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This book should have helped the reader to move from having heard
(perhaps) of epidemiology to knowing epidemiology by the acquisition of some
familiarity with its language and ways of reasoning and operating. The
essentials of epidemiological jargon being clear, it will also be possible to
get a grip on the meaning of the many terms that could not be included in the
book and can be found by consulting when necessary the volume by M. Porta (ed.), A Dictionary of Epidemiology, 5th edn.
(Oxford University Press, 2008).
A fascinating illustration of imaginative and rigorous ‘diagnostic
reasoning’, at the core both of epidemiology (at population level) and of
clinical medicine (at the individual level) springs from the stories that the
late medical writer Berton Roueché presented over several decades in The New Yorker. A highly readable selection is
collected in B. Roueché, The Medical
Detectives (Penguin Books/Plume, 1991).
استخدام علم الأوبئة
Using epidemiology requires us to go beyond surface familiarity with
the subject. It implies not only the ability to read and appreciate an
epidemiological paper or report, as someone who knows epidemiology can do, but
also the skill for scrutinizing its methods and critically assessing its results
and conclusions. Health professionals not directly practising epidemiology need
to possess this skill to a degree sufficient for gauging the relevance of
epidemiological findings to their daily work in clinical medicine or public
health. Given favourable individual circumstances, this objective might be
attained even by a self-teaching endeavour. There is no way, however, that such
skill can be acquired through a simple accumulation of readings. Advancing
through successive steps must be accompanied by a number of practical exercises
in statistical and epidemiological methods. Suitable introductory books to the
former are: D. Altman, D. Machin, T. Bryant, and S. Gardner, Statistics with Confidence, 2nd edn.
(Wiley-Blackwell, 2000) and S. A. Glantz, Primer of
Biostatistics, 5th edn. (McGraw-Hill, 2002). For epidemiological
methods, one may refer to R. Bonita, R. Beaglehole, and T. Kjellström, Basic Epidemiology, 2nd edn. (World Health
Organization, 2006) and to K. J. Rothman, Epidemiology:
An Introduction (Oxford University Press, 2002). A useful
addition to the questions and exercises in these two books is the substantial
set of exercises, with answers, presented in S. E. Norell, Workbook of Epidemiology (Oxford University Press,
1995).
A computer-assisted learning package for basic epidemiological
methods has been prepared and tested by C. du Florey and is available at no cost
at the website: http://www.dundee.ac.uk/~cdvflore/. The
International Epidemiological Association (IEA) website
(http://www.IEAweb.org) cites without commentary a number of
other didactic packages.
Short intensive courses in epidemiological methods, one to four weeks
long, are available in several countries, and a selection of these is quoted in
the R. Bonita et al. book mentioned above. The IEA organizes courses in
developing countries and sponsors the residential summer school of the European
Educational Programme in Epidemiology (http://www.eepe.org).
ممارسة علم الأوبئة
Progressing from using epidemiology to doing it means becoming a
professional regularly carrying out epidemiological work either in research or
in service activities, or both. Substantial training is required, formal through
special courses as well as informal through actual practice, to reach this level
of competence. A vast array of books is available, among which a few key
references may be quoted, some of recent date and some less recent that have
withstood the test of time. For statistical methods, a classic is P. Armitage,
G. Berry, and J. N. S. Matthews, Statistical Methods in
Medical Research, 4th edn. (Blackwell Science, 2002). Specific to
statistical methods in epidemiology are the book by D. Clayton and M. Hills,
Statistical Models in Epidemiology
(Oxford University Press, 1993) and the two volumes by N. E. Breslow and N. E.
Day, Statistical Methods for Cancer Research
(International Agency for Research on Cancer, 1980 and 1987). Current
epidemiological methods are comprehensively treated in K. J. Rothman, S.
Greenland, and T. L. Lasch, Modern
Epidemiology, 3rd edn. (Wolters Kluwer, 2008). Epidemiology in
relation to broad classes of health and disease determinants, environmental,
nutritional, and genetic, are covered respectively in D. Baker and M. J.
Nieuwenhuijsen, Environmental Epidemiology
(Oxford University Press, 2008), W. Willett, Nutritional
Epidemiology, 2nd edn. (Oxford University Press, 1996), and L.
Palmer, G. Davey-Smith, and P. Burton (eds.), An
Introduction to Genetic Epidemiology (The Policy Press, 2009).
Epidemiology in the clinical medicine context is developed in R. B. Haynes, D. L.
Sackett, G. Guyatt, and P. Tugwell, Clinical
epidemiology: how to do clinical practice research, 3rd edn.
(Lippincott Williams & Wilkins, 2006), and randomized clinical trials are
addressed in S. J. Pocock, Clinical Trials, A Practical
Approach (Wiley, 1983).
A wide spectrum of topics, including epidemiology, pertinent to
health and diseases in populations is surveyed in the three volumes of R.
Detels, R. Beaglehole, M. A. Lansing, and M. Gulliford, Oxford Textbook of Public Health, 5th edn. (Oxford University
Press, 2009); although some of the more general chapters may be accessible to
the lay reader, this is a text for professionals.
