Health and Disease Core Competencies (Wintersemester 2018/2019)

Dozent: Prof. Dr. Erwin Böttinger (Digital Health - Personalized Medicine) , Jan-Philipp Sachs (Digital Health - Personalized Medicine) , Ariane Morassi Sasso (Digital Health - Personalized Medicine)

Allgemeine Information

• Semesterwochenstunden: 4
• ECTS: 6
• Benotet: Ja
• Einschreibefrist: 26.10.2018
• Lehrform: Vorlesung / Übung
• Belegungsart: Brückenmodul
• Lehrsprache: Englisch
• Maximale Teilnehmerzahl: 34

Studiengänge, Modulgruppen & Module

Beschreibung

Syllabus Health and Disease Core Competencies

• Block Course (every Wednesday morning, starting 10/17/2018)

• Lecture #1:  9:15-10:45 am
• Lecture #2: 11:00-12:30 am

• Course description

  This course addresses the bridging module “Introduction to Principles in Medicine”. It is designed to equip students entering the Digital Health Program with an informatics/digital engineering background with core competencies in comprehending and evaluating health and disease. With the first block of the course, students will gain a working knowledge in social causes and global disparities on health, fundamentals in medical diagnosis and therapy, biological systems in medicine, taxonomy of diseases, wellness and prevention, and integrative medicine. In the second block, students will be introduced to core concepts in health behavior, mental health and neuropsychiatric diseases, and understand context and challenges in high-burden examples of selected chronic and infectious disease cases. Students will learn to comprehend, assess and apply health and disease-related information in making and communicating decisions in the digital health context.

  Learning Objectives:

• Understand concepts and methods on health and disease in the  practice of medicine
• Ability to critically assess impact of  health and disease topics in engineering and implementing digital solutions
• Critically assess impact of medical challenges and opportunities in digital health context
• Learn to make and communicate assessments and decisions of health and disease issues in development and implementation of digital health solutions

 

Week 1: (17.10.) Introduction: Health and Disease (Böttinger)

• Lecture #1: Course Premises, Objectives, Organisation, and Content
  • What is unique and new about digital health and the HPI Master Program?
  • Understand working definitions and special significance of interdisciplinarity in digital health
  • Overview of course topics and lecturers
  • Requirements for credits and exams
• Lecture #2: Health and Illness (Disease): Historical Perspectives and Social Context
  • Health and disease in different cultures throughout history
  • Key concepts of health behavior
  • Determinants of experiencing health and illness

•  Readings:

  Steven E. Barkan: Health, Illness and Society: An Introduction to Medical Sociology. Rowman & Littlefield, Lanham, 2016. Chapters 1 to 6

  Homework #1: Reading

Week 2: (24.10.) Health and Disease: Social Causes and Global Disparities (Böttinger)

• Lecture #3: Health and Disease: Social Causes
  • Impact of social class, income distribution, and community
  • Demographics and disease: age, race and ethnicity, gender and sex
  • Where we work and where we live: work and environment
• Lecture #4: Health and Disease: Global Disparities
  • Factors in Global Health Inequality: Healthcare Access, Poverty, Education
  • Major Dimensions in Global Health Disparities
  • Chances for Digital Global Health
• Readings:
  • Steven E. Barkan: Health, Illness and Society: An Introduction to Medical Sociology. Rowman & Littlefield, Lanham, 2016.
    • Chapters 1 to 6
• Homework #2: Group exercise to develop high impact use cases for digital health in a) Europe, b) India, and c) Nigeria

Week 3 Wed, Oct-31 No Lectures (Holiday ‘Reformationstag’)

Week 4: (07.11) Fundamentals in medical diagnosis and therapy (Böttinger)

• Lecture #5: Why diagnoses are needed, and how they are established?
  • Why do we need to establish a medical diagnosis in healthcare?
  • The diagnostic process: how is a medical diagnosis established
    • establishing a problem list: complaints, symptoms, and signs
    • differential diagnosis: testing disease hypotheses to explain the problem list
    • use of diagnostic tests in the diagnostic process
  • The principles of 'diagnostic testing': of 'positive' and 'negative' tests
  • What is the difference between a 'diagnostic test' and a 'screening test'
• Readings:
  • LeBlond RF, Brown DD, Suneja M, and Szot JF. DeGowin's Diagnostic Examination, 10th Edition, McGraw Hill Education, New York, 2015.
    • Part 1 Diagnostic Framework, Chapter 1. Diagnosis; Part 4 Use of Laboratory and Diagnostic Imaging, Chapter 17 Principles of Diagnostic Testing
• Lecture #6: Fundamental principles in medical interventions
  • Safeguarding safety and efficacy of medical interventions.
  • From empirical medical practice to evidence-based practice guidelines.
  • Patient autonomy: no intervention without an informed consent.
• Readings:
  • Hall D et al. Informed consent for clinical treatment. Canadian Medical Association Journal, 2012, 184:533
  • Nunes JPL. Medical Therapeutics: from induction to scientific evolution. Perspectives in Biology and Medicine, 2014, 56:568
  • Graham R et al. Clinical Practice Guidelines We Can Trust. The National Academies Press, 2011
    • Chapter 2 Background and Key Stakeholders in Guidelines Development and Use, pg 29.

• Homework  #3: Reading

Week 5: (14.11) Biological Systems in Medicine: Postponed to 09th of January. There is no Lecture on November 14!

 

Week 6: (21.11.) Taxonomy of Diseases (Ariane Sasso)

• Lecture #7: Concepts and the International Classification of Diseases
  • What is Taxonomy of Diseases and Nosology
  • Why is it important?
  • International Classification of Diseases (ICD)
    • Mortality and Morbidity
    • Incidence and Prevalence of Diseases
    • ICD-10 and ICD-11 structure and use cases
• Lecture #8: Challenges and Perspectives for the Future
  • Are the current Taxonomies enough?
  • New era of Taxonomy for Personalized Medicine
• Readings:
  • Szklo, M., Nieto, F. J., & Miller, D. (2018). Epidemiology: beyond the basics:
    • Chapter 2 (Measuring Disease Occurrence)
  • Council, N. R. (2011). Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. Washington, DC: The National Academies Press. https://doi.org/10.17226/13284
    • This Report is Fully Available Online
• Homework #4: Practical Application
  • Based on a given data set:
    • Group patients with similar diagnosis into corresponding ICD categories
    • Calculate the Prevalence for each ICD
    • Plot in a map the prevalence of a given ICD per region (given a set of coordinates)
      • Using the help of an API (https://leafletjs.com/) or Jupyter Notebook

Week 7: (28.11.) Wellness and Prevention (Prof. Michalsen)

• Lecture #09: Prevention
  • Overview on principles of prevention
  • Primary, secondary and tertiary prevention
  • Individualized behavioral versus setting-based / environmental approaches
  • Perspectives of demographic changes: compression of morbidity and longevity  
  • Early diagnosis detecting and check-ups versus real disease prevention
  • lifestyle modification and behavioral interventions: benchmarks
  • Self-efficacy as a tool for successful prevention
• Lecture #10: Wellness
  • Wellness and chronic disease
  • Concept and increasing significance of quality of life and wellness in medicine
  • From patient care to patient-centered medicine
  • Global Traditional Medicine
  • Salutogenesis and patient empowerment
  • Overview on Natural and integrative Medicine and the role in wellness-enhancement

• Aims: understand the principles and challenges of disease prevention in modern societies with unhealthy lifestyles and subsequent increases in chronic disease conditions. Knowing the potential of patient empowerment, lifestyle-based and Integrative Medicine.  Implications for digital health developments

• Readings:

• -Wayne Jonas: How healing works
  -Daniel Buettner: The Blue Zones
  -American Medical Association Complete Guide to Prevention and Wellness: What You  
   Need to Know about Preventing Illness, Staying Healthy, and Living Longer
  -Andreas Michalsen: Heilen mit der Kraft der Natur (English in 2019, Viking/Penguin)

  Homework #5: Remembering own ressources of well-being. Undergoing a challenge of 2 weeks with concrete lifestyle changes regarding diet and fasting, exercise or stress reduction, nature experience, sleep, hydrotherapy and thermal baths. Documenting the effect on well-being 

Week 8: (05.12.) Complementary and Integrative Medicine (Dr. Kessler)

• Lecture #11:Nutritional Concepts, Trends and Beliefs – What Does Research Tell Us?
  • Overview on currently most discussed forms of nutrition and the existing evidence
  • Practical relevance of nutrition in the treatment of chronic diseases
  • Underlying biochemical and physiological mechanisms
• Lecture #12: Yoga and Mind-Body-Medicine – A Ride Through the Evidence
  • Yoga and MBM in research and medical practice – an update.
  • Understanding why and how Yoga, MBM and related techniques work
  • Interactive mini self-experience
• Readings:
  -Systematic Reviews and Meta-Analyses by Holger Cramer et al. on Yoga in chronic diseases: https://www.ncbi.nlm.nih.gov/pubmed/?term=yoga++cramer
  -Book: Greger, Michael, and Gene Stone. How not to die: Discover the foods scientifically proven to prevent and reverse disease. Pan Macmillan, 2016
• Homework #6:
  • Choose one of the introduced diets, adhere to it for 1 week and summarize your experiences with it in 100-200 words
  • Find out for which diagnoses Yoga and/or MBM are already part of existing medical guidelines (for example in Germany or in the USA).

Week 9-10: (12.12./ 19.12.) Health Behavior, Mental Health and Neuropsychiatric Disorders (Drimalla)

Over the moon and down in the dumps: Developing Core Competencies in Mental Health using the Example of "Depression" 

• Lecture #13: What is mental health?
  • Are you mentally healthy? Definition, Prevalence and Relevance of Mental Disorders (clinical significance)
  • Diagnosis of Mental Illness
  • Perception of Mental Illness in society and different cultures

• Way: Mix of self-reflection task ("why/or why not I am mentally healthy?"), debate panel format ("do we need diagnosis?") and partner exchange (“how is this in our culture?”)
  Aim: develop critical thinking about mental illness, diagnosis (pros/cons) and perception

• Lecture #14: Why does someone get ill?
  • Social, psychological, and biological risk factors (vulnerability)
  • Stress, Negative Life-Events and Warning Signs (stress)
  • Resilience, Health Behavior & Well-Being & Positive Psychology (protection)

• Aim: develop an ability to judge digital solutions to support well-being and access health-behavior

• Lecture #15: What does it mean for someone to be mentally ill?  
  • self-harm and other-harm
  • course, relapses and prognosis
  • consequences and secondary problems
  • insight, compliance and stigma

• Aim: understand the general ideas and abstract concepts of mental disorders (verbalize them!) as well as the burden for the patient and be able to apply them on different disorders

• Lecture #16: How does someone get well?
  • Psychotherapy
  • Pharmacotherapy
  • self-help including digital solutions (discussion of their homework)
  • effectiveness, side-effects and maintenance (happy end?) 

• Aim: understand challenges of therapeutic work (e.g. compliance, maintenance) and how they might be approached digital

• Readings:
  • Mohr, D. C., Zhang, M., & Schueller, S. M. (2017). Personal sensing: understanding mental health using ubiquitous sensors and machine learning. Annual review of clinical psychology, 13, 23-47.
    https://pdfs.semanticscholar.org/34b3/2fef0b125dcadb8f7d2751b11259be0dc577.pdf
  • Eysenck, M. W. (2009), Fundamentals of Psychology, Pychology Press: Chapter 21, Appproaches to Abnormality,  pp. 511-521 & Chapter 21,
  • Therapeutic Approaches, pp. 523-537
• Homework #6: Develop a digital mental health solution for a mood disorder // Alternative: Use the learned concepts for understand another disorder

\\ Christmas and New Years Recess

Week 11: (09.01) Biological Systems in Medicine (Prof. Erwin Böttinger & Prof. Christoph Lippert)

• Lecture #17: Introduction to biological systems and their interrelationships in human biology/physiology (Böttinger)
• Lecture #18: Introduction to Bioinformatics and Genomics (Lippert)
• Readings:
• Homework  #7

Week 12-13-14: (16.01./23.01./30.01.)  In-Depths Case Studies of Selected Major Diseases (JP Sachs)

• Lecture #19: #1 Chronic Diseases - Diabetes and Hypertension
• Lecture #20: #2 Surgical Interventions - Appendicitis and Fracture of the femoral neck
• Lecture #21: #3 Infectious Diseases - Bacteria (Tuberculosis and Staphylococcus aureus)
• Lecture #22: #4 Infectious Diseases - Viruses (Common flu, HIV+AIDS, Hepatitis)
• Lecture #23: #5 Cancer - Prostate and Breast cancer
• Lecture #24: #6 Intensive Care - Acute respiratory distress syndrome (ARDS) and Polytrauma
• Readings: tbd
• Homework #8: TBD

 Week 14: (06.02.)  Course Review and Exam Preparation (Böttinger et al)

• Lecture #25: Summary of essential course materials
• Lecture #26: Outlook final examination
• Readings: Review course notes

Week 15: (13.02) FINAL EXAM (Böttinger at al)

•  9:15-10:30h

Leistungserfassung

Prerequisite for admission to the final examination is the submission of five assignments/homework

(2 out of 5 can be delayed with justification)

Final Exam: 90 minutes written exam, mixed format (MC+free text) on February 13, 2019.

Termine

Block Course Wednesday morning, starting October 17, 2018

Lecture #1:  9:15-10:45 am

Lecture #2: 11:00-12:00 am

·  Location: HPI Campus I, Main Building,Room: HE. 51

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