Concepts of epidemiology : an integrated introduction to the ideas, theories, principles and methods of epidemiology / Raj S. Bhopal.

Format:

Book

Author/Creator:

Bhopal, Raj S.

Language:

English

Subjects (All):

Epidemiology.

Medical Subjects:

Epidemiology.

Physical Description:

xxviii, 317 pages : illustrations ; 24 cm

Place of Publication:

Oxford ; New York : Oxford University Press, 2002.

Contents:

1 What is epidemiology? The nature and scope of a biological, social, and ecological science and of epidemiological variables and outcomes 1

1.1 The individual and the population 1

1.2 Definition of epidemiology and statement of its central paradigm 2

1.3 Directions in epidemiology and its uses 3

1.4 Epidemiology as a science, practice, and craft 4

1.5 The nature of epidemiological variables 7

1.6 A disease and health problem: an illustration of the interdependence of clinical medicine and epidemiology 11

1.7 Seeking the theoretical foundations of epidemiology 14

2 The epidemiological concept of population 17

2.1 The individual and the population 17

2.2 Harnessing heterogeneity in individual and group level disease and risk factor patterns 21

2.3 Disease patterns as a manifestation of individuals living in changing social groups 22

2.4 Sick populations and sick individuals 26

2.5 Individual and population level epidemiological variables 31

2.6 Epidemiology and demography: interdependent population sciences 33

2.7 The dynamic nature of human population 39

2.8 Applications of the population concept 40

3 Variation in disease by time, place, and person: A framework for analysis 44

3.2 Reasons for analysing disease variations 45

3.3 Variations and associations: real or artefact? 47

3.4 Applying the real-artefact framework 52

3.5 Disease clustering and clusters in epidemiology 59

3.6 Applications of observations of disease variation 67

3.7 Epidemiological theory underpinning or arising from this chapter 68

4 Variation: Role of error, bias, and confounding 69

4.2 A classification of error and bias 72

4.2.1 The research question, theme or hypothesis 73

4.2.2 Choice of population 76

4.2.3 Non-participation 79

4.2.4 Comparing disease patterns and risk factor-disease outcome relationships in populations which differ (confounding) 79

4.2.5 Measurement 86

4.2.6 Misclassification bias 88

4.2.7 Analysis and interpretation 90

4.2.8 Publication 91

4.2.9 Judgement and action 91

4.3 A practical application of the research chronology schema of bias and error 92

5 Cause and effect: The epidemiological approach 98

5.1 Introduction: causality in science and philosophy 98

5.2 Epidemiological causal strategy and reasoning: the example of Semmelweiss 101

5.3 Models of cause in epidemiology 103

5.3.1 Interplay of host, agent, and environment 103

5.3.2 Necessary and sufficient cause 113

5.4 Guidelines for epidemiological reasoning on cause and effect 115

5.4.1 Comparison of epidemiological and other concepts of causal reasoning 115

5.4.2 Application of criteria to associations 121

5.4.3 Interpretation of data, study design, and causal criteria 129

5.5 Epidemiological theory illustrated by this chapter 130

6 Natural history, spectrum, iceberg, population patterns, and screening: Interrelated concepts in the epidemiology of disease 133

6.1 Natural history of disease 134

6.2 The population pattern of disease 139

6.4 The unmeasured burden of disease: the metaphors of the iceberg and the pyramid 142

6.5 Screening 145

6.6 Applications of the concepts of natural history, spectrum, and screening 156

6.7 Epidemiological theory: symbiosis with clinical medicine and social sciences 160

7 The concept of risk and measures of disease frequency: Incidence and prevalence 163

7.1 Introduction: risks, risk factors, and causes 163

7.2 Quantifying disease frequency, risk factors, and their relationships 164

7.3 Incidence and incidence rate: the concepts of incidence density, person-time incidence and cumulative incidence 167

7.4 Numerator 173

7.5 Denominator 178

7.6 Prevalence and prevalence rate 179

7.7 Relationship of incidence and prevalence 185

7.8 Choice of incidence or prevalence 188

7.9 Presenting rates 188

8 Presentation and interpretation of epidemiological data on risk 191

8.2 Proportional morbidity or mortality ratio (PMR) 192

8.3 Adjusted overall rates: standardization and the calculation of the SMR (Standardized mortality ratio) 194

8.4 Relative measure: relative risk 198

8.5 The odds ratio (OR) 202

8.6 Measurements to assess the impact of a risk factor in groups and populations 207

8.6.1 Attributable risk/exposed group 210

8.6.2 Population attributable risk 212

8.7 Presentation and interpretation of epidemiological data in applied settings 214

8.8 Avoidable morbidity and mortality 217

8.9 Comparison of summary measures of health status 218

8.10 DALY, disability adjusted life years, and QALY, quality adjusted life years 220

8.12 Describing the health status of a population 223

8.13 The construction and development of health status indicators 226

9 Study design 231

9.1 Introduction: interdependence of study design 231

9.2 Classifications of study design: five dichotomies 234

9.3 Case-series: clinical and population based 235

9.4 Cross-sectional study 242

9.5 Case-control study 247

9.6 Cohort study 251

9.7 Trials 255

9.8 Overlap in the conceptual basis of the case-series, cross-sectional, case-control, cohort, and trial designs 257

9.9 Ecological studies: design or analysis? 262

9.10 Size of the study 263

9.11 Data analysis and interpretation 264

10 Theoretical, ethical, contextual, practical, and critical foundations for future epidemiology 267

10.1 The interrelationship of theory, methods, and application: a question of values 267

10.2 Fundamental influences on health 269

10.3 Setting priorities in health and health care 271

10.4 Impact on health of local polluting industries: Teesside study of environment and health 274

10.5 Paradigms: the evolution of epidemiology 276

10.6 Epidemiology: forces for change 277

10.7 Scope of epidemiology and specialization 278

10.8 The context of epidemiological practice

academic and service, USA and UK 279

10.9 The practice of epidemiology in public health 280

10.10 Ethical basis and proper conduct of epidemiology: the need for a code 281

10.10.1 Tobacco industry 281

10.10.2 Authorship 281

10.10.3 Ethnicity and race 282

10.11 Ethical guidelines 284

10.12 Critical appraisal in epidemiology: separating fact from error and fallacy 285

10.12.1 The fallacy of association being causal 287

10.12.2 The weight of evidence fallacy 287

10.12.3 The fallacy of repeated citation 287

10.12.4 The fallacy of authority 288

10.12.5 The fallacy of simple explanation 288

10.12.6 The fallacy of risk 288

10.12.7 The fallacy of inappropriate extrapolation 288

10.12.8 The fallacy of significance tests 288

10.12.9 The fallacy of obfuscation 288

10.12.10 The fallacy of covert bias 289

10.12.11 The nature of critical appraisal 289

10.13 Some questions relevant to the appraisal of epidemiological research 289

10.14 Building on an epidemiological education: role of historical landmarks 291

10.15 Building on an epidemiological education: a reflection on the future of epidemiology 293.

Notes:

Includes bibliographical references (pages [297]-309) and index.

ISBN:

0192631551

OCLC:

48093218