Epidemiology: a problem-solving journey.


:As a scientific discipline, epidemiology has helped liberate the practice of public health and medicine from dogmatic thinking over the past century. This commentary highlights some integrating principles to explain why epidemiology is a problem-solving discipline. The first of these is that epidemiology is an information science. Epidemiology generates information for decision-making at all levels of the health-care system, including information for both individuals and the general public. Although all scientific disciplines produce data that may be used for decision-making, there is more immediacy for the decisions in epidemiology. The second principle is that epidemiology operates within an environment of complex systems. Etiologic factors operate in complex systems, and the use of a systems analysis approach in investigating health problems must be considered. The third principle is that epidemiology is not just a scientific discipline but a professional practice area as well. Epidemiology has a solid disciplinary scientific base, and its practice requires well-grounded academic preparation. Its objectives are very much within the public-social domain, and a well-defined, outcome-oriented, prevention-based philosophy steers its practice. In a number of universities, epidemiology is taught today as a research discipline rather than as an operational, problem-solving one. In conclusion, this commentary emphasizes the need to accept the fact that epidemiology has as much of a social role as a scientific one. Public health action, problem solving, and a sense of mission are what brings many students to epidemiology. A problem-solving, action-oriented epidemiology is consistent with that sense of mission.


Am J Epidemiol


Armenian HK




Has Abstract


2009-01-15 00:00:00














  • The Association of Television Viewing in Childhood With Overweight and Obesity Throughout the Life Course.

    abstract::Few studies have addressed the association between television viewing time in childhood and overweight/obesity across the life course. Among 30,921 mother-daughter dyads from the Nurses' Mothers' Cohort (2001) and the Nurses' Health Study II (1989 and 1991), the following information was collected: daughter's televisi...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Tahir MJ,Willett W,Forman MR

    更新日期:2019-02-01 00:00:00

  • Immunogenicity and safety of a plasma-derived heat-inactivated hepatitis B vaccine (CLB). Studies in volunteers at a low risk of infection with hepatitis B virus.

    abstract::The safety and immunogenicity of a plasma-derived heat-inactivated hepatitis B vaccine (CLB) were evaluated in 471 healthy human volunteers, who, both in their occupations and in their private lives, had been at minimal risk of being infected with hepatitis B virus. The first 202 individuals received three 3-microgram...

    journal_title:American journal of epidemiology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lelie PN,Reesink HW,de Jong-van Manen ST,Dees PJ,Reerink-Brongers EE

    更新日期:1984-11-01 00:00:00

  • Acute myocardial infarction in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched nonveterans.

    abstract::Few studies of veterans have examined cardiovascular disease as the primary outcome, other than in relation to specific conflicts or hazards. To assess the long-term risk and prognosis of acute myocardial infarction (AMI) in United Kingdom veterans from a broad range of military backgrounds and experience, we conducte...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Bergman BP,Mackay DF,Pell JP

    更新日期:2014-06-15 00:00:00

  • Effect of early patient enrollment on the time to completion and publication of randomized controlled trials.

    abstract::The authors evaluated whether early enrollment affects the significance of the results and the time to completion and publication of randomized controlled trials. Seventy-seven efficacy randomized controlled trials (total enrollment, 28,992 patients) initiated by the Acquired Immunodeficiency Syndrome Clinical Trials ...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Haidich AB,Ioannidis JP

    更新日期:2001-11-01 00:00:00

  • Community-acquired Legionnaires' disease associated with a cooling tower: evidence for longer-distance transport of Legionella pneumophila.

    abstract::In the period August 10-29, 1986, 29 confirmed cases of Legionnaires' disease occurred in Sheboygan, Wisconsin; two cases were fatal. No common source of indoor exposure was identified. Water specimens were obtained from all known cooling tower units in Sheboygan; Legionella pneumophila serogroup 1 was isolated at 1 x...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Addiss DG,Davis JP,LaVenture M,Wand PJ,Hutchinson MA,McKinney RM

    更新日期:1989-09-01 00:00:00

  • Invited commentary: variable selection versus shrinkage in the control of multiple confounders.

    abstract::After screening out inappropriate or doubtful covariates on the basis of background knowledge, one may still be left with many potential confounders. It is then tempting to use statistical variable-selection methods to reduce the number used for adjustment. Nonetheless, there is no agreement on how selection should be...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Greenland S

    更新日期:2008-03-01 00:00:00

  • Birth weight and smoking during pregnancy--effect modification by maternal age.

    abstract::Cigarette smoking during pregnancy is an important, avoidable factor associated with low birth weight. Maternal age is also associated with variations in birth weight. Using birth certificate data from all 347,650 singleton births for which maternal age and birth weight were recorded during 1984-1988 in Washington Sta...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Fox SH,Koepsell TD,Daling JR

    更新日期:1994-05-15 00:00:00

  • Marginal structural Cox models for estimating the association between β-interferon exposure and disease progression in a multiple sclerosis cohort.

    abstract::Longitudinal observational data are required to assess the association between exposure to β-interferon medications and disease progression among relapsing-remitting multiple sclerosis (MS) patients in the "real-world" clinical practice setting. Marginal structural Cox models (MSCMs) can provide distinct advantages ov...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Karim ME,Gustafson P,Petkau J,Zhao Y,Shirani A,Kingwell E,Evans C,van der Kop M,Oger J,Tremlett H

    更新日期:2014-07-15 00:00:00

  • Menstrual cycle patterns and risk of breast cancer.

    abstract::Menstrual cycle characteristics may reflect underlying endocrine patterns that influence the risk of breast cancer. Most previous studies of menstrual function and breast cancer risk have used retrospective reports of menstrual bleeding, which may be unreliable. To examine this association, the authors conducted a mai...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Whelan EA,Sandler DP,Root JL,Smith KR,Weinberg CR

    更新日期:1994-12-15 00:00:00

  • A case of cholera in Texas, 1973.

    abstract::The first naturally acquired case of cholera reported in the United States since 1911 occurred in a 51-year-old resident of Port Lavaca, Texas. Extensive epidemiologic investigation of the patient's contacts and environment did not identify a cholera carrier of elucidate a pathway of transmission, but several avenues ...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Weissman JB,DeWitt WE,Thompson J,Muchnick CN,Portnoy BL,Feeley JC,Gangarosa EJ

    更新日期:1974-12-01 00:00:00

  • Observations on the history of epidemiology in western New York, 1843-1960.

    abstract::Epidemiology has a rich tradition in western New York State, beginning with the classic study by Austin Flint of a waterborne typhoid fever outbreak in North Boston in 1843. Other important investigations included the study of the Buffalo poliomyelitis epidemic of 1912, by Wade Hampton Frost, which provided a comprehe...

    journal_title:American journal of epidemiology

    pub_type: 历史文章,杂志文章


    authors: Winkelstein W Jr

    更新日期:1997-12-01 00:00:00

  • The risks of cancers of the colon and rectum in relation to coffee consumption.

    abstract::To assess whether recent coffee consumption is related to the incidence of large bowel cancer, the authors analyzed data from a multipurpose hospital-based case-control study of several cancers, conducted from 1978 to 1986 in Boston, Massachusetts, New York, New York, Philadelphia, Pennsylvania, and Baltimore, Marylan...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Rosenberg L,Werler MM,Palmer JR,Kaufman DW,Warshauer ME,Stolley PD,Shapiro S

    更新日期:1989-11-01 00:00:00

  • Using the Self-Controlled Tree-Temporal Scan Statistic to Assess the Safety of Live Attenuated Herpes Zoster Vaccine.

    abstract::The self-controlled tree-temporal scan statistic allows detection of potential vaccine- or drug-associated adverse events without prespecifying the specific events or postexposure risk intervals of concern. It thus opens a promising new avenue for safety studies. The method has been successfully used to evaluate the s...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Yih WK,Kulldorff M,Dashevsky I,Maro JC

    更新日期:2019-07-01 00:00:00

  • Assessment of Quadrivalent Human Papillomavirus Vaccine Safety Using the Self-Controlled Tree-Temporal Scan Statistic Signal-Detection Method in the Sentinel System.

    abstract::The self-controlled tree-temporal scan statistic-a new signal-detection method-can evaluate whether any of a wide variety of health outcomes are temporally associated with receipt of a specific vaccine, while adjusting for multiple testing. Neither health outcomes nor postvaccination potential periods of increased ris...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Yih WK,Maro JC,Nguyen M,Baker MA,Balsbaugh C,Cole DV,Dashevsky I,Mba-Jonas A,Kulldorff M

    更新日期:2018-06-01 00:00:00

  • Epidemic cholera in West Africa: the role of food handling and high-risk foods.

    abstract::During an epidemic of cholera in Guinea, West Africa, in 1986, the authors conducted two studies of risk factors for transmission. In the capital city, 35 hospitalized cholera patients were more likely than 70 neighborhood-matched controls to have eaten leftover peanut sauces (odds ration (OR) = 3.1, 95% confidence in...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: St Louis ME,Porter JD,Helal A,Drame K,Hargrett-Bean N,Wells JG,Tauxe RV

    更新日期:1990-04-01 00:00:00

  • Prospective study of human papillomavirus seropositivity and risk of nonmelanoma skin cancer.

    abstract::Cutaneous human papillomaviruses (HPVs) have been associated with squamous cell carcinoma (SCC) in case-control studies, but there are limited data from prospective studies assessing whether virus exposure predicts risk of future cancer development. Two major biobanks, the Southern Sweden Microbiology Biobank (1971-20...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Andersson K,Michael KM,Luostarinen T,Waterboer T,Gislefoss R,Hakulinen T,Forslund O,Pawlita M,Dillner J

    更新日期:2012-04-01 00:00:00

  • Misclassification bias arising from random error in exposure measurement: implications for dual measurement strategies.

    abstract::Despite the resulting loss of information, continuous exposure variables are often categorized in epidemiologic data analysis. It has been shown that nondifferential measurement error of exposure can lead to differential misclassification under these circumstances. This paper extends these findings to the misclassific...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Brenner H,Blettner M

    更新日期:1993-09-15 00:00:00

  • Educational status and blood pressure: the Second National Health and Nutrition Examination Survey, 1976-1980, and the Hispanic Health and Nutrition Examination Survey, 1982-1984.

    abstract::An inverse association between socioeconomic status, as measured by years of education, and blood pressure has been reported in a number of studies. However, two secular trends may have changed the nature of this relation: a higher mean level of education in the population and intervention for high blood pressure in t...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Sorel JE,Ragland DR,Syme SL,Davis WB

    更新日期:1992-06-15 00:00:00

  • Exogenous estrogens and endometrial cancer: a case-control study and assessment of potential biases.

    abstract::Eighty-eight cases with newly diagnosed carcinoma of the endometrium and 177 age-matched neighborhood controls were interviewed to test the hypothesis that exogenous estrogens lead to an increased risk of endometrial cancer. Forth-five per cent of the cases and 22% of the controls reported a history of estrogen use wh...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Spengler RF,Clarke EA,Woolever CA,Newman AM,Osborn RW

    更新日期:1981-10-01 00:00:00

  • NHLBI Family Heart Study: objectives and design.

    abstract::The NHLBI Family Heart Study is a multicenter, population-based study of genetic and nongenetic determinants of coronary heart disease (CHD), atherosclerosis, and cardiovascular risk factors. In phase I, 2,000 randomly selected participants and 2,000 with family histories of CHD were identified among 14,592 middle-age...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章,多中心研究


    authors: Higgins M,Province M,Heiss G,Eckfeldt J,Ellison RC,Folsom AR,Rao DC,Sprafka JM,Williams R

    更新日期:1996-06-15 00:00:00

  • Census and geographic differences between respondents and nonrespondents in a case-control study of non-Hodgkin lymphoma.

    abstract::To quantify nonresponse bias and estimate its potential impact, the authors compared census-based socioeconomic and demographic factors and geographic locations among respondents and nonrespondents in a multicenter case-control study of non-Hodgkin lymphoma (1998-2000). Using a geographic information system, the autho...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Shen M,Cozen W,Huang L,Colt J,De Roos AJ,Severson RK,Cerhan JR,Bernstein L,Morton LM,Pickle L,Ward MH

    更新日期:2008-02-01 00:00:00

  • Alcohol consumption and changes in blood pressure among African Americans. The Pitt County Study.

    abstract::The Pitt County Study is a longitudinal investigation of anthropometric, psychosocial, and behavioral predictors of hypertension in African Americans who were aged 25-50 years at baseline in 1988. At baseline, a strong dose-response gradient was observed for alcohol consumption and blood pressure for both sexes. The c...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Curtis AB,James SA,Strogatz DS,Raghunathan TE,Harlow S

    更新日期:1997-11-01 00:00:00

  • The relation between perceived unfair treatment and blood pressure in a racially/ethnically diverse sample of women.

    abstract::Elevated blood pressure is an important public health problem in midlife women, especially among minority groups. Few studies have examined the impact of perceived unfair treatment due to different factors such as racism, sexism, or ageism on blood pressure. By use of a racially/ethnically diverse community sample of ...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Brown C,Matthews KA,Bromberger JT,Chang Y

    更新日期:2006-08-01 00:00:00

  • Do genetic factors explain the association between poor oral health and cardiovascular disease? A prospective study among Swedish twins.

    abstract::Epidemiologic studies suggest positive associations between poor oral health and cardiovascular disease. The authors undertook a prospective study among 15,273 Swedish twins (1963-2000) to examine whether genetic factors underlying the 2 diseases could explain previous associations. They estimated hazard ratios and 95...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Mucci LA,Hsieh CC,Williams PL,Arora M,Adami HO,de Faire U,Douglass CW,Pedersen NL

    更新日期:2009-09-01 00:00:00

  • Beyond the Intensive Care Unit (ICU): Countywide Impact of Universal ICU Staphylococcus aureus Decolonization.

    abstract::A recent trial showed that universal decolonization in adult intensive care units (ICUs) resulted in greater reductions in all bloodstream infections and clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) than either targeted decolonization or screening and isolation. Since regional health-care fa...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Lee BY,Bartsch SM,Wong KF,McKinnell JA,Cui E,Cao C,Kim DS,Miller LG,Huang SS

    更新日期:2016-03-01 00:00:00

  • All-cause and cardiovascular mortality among Mexican-American and non-Hispanic White older participants in the San Antonio Heart Study- evidence against the "Hispanic paradox".

    abstract::The observation that Hispanics have lower all-cause and cardiovascular mortality rates despite increased rates of diabetes and obesity and lower socioeconomic status has been termed the "Hispanic paradox." The authors therefore examined the relation between ethnicity and mortality in 1,438 Mexican-American and 921 non...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Hunt KJ,Resendez RG,Williams K,Haffner SM,Stern MP,Hazuda HP

    更新日期:2003-12-01 00:00:00

  • Case-control study of exposure to medication and the risk of injurious falls requiring hospitalization among nursing home residents.

    abstract::The association between injurious falls requiring hospitalization and selected classes of medications was examined in a case-control study of nursing home residents. Information for this study was obtained exclusively from four computerized administrative databases. Over the period from April 1987 to March 1992, a tot...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Mustard CA,Mayer T

    更新日期:1997-04-15 00:00:00

  • Tracking of risk factors for coronary heart disease over a 14-year period: a comparison between lifestyle and biologic risk factors with data from the Amsterdam Growth and Health Study.

    abstract::Because the magnitude of tracking coefficients (i.e., stability coefficients and tracking for subjects at risk) greatly depends on the initial age of subjects, the number and spacing of longitudinal measurements, and the length of the total time period, it is difficult to compare tracking coefficients from different s...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Twisk JW,Kemper HC,van Mechelen W,Post GB

    更新日期:1997-05-15 00:00:00

  • Lessons Learned From Past Gene-Environment Interaction Successes.

    abstract::Genetic and environmental factors are both known to contribute to susceptibility to complex diseases. Therefore, the study of gene-environment interaction (G×E) has been a focus of research for several years. In this article, select examples of G×E from the literature are described to highlight different approaches an...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章,评审


    authors: Ritz BR,Chatterjee N,Garcia-Closas M,Gauderman WJ,Pierce BL,Kraft P,Tanner CM,Mechanic LE,McAllister K

    更新日期:2017-10-01 00:00:00

  • Four and two-thirds years incidence of coronary heart disease in middle-aged men: the Oslo study.

    abstract::The association between four and two-thirds years incidence of coronary heart disease (CHD) and serum cholesterol, blood pressure (BP), height, body weight, cigarette smoking and physical activity at work and at leisure, was studied in 14,816 Oslo men, aged 40-49 years at entry to the study and free of cardiovascular ...

    journal_title:American journal of epidemiology

    pub_type: 杂志文章


    authors: Holme I,Helgeland A,Hjermann I,Leren P,Lund-Larsen PG

    更新日期:1980-07-01 00:00:00