Concepts of Epidemiology An integrated introduction to the ideas, theories, principles and methods of epidemiology

by Bhopal, Raj

• ISBN13: 9780192631558
• ISBN10: 0192631551
• Additional ISBN(s): 9780191562372
• Format: Paperback
• Copyright: 2002-06-13
• Publisher: Oxford University Press
• More Book Details
• Purchase Benefits

Summary

Epidemiology concerns the frequency, pattern, and causes of disease in populations. It is one of the most important modern sciences underpinning health and healthcare- including medicine, public health and profession allied to medicine. Concepts in Epidemiology explains and illustrates the key concepts(language, principles and methods) that underpin the science of epidemiology and its applications to policy making, health service planning and health promotion. Richly illustrated, there are exercises to help readers deepen their understanding, with detrailed material captured in tables. Each chapter ends in a summary, and all technical and specialized terminology is explained and defined in a glossary. The book places heavy emphasis on integrating the ideas of epidemiology. Topics include: the nature and scope of epidemiology; the epidemiological concepts of population; variation in disease by time, place and person: error, bias, risk modification and confounding; cause and effect: the concepts of natural history, spectrum, iceberg, population patterns and screening; risk and measures of disease frequency; presentation and interpretation of epidemiological data on risk; study design; and theoretical, ethical, contextual, practical and critical foundations of epidemiology.

Table of Contents

Glossary	xx
What is epidemiology? The nature and scope of a biological, social, and ecological science and of epidemiological variables and outcomes	1	(16)
The individual and the population	1	(1)
Definition of epidemiology and statement of its central paradigm	2	(1)
Directions in epidemiology and its uses	3	(1)
Epidemiology as a science, practice, and craft	4	(3)
The nature of epidemiological variables	7	(4)
A disease and health problem: an illustration of the interdependence of clinical medicine and epidemiology	11	(3)
Seeking the theoretical foundations of epidemiology	14	(3)
Summary	15	(2)
The epidemiological concept of population	17	(27)
The individual and the population	17	(4)
Harnessing heterogeneity in individual and group level disease and risk factor patterns	21	(1)
Disease patterns as a manifestation of individuals living in changing social groups	22	(4)
Sick populations and sick individuals	26	(5)
Individual and population level epidemiological variables	31	(2)
Epidemiology and demography: interdependent population sciences	33	(6)
The dynamic nature of human population	39	(1)
Applications of the population concept	40	(2)
Conclusion	42	(2)
Summary	43	(1)
Variation in disease by time, place, and person: A framework for analysis	44	(25)
Introduction	44	(1)
Reasons for analysing disease variations	45	(2)
Variations and associations: real or artefact?	47	(5)
Applying the real-artefact framework	52	(7)
Disease clustering and clusters in epidemiology	59	(8)
Applications of observations of disease variation	67	(1)
Epidemiological theory underpinning or arising from this chapter	68	(1)
Conclusion	68	(1)
Summary	68	(1)
Variation: Role of error, bias, and confounding	69	(29)
Introduction	69	(3)
A classification of error and bias	72	(20)
The research question, theme or hypothesis	73	(3)
Choice of population	76	(3)
Non-participation	79	(1)
Comparing disease patterns and risk factor-disease outcome relationships in populations which differ (confounding)	79	(7)
Measurement	86	(2)
Misclassification bias	88	(2)
Analysis and interpretation	90	(1)
Publication	91	(1)
Judgement and action	91	(1)
A practical application of the research chronology schema of bias and error	92	(2)
Conclusion	94	(4)
Summary	97	(1)
Cause and effect: The epidemiological approach	98	(35)
Introduction: causality in science and philosophy	98	(3)
Epidemiological causal strategy and reasoning: the example of Semmelweiss	101	(2)
Models of cause in epidemiology	103	(12)
Interplay of host, agent, and environment	103	(10)
Necessary and sufficient cause	113	(2)
Guidelines for epidemiological reasoning on cause and effect	115	(15)
Comparison of epidemiological and other concepts of causal reasoning	115	(6)
Application of criteria to associations	121	(8)
Interpretation of data, study design, and causal criteria	129	(1)
Epidemiological theory illustrated by this chapter	130	(1)
Conclusion	130	(3)
Summary	132	(1)
Natural history, spectrum, iceberg, population patterns, and screening: Interrelated concepts in the epidemiology of disease	133	(30)
Natural history of disease	134	(5)
The population pattern of disease	139	(1)
Spectrum of disease	140	(2)
The unmeasured burden of disease: the metaphors of the iceberg and the pyramid	142	(3)
Screening	145	(11)
Applications of the concepts of natural history, spectrum, and screening	156	(4)
Epidemiological theory: symbiosis with clinical medicine and social sciences	160	(1)
Conclusion	161	(2)
Summary	161	(2)
The concept of risk and measures of disease frequency: Incidence and prevalence	163	(28)
Introduction: risks, risk factors, and causes	163	(1)
Quantifying disease frequency, risk factors, and their relationships	164	(3)
Incidence and incidence rate: the concepts of incidence density, person-time incidence and cumulative incidence	167	(6)
Numerator	173	(5)
Denominator	178	(1)
Prevalence and prevalence rate	179	(6)
Relationship of incidence and prevalence	185	(3)
Choice of incidence or prevalence	188	(1)
Presenting rates	188	(1)
Conclusion	189	(2)
Summary	190	(1)
Presentation and interpretation of epidemiological data on risk	191	(40)
Introduction	191	(1)
Proportional morbidity or mortality ratio (PMR)	192	(2)
Adjusted overall rates: standardization and the calculation of the SMR (Standardized mortality ratio)	194	(4)
Relative measure: relative risk	198	(4)
The odds ratio (OR)	202	(5)
Measurements to assess the impact of a risk factor in groups and populations	207	(7)
Attributable risk/exposed group	210	(2)
Population attributable risk	212	(2)
Presentation and interpretation of epidemiological data in applied settings	214	(3)
Avoidable morbidity and mortality	217	(1)
Comparison of summary measures of health status	218	(2)
DALY, disability adjusted life years, and QALY, quality adjusted life years	220	(2)
Numbers needed to treat (NNT) or to prevent (NNP)	222	(1)
Describing the health status of a population	223	(3)
The construction and development of health status indicators	226	(2)
Conclusion	228	(3)
Summary	230	(1)
Study design	231	(36)
Introduction: interdependence of study design	231	(3)
Classifications of study design: five dichotomies	234	(1)
Case-series: clinical and population based	235	(7)
Cross-sectional study	242	(5)
Case-control study	247	(4)
Cohort study	251	(4)
Trials	255	(2)
Overlap in the conceptual basis of the case-series, cross-sectional, case-control, cohort, and trial designs	257	(5)
Ecological studies: design or analysis?	262	(1)
Size of the study	263	(1)
Data analysis and interpretation	264	(1)
Conclusion	265	(2)
Summary	265	(2)
Theoretical, ethical, contextual, practical, and critical foundations for future epidemiology	267	(30)
The interrelationship of theory, methods, and application: a question of values	267	(2)
Fundamental influences on health	269	(2)
Setting priorities in health and health care	271	(3)
Impact on health of local polluting industries: Teesside study of environment and health	274	(2)
Paradigms: the evolution of epidemiology	276	(1)
Epidemiology: forces for change	277	(1)
Scope of epidemiology and specialization	278	(1)
The context of epidemiological practice-academic and service, USA and UK	279	(1)
The practice of epidemiology in public health	280	(1)
Ethical basis and proper conduct of epidemiology: the need for a code	281	(3)
Tobacco industry	281	(1)
Authorship	281	(1)
Ethnicity and race	282	(2)
Ethical guidelines	284	(1)
Critical appraisal in epidemiology: separating fact from error and fallacy	285	(4)
The fallacy of association being causal	287	(1)
The weight of evidence fallacy	287	(1)
The fallacy of repeated citation	287	(1)
The fallacy of authority	288	(1)
The fallacy of simple explanation	288	(1)
The fallacy of risk	288	(1)
The fallacy of inappropriate extrapolation	288	(1)
The fallacy of significance tests	288	(1)
The fallacy of obfuscation	288	(1)
The fallacy of covert bias	289	(1)
The nature of critical appraisal	289	(1)
Some questions relevant to the appraisal of epidemiological research	289	(2)
Building on an epidemiological education: role of historical landmarks	291	(2)
Building on an epidemiological education: a reflection on the future of epidemiology	293	(4)
Summary	295	(2)
References and further reading	297	(14)
Index	311