Epi Tools Everyone Can Use

1
Epi Tools Everyone Can Use

• Emily Mosites, MPH
• Alice Green, DVM
• Katie Garman, MPH

2
Objectives

• Review concepts from regional outbreak training
• Line list
• Resources for outbreaks
• Demonstrate use of statistical software to
  develop
• Epi-curve
• Symptom profile
• 2x2 tables (OR, RR)
• Data management/ analysis tips

3
Regional Outbreak Training Objectives

• Provide Regional Health Departments with tools to
  investigate clusters and outbreaks
• Today foodborne diseases
• Concepts are generalizable
• Promote collaboration and understanding between
  epidemiologists/CEDS staff, environmentalists,
  and laboratorians
• Epi-Ready model

4
The Stool
5
(No Transcript)
6
Tools

• Many tools you can use
• Todays focus
• Excel
• SAS
• EpiInfo

7
Compile a Line list Excel
8
Data Entry Tips

• Blank does not equal No
• Single-word variable name
• Use 1 yes 0 no OR 1yes 3no
• Proper alignment to calculate RR

9
Analysis in Excel
10
Why Excel?

• If you dont want to start having dreams in SAS
  code
• If you have never heard of EpiInfo
• If you find yourself doing analysis in the middle
  of the woods with only Microsoft Office
• USE EXCEL!!!

11
Overview

• Summarizing Data with PivotTables
• RR, OR, and Chi Squares Test Page
• Incubation period and EpiCurve
• We will send you an excel workbook with these
  formulas and explanations!

12

Why use SAS in an outbreak investigation?

• Its powerful
• Fishers exact
• Easy to screen large numbers of variables
• Its subsidized by CDC
• Its fun!!
• Embrace your dorkiness

13

14

15

16

17

18

19

20

21

22

Fishers Exact Test

23

24

Meal Date (exposure)

25

Illness Onset Date

26

End Illness Date

27

• Why use Epi-Info (Version 3.5.1)
• Easy
• Point and click
• Rapid questionnaire development
• Simple commands
• Accessible
• available anywhere at anytime at www.cdc.gov
• FREE

28
www.cdc.gov/epiinfo
29
Click on analyze data
30
Click on Read (Import)
31
Select the correct data format
Find your file
32
Make sure all of your records have been imported
33
Start looking at your data
34
Select
Type 1 to select those who were sick
Select your variable
35
List
Select your variable
Sick 1 is selected To unselect click on cancel
select
36
Create symptom profile using frequency command
37
Frequencies
Stratify by sick
Select your variables
38
Symptom Profile
39
Develop an epi curve using the graph command
40
Graph
Select Bar
Choose onset date
41
(No Transcript)
42
Calculating relative risk or odds ratio using the
tables command
43
Remember

• In order to calculate RR
• 1 yes
• 3 no

0 well 1 ill
BBQ 15 20
No BBQ 20 5
1 ill 3 well
BBQ 20 15
No BBQ 5 20
RR 15/(1520) 0.53 20/(205)
RR 20/(2015) 2.85 5/(520)
44
Add outcome variable
Add exposure variable
45
BBQ Chicken
46
Sweet Tea
47
Resources for Outbreaks
48
http//health.state.tn.us/ceds/resources.htm
Modifiable gastrointestinal outbreak
questionnaires
Sample databases
49
Thank you!

• Connie Robinson and staff
• Rand Carpenter
• John Dunn

50
Questions

• Emily Emily.Mosites_at_tn.gov
• Alice Alice.Green_at_tn.gov
• Katie Katie.Garman_at_tn.gov
• 615-741-7247