FEM-WIKI

Welcome to FEMWIKI

The Field Epidemiology Manual was originally developed by the ECDC to support the European Programme for Intervention Epidemiology Training (EPIET). Trainers, supervisors, scientific coordinators, and facilitators created draft chapters using the lectures they delivered during the EPIET introductory course. The philosophy of sharing and building knowledge (in particular training materials) led to the creation of a collaborative information space for the epidemiological training community - The FEM Wiki.

Eventually, the ECDC decommissioned the FEM Wiki and archived the last version as a PDF. Since FEM Wiki content was developed under Creative Commons, the Dutch Public Health Learning Support Company Transmissible decided to reinstall the Field Epidemiology manual as it was intended: a professional collaborative platform.

The aim of the FEM Wiki is to create a library of training materials for field epidemiology training programs.

Article Portal

Assessing the burden of disease and risk assessment -- (approved version) 
Descriptive data analysis

Analysis by person characteristics

Analysis by place characteristics -- (approved version) 

Choosing an appropriate type of map Which indicator to map? -- (approved version)

Analysis by time characteristics 

Methods for setting thresholds in time series analysis -- (approved version) Smoothing techniques for describing time series -- (approved version) Spatial Analysis (Geographical Information Systems)

Epidemic Intelligence 
Rapid Risk Assessment 

Classifying and Measuring Risk Identifying Risk Stage 0: Preparation for rapid risk assessment Stage 1: Collecting event information Stage 2: Systematically collecting information Stage 3: Extracting relevant evidence Stage 4: Appraising evidence Stage 5; Estimating the risk

Surveillance - Principles -- (approved version) 

Criteria for Surveillance Event-based Surveillance

Indicator-based Surveillance
Establishing a Surveillance System
Analysis of Surveillance Data 

Analysis, Interpretation and Dissemination -- (approved version) Quality checking -- (approved version) Common errors in surveillance data analysis

Evaluation of Surveillance Systems

10 common errors in surveillance evaluations Quality, Governance and Operating Procedures -- (approved version)

Surveillance attributes for evaluation

capture-recapture Sources and Types of Data -- (approved version)

Types of Surveillance System (Active vs Passive)

Surveillance System Design and Operation -- (approved version) Uses of Surveillance Data Objectives of Surveillance – Inputs and Outputs -- (approved version) Opportunities and Challenges -- (approved version) Surveillance or Research? -- (approved version) The Components of Surveillance The Role of Surveillance -- (approved version)

Field Epidemiology 

Combining Studies: Meta-Analysis Key definitions in infectious diseases epidemiology

Measurement in Field Epidemiology
Cluster Investigations

Statistical Methods for Cluster Investigation Types of Cluster Getting Measurement Right Measures of association

Measures of Disease Impact -- (approved version) 

Impact numbers Measures of disease impact - Further reading -- (approved version) Measures of impact among the exposed -- (approved version) Measures of impact in the population -- (approved version) Quantifying disease burden -- (approved version)

Measures of Disease Occurrence 

Attack rates and case fatality Incidence rate -- (approved version)

Odds 

Probability Prevalence -- (approved version) Relation between risk and incidence rate Risks and Rates

Problems with Measurement
Bias 

Detection Bias

Effect Modification and Confounding -- (approved version) 

Confounding in studies -- (approved version) Criteria for confounding -- (approved version) Dose Effect -- (approved version) Effect Modification -- (approved version) Interaction -- (approved version) Residual Confounding -- (approved version)

Information (Measurement) Bias 

Interviewer Bias Recall Bias Reporting Bias Response Bias Preventing bias

Selection Bias 
Selection bias and case-control studies 

Ascertainment Bias Diagnostic bias Non-response bias Referral bias Survival bias Selection bias and cohort studies

Testing the Tests -- (approved version) 

Diagnostic tests versus screening tests -- (approved version) Glossary -- (approved version) Parallel versus Serial testing -- (approved version) Receiver operating curve -- (approved version) Test Precision Test reliability -- (approved version) Test Reproducibility Threshold setting -- (approved version) Validity and accuracy -- (approved version)

Methods in Field Epidemiology
Scientific (evidence base for prevention)
Causal Inference -- (approved version) 

Causal mechanisms -- (approved version) Viewpoints for Causality (Bradford Hill) -- (approved version)

Types of Study 
Analytical Study Designs 

Advantages and disadvantages of cohort and case control studies

Case-control studies -- (approved version) 

Case-cohort study -- (approved version) Density case control studies Table measuring risk, rate and odds ratio Traditional case-control studies -- (approved version)

Choosing a Reference Group -- (approved version) 

Control Selection Developing a control definition Special Considerations in Control Selection -- (approved version)

Cohort studies -- (approved version) 

Measuring incidence rates Measuring risk Reference group for cohort studies -- (approved version) Cross-sectional Studies

Matching -- (approved version) 

Advantages and disadvantages of matching -- (approved version) Principles of matching Restriction -- (approved version) Table format and Analysis -- (approved version) Measures of effect in various study designs -- (approved version)

Non-traditional designs -- (approved version) 

Case cross over studies -- (approved version) Case to case study design -- (approved version) Descriptive Studies Experimental Studies

Outbreak Investigations -- (approved version) 
Case definitions for outbreak assessment -- (approved version) 
Case Definitions

Defining a Case Sensitivity and Specificity of a case definition Various Levels of Case Definition

Confirm the outbreak 
Types of Outbreak 

Continuing Source Distinguishing Different Sources or Modes of Transmission during an outbreak -- (approved version) Identifying Multiple Possible Outbreak Sources -- (approved version) Person to Person Point Source

Refining the estimated point in time of an outbreak source 

Incubation period, Latent period and Generation time. Unmasking Outbreak Source through Segmentation -- (approved version) Vector Borne

Describe the outbreak
Construction of Epidemic Curves -- (approved version) 

Diagnostic Applications of the Epidemic Curve -- (approved version) Disentangling Complex Data -- (approved version) Use of Epidemic Curves for characterising Outbreak Sources -- (approved version)

Informing Action / Improving Knowledge

Additional resources for presenting findings -- (approved version) Choosing a method of data display -- (approved version)

Communication of findings
To professionals

Definition of an Outbreak Investigation Report -- (approved version) Frequent Problems with writing an Outbreak Investigation Report -- (approved version) Structure of an Outbreak Investigation Report -- (approved version) Writing an Outbreak Investigation Report -- (approved version)

Writing style of an Outbreak Investigation Report -- (approved version) 

SOCO (single over-riding communications objective) To Public and the Media

Graphs, charts, diagrams -- (approved version) 

Bar graphs Frequency polygons Histograms Line graphs Other types of data display Pie charts -- (approved version) Interpreting Data Maps -- (approved version) Presenting Data -- (approved version) Tables -- (approved version) Types of variables and line listing -- (approved version) Use of computers -- (approved version)

Investigations in Special Circumstances

Disasters and Emergencies Health care settings Possible Terrorist / Deliberate Event Prisons Schools Outbreak investigations: 10 steps, 10 pitfalls Outbreak steps : additional points

Rationale for Outbreak Investigations

Public health response (informing control) The outbreak management team Formal Risk Assessment

Health Economics

Cost-effectiveness Cost-minimisation Cost-utility Measuring the Quality of Healthcare Sensitivity Analysis

Screening

Evaluation of Screening Measures of Accuracy in Screening Principles of Screening

General Communication

Aide memoire for oral presentations and visual aids

Health communication

Crisis communication Health advocacy Health education Health literacy Outbreak communication Risk communication Social marketing

Writing a Study Protocol -- (approved version) 
Analysing a public health problem 

SMART definitions Checklist for study protocols Data collection instrument

Questionnaire Design -- (approved version) 

Advantages and Disadvantages of Questionnaires Bias in Questionnaires -- (approved version)

Hints to Design a Good Questionnaire -- (approved version) 

Questionnaire Layout and Coding -- (approved version) Seven Golden Rules to Design Questions -- (approved version) Piloting Questionnaires Ten Steps to Design a Questionnaire Types of Questionnaires -- (approved version)

Types of Questions -- (approved version) 

Format of closed questions -- (approved version) Validated questionnaires

Writing for Publications

Checklist for posters -- (approved version) Scientific paper review form Writing for Stakeholders

Infection control and hospital hygiene

Antimicrobial stewardship Healthcare-associated infection prevention and control as a part of patient safety programme

Healthcare-associated infection prevention and control programme

Cooperative learning as active learning in adult Education and training of staff

Healthcare-associated infections and risk assessment

Burden of HAIs

Main pathogens and resistance
Antimicrobial resistance.

Acquired resistance Mechanisms of antimicrobial resistance Multidrug-resistant organisms (MDRO)

Types of HAIs

CAUTI CLABSI SSI VAP

Infection control interventions

Cohorting patients and/or staff Contact precautions Developing infection control interventions: isolation Environment as a source of healthcare-associated infections

Hand hygiene

Gloves and hand hygiene

Hand hygiene - principles

Five moments for hand hygiene Hand hygiene before invasive procedures Hand hygiene for patients and visitors Indications for hand hygiene Hand hygiene education and promotion Hand hygiene methods

Hand hygiene products selection and evaluation

Aesthetic preferences Evaluation of the microbicidal activities of hand-rub and hand-wash agents Pilot testing Product accessibility and cost Selection and evaluation for specific products Microbial flora of the hands Nails, rings, watches, bracelets Skin care Hospital cleaning and decontamination Immunization of health care workers Isolation of patients with Clostridium difficile infection (CDI) Methods for assessing environmental cleanliness Microbial typing Molecular epidemiology Pre-emptive isolation Reprocessing of flexible endoscopes Standard precautions

The role of the clinical microbiology laboratory in infection prevention and control

Clinical role of the microbiology laboratory. Epidemiological/public health role of the clinical microbiology laboratory

Surveillance and investigation of healthcare-associated infections
Case definitions of healthcare infections
HAI case definitions for use in hospitals

Bloodstream Infection Bone and Joint Infection Cardiovascular System Infection Catheter-Related Infection Central Nervous System Infection Eye, Ear, Nose or Mouth Infection Gastrointestinal System Infections Lower Respiratory Tract Infection other than pneumonia Pneumonia Reproductive Tract Infections Skin and Soft Tissue Infections Specific Neonatal Case definitions Surgical Site Infection Systemic Infections Urinary Tract Infection

European surveillance of healthcare-associated infections
ECDC point prevalence survey of healthcare-associated infections and antimicrobial use in acute care hospitals
ECDC “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol

ECDC “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals”, definition of healthcare-associated infection ECDC PPS - antimicrobial use definition ECDC PPS - inclusion/exclusion criteria ECDC point prevalence survey of healthcare-associated infections and antimicrobial use in long term care facilities ECDC surveillance of Surgical Site Infections

HAI Surveillance at the EU level - importance of international networks

ECDC Programme on antimicrobial resistance and healthcare-associated infections European Antimicrobial Resistance Surveillance Network (EARS-Net) European Surveillance of Antimicrobial Consumption Network (ESAC-Net) Healthcare-Associated Infections Network (HAI-Net) Surveillance of Clostridium difficile infections Surveillance of HAIs in intensive care units The European Surveillance System (TESSy)

Surveillance of healthcare-associated infections - definition

Surveillance methodologies for healthcare associated infections

Surveillance of healthcare-associated infections - other approaches

Surveillance for MV Patients in the ICU

Introduction to Public Health and basic concepts 
Public Health Informatics -- (approved version) 

Apps for epidemiologists

Data Capture Systems

Electronic Data Transfer Online Reporting Web-crawling Applications

Health Informatics Standards – general introduction -- (approved version) 

Health Informatics Standards - Health Information Systems and Processes Health Informatics Standards - Standard Content Software for epidemiologists -- (approved version) Weblinks for epidemiologists

Public Health Interventions -- (approved version) 

Contact tracing Host -- (approved version)

Prevention -- (approved version) 

Hygiene and Sanitation

Primary prevention 
Vaccination

Herd immunity Measuring protection Secondary prevention Tertiary prevention Reservoir for infectious agents Source of infection Transmission routes

Public Health Law -- (approved version) 

Brief history of International Communicable Disease Law

EU Public Health Legislation -- (approved version) 
Decision 1082/2013/EU: Serious cross border health threat

Some key recitals under 1082 EU Food Safety Legislation EU Legislation for Communicable Diseases Surveillance

International Health Regulations 2005 edition

Applying Epidemiology for the International Health Regulations. -- (approved version)

Public Health Microbiology
Applied Immunology

Antibodies Antigen presenting cells (APC) Antigens (Ag)

How pathogens try to trick our defenses

Helminthic mechanisms of immune evasion Mechanism of infectious disease What determines our susceptibility to infections? Practical Aspects of Specimen Collection and Shipment

The Role of Microbiology

Bioinformatics Expert Advice Laboratory Support Types of Microorganisms Public Health Programs -- (approved version)

Statistical Concepts
Models
Logistic Regression -- (approved version) 

Estimating Odds Ratios in the presence of interaction -- (approved version) Fitting logistic regression models -- (approved version) Interpreting model coefficients -- (approved version) Linear models -- (approved version) Model building strategies -- (approved version) The logistic model -- (approved version)

Stratified Analysis -- (approved version) 

The Mantel Haenszel Method Power and Sample Size Presenting Statistics

Sampling 

Concepts in sampling -- (approved version)

Statistical Tests
Significance and Confidence 

Confidence Intervals Significant probability to be different from the expected -- (approved version) The idea of Statistical Inference