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CLEPAN
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Clinical Epidemiological Analysis (CLEPAN) is a free, user-friendly platform developed by Aarhus University researchers to help medical, Master’s, and PhD students, as well as clinicians, understand the concepts of clinical epidemiology. It offers interactive tools and updated content on epidemiological concepts, study designs, and data visualization, without requiring advanced computer skills.
The CLEPAN Interface Background Sound scientific evidence is a prerequisite for any modern health service system to provide safe, high-quality patient care and to take maximum advantage of advances in diagnostics, treatment, rehabilitation, and prevention. This evidence is derived best from continually updated answers to four key generic clinical questions: 1. Diagnosis: Which tests/examinations should be used to diagnose a disease and predict its course while minimizing false positive and negative results? 2. Prognosis: What is the expected course of a disease — spontaneous cure, untreated progression (natural history), or progression with treatment (clinical course)? 3. Intervention: How effective is a clinical intervention in curing, preventing, slowing progression, or reducing symptoms of a disease? 4. Risk - Harm: What are the risks and potential side effects of selected treatments and the safety and quality of clinical care? Addressing these questions requires integrated knowledge of clinical medicine, epidemiology, and biostatistics. In recent decades clinical epidemiology therefore has become a core discipline in clinical care, responding to the increasing need for evidence-based medicine, quality assessment, protection of patient safety, resource optimization, meta-analyses, and development of clinical guidelines, all of which are based on clinical epidemiological concepts. CLEPAN helps in understanding the basic elements of clinical epidemiology and describes the key concepts and analytical methods needed to develop knowledge for research that contribute to scientific evidence. The idea of CLEPAN CLEPAN is primarily aimed at medical, Master’s, and PhD students, clinicians without formal research training, and others looking to advance their skills in clinical medicine, epidemiology, and biostatistics. The learning platform introduces its users to the principles of clinical epidemiology without requiring an advanced computer program. CLEPAN is based on Professor Henrik Toft Sørensen’s notes from teaching medical and PhD students for close to 25 years. The first version of the learning platform was created in 2016. “I noticed a significant need among students for a learning platform that is easily accessible without requiring a substantial investment of money and time to master an advanced computer program,” says Henrik Toft Sørensen. CLEPAN has been updated continuously based on the feedback received from students and teachers who use the platform. Recently, the platform underwent a major update to include new features.
Henrik Toft Sørensen
continues: “I am grateful to the many students and colleagues who
have tested and proofread CLEPAN. Their input has been invaluable in
improving CLEPAN and meeting the needs of its users.” The CLEPAN platform starts with a section on Measures of Disease Occurrence, Outcome, and Prognosis, where key metrics like incidence, prevalence, risk, and case fatality are explained. The second major section explores Study Designs, introducing clinical trials, cohort and case-control studies, cross-sectional analyses, and meta-analyses. This is crucial for understanding how evidence is generated and compared across different research contexts. The section Sample Size Calculations offers guidance on determining appropriate sample sizes for different study types, including superiority, equivalence, and non-inferiority clinical trials. A key challenge in clinical epidemiological research is the presence of bias; therefore, the Bias in Epidemiology section was developed to aid understanding of the types of bias — selection bias, information bias, and confounding — and to offer techniques for controlling bias through stratified analysis or standardization. In addition, the Bias Analysis part covers advanced topics like E-values, misclassification assessment, and sensitivity analysis, helping researchers critically evaluate the robustness of their findings. Associate Professor Erzsébet Horváth-Puhó says: “During the 2024 update of the platform, our goal was to redesign CLEPAN to be even more user-friendly and easier to navigate. Additionally, we focused on improving the platform’s structure, enhancing the built-in calculators, and adding new features. For example, data visualization tools such as histograms, box plots, pie charts, and other graphical representations were introduced to support better data understanding and interpretation. We also dedicated a section on advanced survival analyses describing the differences between Kaplan-Meier curves and cumulative incidence curves used in the presence of competing risk.” For example, users interested in learning the basic concepts of cohort studies can refer to the Study Designs section, where an overview of the design is provided. This is followed by built-in calculators that allow users to calculate key absolute and relative measures, including incidence among exposed and unexposed groups, relative risk with a 95% confidence interval, and risk difference with its corresponding confidence interval.
Consider a cohort study with 120 exposed and 120 unexposed individuals, where 30 and 10 outcome events occur in each group, respectively. Using the built-in calculators, the incidence among the exposed is calculated as 0.25, while the incidence among the unexposed is 0.08. The relative risk, comparing these two groups, is 3.00 with a 95% confidence interval of 1.54 to 5.86. Additionally, the risk difference is 0.17, with a confidence interval ranging from 0.07 to 0.26.
Overall, CLEPAN offers a user-friendly, easy-to-follow structure with illustrative examples and built-in calculators and a robust framework for understanding and applying basic epidemiological principles. CLEPAN is used worldwide CLEPAN was created by researchers at Aarhus University in Denmark and has been used for many years in clinical epidemiology classes for medical students and PhD students at the university. The learning platform has more than 500 users located around the world, e.g. in Europe, North America, Asia, and Africa.
Want to try CLEPAN? Contact CLEPAN was developed by Professor Henrik Toft Sørensen and recently updated in close collaboration with Associate Professor Erzsébet Horváth-Puhó. The team would be happy to receive comments and suggestions for future improvements at CLEPAN@clin.au.dk.
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