on how to conduct
an outbreak investigation.
Section 3: Introduction
The exercise aims to simulate an investigation of a disease outbreak, and
involves the following stages:
1.
2.
3.
4.
data collection
data entry and cleaning
data analysis
interpretation and presentation
3.1: Introduction
Because you are working at a distance, you will need to be patient about
getting feedback and contributions from other members of the group. Do not be
tempted to complete the task on your own!
Group work provides many benefits that are not available to someone working
alone.
These are:
The groups will be allocated according to the time window when you are willing
and able to undertake this exercise.
It is likely that your background, training and experiences will differ from those
of other group members. This variety of experience and combined knowledge
can lead to interesting discussions and help the group to manage the task
effectively.
There are just a few things to consider if you are not used to working in a group,
and these will be reviewed on the next page.
The members of a group can contribute differently to the way in which the
group works and to the final product.
In fact, different characteristics are often required for the group to work well
together. Some of these have been listed on the opposite page you may be
aware of others.
Click on each to see a description of what the role involves.
Co-ordination
Motivation
Creativity
Resourcefulness
Evaluation
Team Work
Monitoring
Implementation_
Co-ordination
Motivation
Creativity
Resourcefulness
Evaluation
Team Work
Monitoring
Implementation_
Every effort should be made to include all members in each stage of the task, but
where tasks need to be allocated it may be useful to divide the responsibilities
between the group members according to each individual's perceived strengths.
Co-ordination
Motivation
Creativity
Resourcefulness
Evaluation
Team Work
Monitoring
Implementation_
The process of a group collaboration can be grouped into three main phases:
starting, progressing and summarising.
(i) Starting
It is useful to start by trying to generate ideas about the project. This is often
referred to as brainstorming, and involves sharing any ideas that you have with
the rest of the group. The other members of the group can then give their
comments on the ideas. This often gets the discussion started. It is important to
critically evaluate the ideas and developments at every stage, but remember that
this should not involve criticising any specific individual.
This should lead to the development of a framework of how to proceed with the
task, which will help to give the work focus.
Section 6: Instructions
Once you have registered your availability, you will be informed of the time
window to which you have been allocated. The final allocation will depend on
the availability of other group members.
In the weeks before the start of the exercise, you should work through Session
EC04, or review the material if you have completed the session previously.
Before the start of the exercise you will be contacted by DL support who will
inform you which group you have been assigned to. You will also be provided
with instructions about how to contact the other members of your group via a
conference on Moodle, which only the members of your group and your tutor
will be able to access during the exercise.
Once you have received this information, it is your responsibility to establish
contact with the other members of your group, and to introduce yourself to
them.
We suggest that you do this as soon as possible, in case there are any problems
with communication or with the availability of other group members.
A tutor, who will be assigned to your group during the six-week period, will
introduce his/her self to you through your groups Moodle conference.
6.1: Instructions
The exercise
There are two choices for the outbreak exercise developed and developing
country setting. Both options follow a similar format.
You are a team of health professionals that are responsible for investigating the
outbreak and have to advise the local health authority on the necessary control
measures.
Your group will need to obtain relevant data to enable you to identify the cause
of the outbreak, and to decide on appropriate measures necessary to stop
further cases of the disease.
6.2: Instructions
You have 6 weeks to complete the exercise, but remember that you will need to
allow some time for communicating with all the group members and receiving
feedback.
In a real outbreak situation, you would need to act quickly to identify the cause
of the outbreak and implement appropriate control measures. For the purposes
of this exercise, you should consider one week of the exercise to be
approximately equivalent to one day in a real outbreak situation.
The following is suggested as an approximate time frame for the exercise. You
may prefer to distribute the time differently.
1. Data collection:
i.
ii.
iii.
6.3: Instructions
1. Data collection
As a group, you need to design a questionnaire that can be administered to the
relevant people to help you identify the cause of the outbreak. You will need to
consider what questions you wish to ask, and to whom you want to administer
the questionnaire.
You will be given a chance to pilot the questionnaire on 2 people. Send the draft
questionnaire as a word document as anattachment to your tutor, along with the
names of the first two interviewees. The questionnaire should be approximately 1
side of A4 (21cm x 30cm) paper, and take 5 10 minutes to administer.
6.4: Instructions
1. Data collection (continued)
The tutor will send you the 2 pilot responses for the questionnaire. Look
carefully at these responses to see if you need to make any changes to the
questionnaire. Your tutor will only give you the responses to your questionnaire,
and won't give any other specific feedback unless he/she feels that you might
be making a major omission.
We suggest that you send the pilot questionnaire to your tutor after one week, to
give sufficient time to receive the pilot responses and re-design the questionnaire
by the end of week 2.
After making final changes, you need to submit the final questionnaire as before
to your tutor, as an unformatted text file attachment. You will also need to send
a list to your tutor of all the individuals you want to administer the
questionnaire to.
Because the data you receive will depend on the nature of your questionnaire,
you need to allow one full week for your tutor to collate and return all the
responses.
6.5: Instructions
1. Data collection (continued)
To summarise the data collection process:
6.6: Instructions
2. Data entry and cleaning
The data will be returned to you with a separate page for each respondent.
We suggest that you prepare an Epi-Data questionnaire and check file while you
wait for the responses to be returned to you. Once you receive the responses,
this file can be used for data entry.
The group needs to decide on the best method for entering the data accurately.
You also need to think about checking the data quality. You may wish to refer to
EP103 to remind yourself of the methods for entering, checking and cleaning
data.
6.7: Instructions
2. Data entry and cleaning (continued)
More information available in this exercise
After an initial look at the responses you receive, you may realise that you need
more information. In real life, you might have laboratory tests done or be able
tore-interview people.
However, laboratory tests will be dependent on the accessibility and reliability of
local laboratory facilities. Individuals may refuse to give samples. You also need
results fast remember that you are carrying out a rapid investigation to stop
the disease from spreading!
Following-up individuals can also have drawbacks. Individuals may die or be
absent, and most commonly, there is a recall error. For example, try
remembering what you ate 2 weeks ago!
6.8: Instructions
2. Data entry and cleaning (continued)
Laboratory tests
You can request tests using the format shown opposite in a posting to your
tutor on the Moodle page for the outbreak exercise.
Laboratory facilities may be limited, and you will be sent further details of this
relevant to your specific outbreak.
Allow 5 working days for the tests to be carried out and the results returned to
you.
Name and identifier of person/object:
Type of specimen:
Type of test:
6.9: Instructions
2. Data entry and cleaning (continued)
Re-interviewing
If necessary (and if there is enough time), you will have the opportunity to reinterview each person once. This is not a chance to re-administer the
questionnaire, so you will only be able to ask the SAME 2 questions to each
person. Again allow 5 working days for the responses to be returned to you.
These further questions can be submitted in a posting to your tutor via Moodle
using the following format:
Name of person and identifier:
Question 1:
Question 2:
6.10: Instructions
3. Data analysis
After entering the data in Epi-Info, you will need to agree on the analyses you
wish to do. Refer to EC04 for help with this.
Data analysis can be carried-out in either Epi-Info or STATA, depending on
which software package you feel more comfortable with.
Follow the instructions opposite if you wish to export your data to STATA.
Interaction: Tabs: Out of Epi-Info:
Follow these steps in Epi-Info:
1. Choose Export files from the Programs drop-down menu.
2. Enter the Epi-Info file name; using the arrows, move the cursor to select the
Delim file format; choose an output file name and select OK.
Interaction: Hyperlink: Delim file format (pop up box appears):
This produces a comma and quote delimited file with a * .sdf file extension. All
fields are delimited by quotation marks and separated by commas. The first 3
records contain field lengths, data types and field names.
Interaction: Tabs: Into STATA:
3. In the EPED text editor in Epi-Info,
open the delimited file which will have an *.sdf extension. Delete only the first
two lines of the file, which contain the field lengths and data types. Be very
careful not to delete any of the variable names! STATA needs the field
names, so this should now be the first line. Save this file in the same format.
4. In STATA, type the following at the
command prompt: insheet using
filename.sdf, names.
Replace 'filename' with the directory and file name as appropriate. This file can
then be saved in STATA format using the save filename command.
Interaction: Tabs: Date format:
If you have dates in your dataset, STATA will read them as text instead. You will
be able to view the correct dates, but not to manipulate them as dates. To use
the dates in any analysis, you will need to create a new date variable using the
following commands:
generate newdate = date(olddate,DMY)
format newdate %dD/N/CY
Replace 'olddate' with the name of the
Epi-Info date variable and 'newdate' with the name of your new date variable.
The second command will create a user-friendly format to view the new date
variable.
6.11: Instructions
3. Data analysis (continued)
Graphics
If you wish to include any graphs in your final report, we recommend that you
produce them in STATA (save the graph as a Windows Metafile type *.wmf file
for printing or importing into a word-processing package).
Alternatively if you have access to any spreadsheet software (e.g. Excel,
QuatroPro) these will also allow you to produce and print out graphs.
Map of outbreak (developing outbreak only)
A map of the outbreak can be produced using powerpoint to show the location
of cases and other relevant information. A map template will be sent to you at
the beginning of the outbreak, with instructions on how to edit the map. You
will be able to share copies of this map file between members of your group by
email. You may wish to save multiple versions, if group members are plotting
different types of data.
We suggest that you include the final map(s) you produce as part of your final
report. The map file(s) should be sent as an e-mail attachment along with the
report document.
6.12: Instructions
4. Interpretation and Presentation
The interpretation of your analyses will require discussion among the group. We
recommend that your interpretation is ongoing, from the moment you receive
your data and start to analyse it.
Remember that you are a team of professionals, and you need to produce one
coherent report for the health authorities. It is important that you aim to reach a
consensus when interpreting the data. If there are very strong differences of
opinion that cannot be resolved you may want to try expressing these viewpoints
but if the report is confusing, the recipients will not be happy!
So that all group members can contribute to and comment on the summary
document you produce, it is important that you work in a format that is
compatible within the group. Not all students have the same word-processing
software, so find out what software each member has and use one that
everybody can read.
Once the exercise has been completed and marked, you will receive feedback on
the exercise from your tutor.
The report of your investigation will be assessed and you will receive feedback.
The report will need to include the following information:
The report should be no more than 5 pages of single-spaced text (not counting
tables, figures and references). Font should be no smaller 11 point with sensible
margins (2cm all round is ok). Please include the final version of your
questionnaire as an appendix to your report.