What is Clinical Epidemiology?

Clinical Epidemiology is the “study of groups of people to achieve the background evidence needed for clinical decisions in patient care” (White, 1996).  It must generate the best possible evidence from groups of individuals regarding the effectiveness and efficiency of various clinical courses of action.  It must also translate this evidence (or the lack thereof) into rational clinical decisions pertaining to the management of individual patients.

Clinical Epidemiology utilizes techniques developed by classical epidemiology and adapts these to the study of individual patients.  It incorporates concepts from related fields such as Biostatistics, Health Social Science, and Health Economics.  It deals mainly with the teaching of clinical research methodology and evidence-based medicine. Clinical Epidemiology is an evolving discipline and is considered as a basic science in clinical medicine. 

 

VISION

A trans-disciplinary center of excellence in the education of health care professionals and application of clinical epidemiology principles towards achieving accessible, equitable, efficient, ethical and culturally sensitive health care for all Filipinos.

 

MISSION

Guided by science and compassion, we commit to the education of health care professionals in clinical epidemiology and its related disciplines for improved evidence-based decision making in health care and policies that engages patients, families and communities.

 

GOALS

  1. To train health care providers in quantitative and qualitative assessment principles drawn from clinical epidemiology, biostatistics, health economics and health social sciences.
  2. To generate relevant health research addressing the priority health needs of the Filipino people.
  3. To provide technical assistance in the evaluation of the health needs of the country, identification of effective and efficient health interventions, rational allocation of resources and successful implementation and monitoring of health programs.

History of Clinical Epidemiology

In the early 1980s, the Rockefeller Foundation issued a call to major medical schools in the world to participate in a new initiative which would promote clinical practice based on the best evidence of effectiveness and efficient use of resources. The springboard for this new initiative was the training of physicians in clinical epidemiology. Subsequently, other disciplines of biostatistics, clinical economics and health social sciences were introduced to comprise a holistic perspective of health and health care.  The University of the Philippines College of Medicine was one of the first medical schools to respond to this call, and since then, it has been and continues to be the leading center for clinical epidemiology in the Philippines.Training in the field of Clinical Epidemiology started in the early 1980s in three centers – McMaster University in Canada, University of Pennsylvania in Philadelphia, and the University of Newcastle in Australia.  The Philippines was among the first countries in the developing world to send trainees in the field.  Training in Clinical Epidemiology involved completion of a Masters’ degree and successful defense of a thesis.  These training programs were funded directly by the Rockefeller Foundation and later, through the International Clinical Epidemiology Network (INCLEN) and Philippine Council for Health Research and Development.

The first Clinical Epidemiology Unit (CEU) in the Philippines was established out of firm belief that epidemiological skills and concepts are important in the training, service and research activities of a clinician.  The groundwork for its establishment was laid out in 1982 by Dr. Kerr White, then Associate Director for Health Sciences of the Rockefeller Foundation, and Dr. Ernesto O. Domingo, then Chair of the PGH Department of Medicine.  It became operational in 1984 as a unit under the Department of Medicine led by Dr Mary Ann D. Lansang, the first clinical epidemiologist in the country. In 1990, CEU transferred to its new office at Paz Mendoza Building.

The training of specialist physicians from various departments continued. With the addition of biostatisticians, health social scientists and clinical economists into the unit and with more graduates from other clinical specialties, the CEU eventually became a unit under the office of the Dean of the College of Medicine in 1992.  In a short period of time, a critical mass had been trained and they have since advocated the use of clinical epidemiology in research, education and clinical practice.

Pioneering Activities of the then CEU (now Department of Clinical Epidemiology – DCE:

    • Introduced the discipline of clinical epidemiology to medical residents, fellows and students of the UP College of Medicine through regular short courses/training workshops on critical appraisal of the medical literature and research methodology.
    • Introduced the concept and practice of Evidence Based Medicine to medical practitioners.
    • Created the first Master of Science in Clinical Epidemiology program in the Philippines in 1992
    • Started teaching Basic Research Methods courses in the undergraduate programs for Year Levels III, IV, V and VI in 1992
    • Provided methodological and statistical support for research projects

Since 1992, the Clinical Epidemiology Unit has offered the Master of Science in Epidemiology (Clinical Epidemiology), a joint program offering with the Department of Epidemiology and Biostatistics of the UP College of Public Health, which offers the Public Health Epidemiology track.

In 1998, the unit was one of the key players in the development of the Master in Clinical Medicine program of the College of Medicine. The Master in Clinical Medicine program includes courses in Clinical Epidemiology, plus a Clinical Statistics course, which was specifically created for these programs.

Recognizing the distinct functions of the CEU and the evolving discipline of Clinical Epidemiology in education and research, the Board of Regents (BoR) approved the creation of the Department of Clinical Epidemiology under the UP College of Medicine-Manila on May 27, 1999 in its 1131st meeting. The creation of the new Department was for better coordination of the undergraduate, graduate and postgraduate programs offered by the unit and to further promote the discipline of Clinical Epidemiology. The Department’s primary role is the administration of the academic activities in Clinical Epidemiology while the Institute of Clinical Epidemiology under the National Institutes of Health is primarily responsible for the conducting the research activities of the faculty. As per the BoR resolution — the director of the Institute shall also be the chair of the Department.

DIRECTORS/CHAIRS:

Founding Head
Dr. Ernesto O. Domingo, MD
National Scientist

Dr. Mary Ann D. Lansang               1984 – 1987
Dr. Corazon A. Ngelangel               1987 – 1989
Dr. Renato B. Dantes+                     1990 – 1993
Dr. Tessa Tan–Torres Edejer           1993 – 1998
Dr. Mario R. Festin                          1998 – 2000
Prof. Cynthia P. Cordero                  2000 – 2003
Dr. Noel R. Juban                             2004 – 2012
Dr. Marissa M. Alejandria                 2013 – 2018
Dr. Jacinto Blas V. Mantaring III  August 2018 – present

I. Master of Science in Epidemiology (Clinical Epidemiology)

The UP College of Medicine and the College of Public Health are jointly offering the Master of Science in Epidemiology with 2 tracks: Clinical Epidemiology and Public Health Epidemiology.  Clinical epidemiology enables health professionals to successfully implement a health program or to deliver better health care to individuals or communities using evidence generated from research. The program is also designed to equip health care practitioners with skills necessary to generate and evaluate valid and reliable research on health problems that they encounter.

II. Diploma in Epidemiology (Clinical Epidemiology)

The Diploma in Epidemiology (Clinical Epidemiology) is a non-thesis option for students who would like to complete only the academic requirements of the program.

Both the M.S. and Diploma programs in Clinical Epidemiology are designed to equip clinicians with skills to generate and evaluate new information and technology relevant to their field of work. The recommended time for completion of the academic coursework for both programs is one school year (full – time) or two years (part – time).

Specifically, the graduates should be able to:

  1. Demonstrate skills in the application of epidemiologic concepts and principles to the solution of clinical and public health problems;
  2. Deliver technical services to clinicians or public health workers on how to properly identify factors in disease causation; evaluate the reliability and validity of measurements; determine the efficacy and effectiveness of interventions; plan strategies for disease control/prevention; devise methods for evaluating health technology programs; and generate research whose results can be bases for health policy formulation.
  3. Develop a critical attitude in evaluating scientific literature and information in the management of health problems.
  4. Appreciate the role of both health economics and the social sciences in making health interventions efficient and culturally acceptable.
  5. Identify, plan, implement, analyze and interpret clinical or public health research projects.

From Academic Year 1992-93 to 2017-18, the Department has accepted 222 students into the MSc Clinical Epidemiology and 17 students into the Diploma in Clinical Epidemiology programs. As of Academic Year 2017-

18, 90 students have graduated with the degree of Master of Science in Clinical Epidemiology and 10 students graduated with the degree of Diploma in Clinical Epidemiology.

PROGRAM SCHEDULE
Year 1

Course NumberCourse TitleUnitsPrerequisite
FULL-TIMEPART-TIME   
1st Semester
CE 201CE 201Concepts of Clinical Economics and Health Social Sciences2 
CE 211CE 211Fundamentals of Clinical Epidemiology2 
CE 212CE 212Basic Clinical Research Methodology2CE 211
CE  213CE  213**Critical Appraisal of Medical Literature1CE 211
CE 218CE 218Ethics in Clinical Epidemiology1 
*BIOSTAT 201 Fundamentals of Biostatistics 13 
*BIOSTAT 202 Fundamentals of Biostatistics 22 
2nd Semester
CE 214CE 214Research Organization and Management2 
CE 215 Synthesis of Research2BIOSTAT 201 & 202 or CE 205, CE 211, CE 212
CE 217CE 217Research Designs in Clinical Epidemiology2CE 211, CE 212
CE 221CE 221Principles and Techniques of Health Policy Formulation2 
CE 298 Independent Study3CE 211, CE 212, BIOSTAT 201 or CE 205
Elective 1Elective 1   
Elective 2    

*offered by the Department of Epidemiology & Biostatistics, College of Public Health

Year 2

Course NumberCourse TitleUnitsPrerequisite
FULL-TIMEPART-TIME   
1st Semester
*CE 300 *Thesis6 
 BIOSTAT 201Fundamentals of Biostatistics 13 
 BIOSTAT 202Fundamentals of Biostatistics 22 
2nd Semester
Residency    
 CE 215Synthesis of Research2BIOSTAT 201 & 202 or CE 205, CE 211, CE 212
 CE 298Independent Study3BIOSTAT 201 or CE 205, CE 211, CE 212
 Elective 2   

Year 3

Course NumberCourse TitleUnitsPrerequisite
FULL TIMEPART TIME   
1st Semester
Residency*CE 300*Thesis6 
2nd Semester
 Residency   

* for MS Clinical Epidemiology students only

Electives

Course NumberCourse TitleUnitsPrerequisite
Electives 1
CE 205Clinical Statistics5 
CE 223Informatics for Clinical Decision Making2CE 213
CE 224Medical Writing and Communications2 
CE 297Seminars in Health Social Science2 
CE 299Social Science Research Methods in Health2 
*Pharma 250Introduction to Pharmacoepidemiology2 
Electives 2
CE 207Advance Clinical Statistics2BIOSTAT 201 & 202 or CE 205
CE 222Advances in Clinical Economics2BIOSTAT 201 & 202 or CE 205

*offered by the Department of Pharmacology and Toxicology, UPCMNOTE:

(1) All students are required to enroll for residency after completion of their         coursework and until they successfully defended their thesis.
(2) Diploma and MS students who were not able to finish after two years             and five years respectively, must apply for extension of their residency.
(3) Diploma students have the option to pursue a Master of Science degree.       However, the validity of their coursework is for five years only.

Summary of Courses

Core Courses        :                 5 units (BIOSTAT 201 & 202)
Major Courses       :               19 units
Electives                :                 4 units
Thesis                    :                 6 units
TOTAL                   :               34 units

III. Undergraduate Courses (Doctor of Medicine Degree)

IDC 211 (Introduction to Basic Health Research)

Course Description:  This is the first of a series of courses imparting knowledge on the principles and application of basic health research methods.  Expertise on the basic sciences as a minefield of research ideas is provided by the different basic science faculty (Anatomy, Physiology, Biochemistry and Pharmacology) while expertise on research methodology is provided by the faculty of the Department of Clinical Epidemiology.

IDC 212 (Introduction to Clinical Epidemiology)

Course Description:  The second of the series of research methods courses focuses on the concepts of Clinical Epidemiology – issues of normality and abnormality, disease frequency, risk assessment, causation, prognosis, treatment and disease prevention, hypothesis testing, summarizing the evidence and knowledge translation.

IDC 213 (Introduction to Evidence-Based Medicine)

Course Description:  This is a three-day course on “Evidence Based Clinical Decision Making”.  The general objective of the course is to introduce the concept of critical appraisal of the medical literature and applying the research findings to clinical decision-making.  The teaching methods in this course are plenary lectures, small group discussions, group presentations and hands-on medical literature search.

CE 291 (Clinical Epidemiology Research Elective)

Course Description: This is a four-week rotation wherein the student is paired with a consultant with an ongoing research project. The student is exposed to various stages of a research project, from proposal development, questionnaire design, project implementation, statistical analysis, report preparation, health policy implications and use of evidence.

The Faculty

Regular Faculty

Marissa M. Alejandria, MD, MSc (Clinical Epidemiology and Clinical Tropical Medicine)
Director, Institute of Clinical Epidemiology
Clinical Epidemiologist and Infectious Diseases Specialist

Jacinto Blas V. Mantaring, MD, MSc
Professor and Chair
MS Program Director
Clinical Epidemiologist and Neonatologist

Nina T. Castillo-Carandang, MA, MSc
Associate Professor and Assistant Chair for Administration
Health Social Scientist

Cynthia P. Cordero, MSc, MMedStat
Professor and Assistant to the MS Course Director
Biostatistician

Maria Lourdes E. Amarillo, MPH (Biostatistics)
Associate Professor
Biostatistician

Noel R. Juban, MD, MSc
Professor
Clinical Epidemiologist and Community Medicine Specialist

Carlo Irwin A. Panelo, MD, MA
Associate Professor
Clinical Economist

Clinical Professor
Mary Ann D. Lansang, MD, MSc
Clinical Epidemiologist and Infectious Diseases Specialist

Current Cross Appointees (as of July 15, 2018)

Antonio Miguel L. Dans, MD, MSc
Professor, Department of Medicine
Clinical Epidemiologist, Adult Medicine Specialist and Cardiologist

Leonila F. Dans, MD, MSc
Professor, Department of Pediatrics
Clinical Epidemiologist and Pediatric Rheumatologist

Mario R. Festin, MD, MSc, MHPEd (on secondment)
Professor, Department of Obstetrics and Gynecology
Clinical Epidemiologist and Obstetrician-Gynecologist

Maria Antonia A. Habana, MD, MSc
Professor, Department of Obstetrics and Gynecology
Clinical Epidemiologist and Obstetrician-Gynecologist

Corazon A. Ngelangel, MD, MSc, PhD
Professor, Department of Medicine
Clinical Epidemiologist and Medical Oncologist

Felix Eduardo R. Punzalan, MD, MSc
Clinical Associate Professor, Department of Medicine
Clinical Epidemiologist and Cardiologist

Laurie S. Ramiro, MSc, PhD
Professor, College of Arts and Sciences
Health Social Scientist

Senior Lecturer
Bernadette A. Tumanan-Mendoza, MD, MSc
Clinical Epidemiologist and Cardiologist

Institute of Clinical Epidemiology Research Faculty with Teaching Assignments in the Department

Emmanuel S. Baja, Sc.D.
Research Associate Professor and Deputy Director, ICE
Environmental Epidemiologist

Emmanuel P. Estrella, MD, MSc
Research Associate Professor
Clinical Epidemiologist and Orthopedic Specialist

Mary Ann J. Ladia, PhD
University Researcher
Medical Anthropologist

Hilton Y. Lam, MHA, PhD
Research Associate Professor
Clinical Economist

Marie Carmela M. Lapitan, MD, MSc
Research Professor
Urologist

Olivia T. Sison, MSPH (Biostatistics)
Research Assistant Professor
Biostatistician

Clinical Associate Professor
John Mark Velasco, MD, MSc
Research Associate Professor
Institute of Molecular Biology and Biotechnology

Adjunct Professor
Thien Kieu Thi, MD, PhD
Family Medicine and Neuro-epidemiologist

Administrative Officer
Girlie C. Monis

Administrative Assistant
Sandra Lesigues

 Training Workshops

      1. Research Methodology
      2. Evidence-based Medicine
      3. Development of Systematic Reviews
      4. Development of Clinical Practice Guidelines
      5. Good Clinical Practice and Ethics
      6. A Mixed Methods Approach to Health Research
      7. Data Management and Statistics for Health Research
      8. Effective Writing and Presentation of Scientific Researches
      9. Training for Technical Review Board Members

 

We also offer:

      1. Consultations for research projects/protocols
      2. Mentoring for research projects
      3. Extension services specially for partner agencies such as DOH, PhilHealth, PCHRD and professional medical societies
      4. Statistical consultations and data analysis

Ongoing Research Projects as of 2018

Dr. Jacinto Blas Mantaring
Development of Ethics Guidelines for Defining Public Health Research versus Public Health Practice  – funded by PCHRD
 

Dr. Marissa Alejandria
Immune Activation Dynamics of HIV-Infected Filipino Patients on Antiretroviral Therapy – funded by PCHRD, PSMID and University of Hawaii

Clinical Practice Guidelines on Acute Infectious Diarrhea – funded by DOH

Quantitative molecular signatures and predictors of sepsis and the development of its complications using gene expression markers and pathway analyses – funded by PCHRD

Clinical Practice Guidelines on Sepsis – funded by PSMID

Prof Cynthia Cordero
System and Manpower Requirements of Introducing infant massage to mother/caregivers among facility administrators and frontline providers – funded by Johnson & Johnson Philippines Inc

Dr. Noel Juban
Development of Plans and Strategies for the Implementation of the Gelia Castillo Award for Social Innovation in Health (GCASIH) – funded by PCHRD

Development of Technical Review Board Manual for Regional Health Research and Development Consortia – funded by PCHRD

Social Innovations in Health – funded by WHO-TDR

Prof Nina Carandang
Nutritional Status and Knowledge, Attitudes, and Practices Towards a Healthy

Lifestyle of the Filipino Urban Worker – Co- Investigator, funded by United Laboratories, Inc

Dr. Corazon Ngelangel
Protection Against Financial Catastrophe: Evaluation of Z Benefit Packages Providing Financial Risk Protection and Improved Clinical Outcomes – funded by PCHRD

Completed Research Projects from 2016-2018

Dr Mary Ann Lansang

2016 National TB Prevalence Survey – funded by PCHRD

Prof Cynthia Cordero
Development of Guidelines for Health Research Priority Setting in the Philippines – funded by PCHRD

Prof Ma Lourdes Amarillo
Focal prevalence survey of schistosomiasis in endemic barangays in three provinces (South Cotabato, Sultan Kudarat and North Cotabato), Region XII – funded by DOH Region XII

A Study on the Death Certification and Registration Process in Selected Areas with High Unregistered Deaths – funded by PCHRD

Dr. Ma Antonia Habana
Clinical Practice Guidelines on Uterine Leiomyoma – funded by Pharmalink A Division of Zuellig Pharma Corporation

Dr. Noel Juban
Assessment of the PhilHealth CARES Project (January-August 2017) – funded by PCHRD

Address: Department of Clinical Epidemiology
Room 103 Paz Mendoza Building
UP College of Medicine
547 Pedro Gil St, Ermita, Manila
Telefax: (632) 525-4098
Email address:updce@post.upm.edu.ph

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