EpiBlog

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog"; The new developments in the saga on data protection in the EU has rightly generated lots of concern. Many years of investments in infrastructure to help improving our knowledge on how to improve treatment and prevention for diseases and ill health may all be wasted.  Here is the latest report on the topic from cancer epidemiologists. –From the Rapid Response Group  

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Evert Ben van Veen has written a summary of the LIBE views and makes comparisons to the proposed data protection regulation. The LIBE proposal will set back epidemiologic research in many European countries if used in the new law. It will threaten free and critical research and the principles of democracy and open societies.

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The rapid response committee has kept IEA members up to date on important legal issues related to use of data in epidemiologic research, especially data collected for monitoring or administrative use. The proposed Regulation provided a legal framework that would not add new restrictions to our use of health data in research. That may unfortunately have changed. Albrecht’s revisions to the proposed text will have serious consequences for epidemiology if they are all accepted. Please note Welcome Trust’s concern below and have a look at the changes yourself – pay special attention to amendments 15,17,19,22 and 31.

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The text on data protection for the EU is being debated and it is clear that several changes will be made. It is currently unclear whether we end up with a directive or a regulation. A directive will provide more flexibility for individual countries in how they practice the law. A regulation imposes a common law for all member states. By November 2012 6 countries support a ‘directive mode’. Not quite enough to avoid that a regulation will be implemented by parliament but many countries have not yet made their position clear. There are other part of the text being debated so the battle is far from over and we still run a risk of having less options for doing research after new legislation has been agreed upon next year.

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog"; At the IEA European Congress in Porto the new EU regulation was debated on Friday September 7th, 2012. At the session the Italian Judge Giovanni Buttarelli was present and took part in a panel debate with epidemiologists from Germany, Italy, Portugal and Denmark. He has worked as the supervisor and advisor (EDPS) for the EU on legal issues related to data protection. The discussion addressed the current draft of the regulation (July, 2012), but several changes are expected in the next version of the text. Most epidemiologists can live with the current draft version of the new text because its paragraph 83 provides a framework for us to use data generated for a different purpose in research. However, there is no guarantee that this exemption will remain in the final text. Buttarelli’s advice was to follow the process in EU closely and request a ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";NEJM recently (2012; 367: 1355-1360) requested better analyses of missing data in randomized trial. This recommendation may be expanded to other study designs, especially since the problem with missing responders and missing responses is increasing. This suggestion will not only provide work for statisticians and epidemiologists in the time to come, it will also provide better justified conclusions and most importantly will open up for other types of sensitivity analyses.

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Since our last report, several groups have been active in suggesting modification of the text to facilitate epidemiologic research in Europe. Epidemiologists have contacted members of the European Parliament from their home countries. Ministers of Research have been contacted, and newspaper articles have been published on the topic. Not only epidemiologists have been active. Large funding agencies, societies, patient organizations, and the EMA have also voiced their opinion. Attempts to modify the text have so far included keeping the text as a Directive and not as a Regulative. Since a Directive will provide more freedom for individual interpretation for the member states. Some have also suggested excluding research from the Directive or have provided modifications of critical passages in the text to make it more “research friendly”. Although research problems are now being considered by the EU, epidemiologists have to continue the debate and try to influence ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Proposal for a Regulation of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data Comments and follow-up of “EpiBlog: Informed consent” and “EpiBlog: A New EU Directive for Data Protection in Europe” I have seen the future, baby it is murder —Leonard Cohen As previously announced, the European Union will replace their Directive on Data Protection with a new text. A draft is now available on this website: http://www.statewatch.org/news/2011/dec/eu-com-draft-dp-reg-inter-service-consultation.pdf, and it is not pleasant reading for epidemiologists. Should this text be adopted as a regulation (and that is what they propose) it will be much more difficult to do research in the future, at least in parts of Europe. Our opportunities to identify new toxic hazards, to evaluate health programs, to see if laws have unwanted or ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Understanding case-control studies as involving sampling the necessary information from an underlying, often unknown, cohort to learn about the relative increase in disease occurrence among exposed compared to not-exposed goes back to the 1980s. But comparing cases and controls in a table (often table 1) is still what we see. “You should stop this business of comparing cases and controls” was what Miettinen’s students were told more than 30 years ago. Apparently, not many listened…

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Informed consent is a key concept in research ethics, and it has a central place in the Helsinki Declaration. In the randomized clinical trial, participants need to be informed about the potential risks and benefits of the treatment under study in order to make an informed decision before saying yes or no to the invitation to take part in the trial. It is more complicated in observational studies. People are not invited to take part in any experiment. They are invited to provide data or agree to have their data used in research to benefit others, in some situations also themselves. In some cases, informed consent is impossible because the participants are no longer alive or capable of making a decision. In some cases, the specific aims of the study are difficult to explain, like in the GWAS studies. In some cases, it ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";It is well documented that NCDs carry an increasing burden of diseases and mortality in affluent as well as poor countries. NCDs amount to 63 % of all deaths in the world, and 80 % of these occur in low and middle income countries (LMICs). Cardiovascular diseases and chronic obstructive diseases are expected to increase rapidly in many LMICs, and NCDs are a major cause of poverty, loss of productivity and quality of life worldwide. The global fight against communicable diseases is still important, and it has been successful in many areas. The concern is that many still act as if health problems in LMICs are mainly related to communicable diseases. Most of the research and prevention efforts have been devoted to the fight against “tropical diseases”, which may appear to be the main health problems for foreigners working (and doing medical research) ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Many countries are prepared to address epidemics of infectious diseases, because they have organizations, training programs, legislation and monitoring systems. Best known is probably the CDC in theUS, but many other countries in Asia, Europe, Latin America and theMiddle Easthave invested in a similar preparedness. The European Union has, for example, established a European CDC to help individual countries cope with preventing the spread of infectious disease, especially when they occur more frequently than expected. But not all diseases are caused by infections, and other causes may also cluster in time and cause epidemics. We have, for example, at present epidemics in diabetes, obesity, Attention Deficit Hyperactivity Disorder (ADHD) and autism, and many more. We recently had an epidemic of CVD in the developed countries of the world, and we might be having an epidemic in developing countries, but we do not know ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";In a recent editorial from the BMJ, arguments for sharing data were once more repeated (ensures reproducibility, allows testing of secondary hypotheses, facilitates development of new statistical methods, provides a resource for teaching, aids design of new studies, simplifies data acquisition for meta analysis, and helps prevent fraud and selective reporting). Although substantial support to the principle of open access to data has come from many sides, including the IEA, “the system is broken and needs fixing”, BMJ claims, and we agree. The BMJ suggests that time has come for scientific journals to refuse publication unless data are openly available and for funding agencies to request that the data they have paid for are available to external researchers. Many journals and funding agencies have this policy now, but they do not always follow up on the requests or accept access by committees that ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The really old-school epidemiologists will remember how influential epidemiologists in the 1980s complained about all these new methods that flooded our scientific papers, like the log-linear models, later the logistic regression model and then the Cox models. Epidemiologists had been served well in aetiological studies by doing stratified analyses using first Cochran’s way of weighting stratum specific estimates to a common measure of association (Cochran, 1954). Later the Mantel-Haenszel method took over (Mantel-Haenszel, 1959). All of this could be done with pencil and paper or by using the growing power of pocket calculators – anyone remember the HP41-C?  What these new methods had added to our toolbox, except making calculations simple once they entered standard computer packages, was not clear in the beginning. What had we gained we did not have before in our search for determinants of diseases, was the question asked ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Epidemiology has never been a static science in its more than 100 years of existence. Methods change over time, and research, focus, funding and infrastructures do not remain as they once were. Still, the changes we see now overshadow anything we have seen in the past. Large-scale cohorts are being planned, have started and will start soon all over the world. Funding exceeds anything we have seen before with hundreds of millions of dollars, even billions. All is driven by new technologies; the ability to examine millions of gene variations, epigenetic changes, copy variants and soon total gene sequencing at low costs using small volumes of blood, saliva or other bio materials. Most of this is based on cohort studies, because the research ideas are explorative or lacking. Strong deduction based on a prior hypothesis stating predictions that can be refuted is ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Many European epidemiologists will remember that the first draft EU proposed on Data Protection would have made it almost impossible to do epidemiologic research and many other types of research as well. Only after substantial consultations in Brussels by colleagues and patient organizations did we end up with a Directive that allowed (at least in some European countries) to continue research activities of importance to provide the best possible disease prevention and medical treatment to the citizens of the EU. In some countries the interpretation of the Directive is still a major obstacle to epidemiologic research and some of these countries may have an interest in a restrictive interpretation of the Directive. Since new communications methods are being used (Facebook mentioned as an example) EUs considers it necessary to revise the Directive. We hope that this revison will take into consideration that research is an important ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Epidemiology is the scientific discipline that aims to  identify the occurrence and determinants of health and diseases in human populations and the application of this knowledge to control health problems. It is a discipline that systematically uses population experience concerning exposures (social factors, lifestyle factors, environmental factors, treatments, etc.) and health. It is a discipline that uses experimental and observational methods. As in other areas of scientific research our findings are not always right; they are seldom completely right and sometimes simply wrong. Many of our observations will not be replicated by others. Our findings may suggest causal links, but no single study can claim causality, whether the study is based on experimental or observational designs. Conclusions are based on a body of literature, and journalists should always ask the researcher what previous studies have found, and what the new study adds to ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Readers of Epidemiology (the journal) will be aware of the request to pre-register not only randomized trials but also observational studies. This request comes from the industry sponsored European Center for Ecotoxicology and Toxicology of Chemicals (1) and some journals have already adopted the rule. We are pleased to see Epidemiology will not be among them (2) and a number of invited authors add important points to the discussion (3-6). The BMJ had asked Sørensen and Rothman to write an editorial on the topic and in spite of their warnings BMJ will actively support the registration of observational studies (BMJ 2010; 340: 374-376). We accept that such a pre-registration may make sense for studies designed to provide specific documentation or to be used to make a specific decisions. Registration of randomized trials and animal studies used to examine toxicity of specific exposures ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The history of the case-control study dates back to the beginning of the 20th century, probably inspired by writings by Hippocrates and John Stuart Mill. Hippocrates encouraged doctors to pay attention to what was common and particular for their patients. Mill provided the method of agreement and disagreement in search for causation. Much later Cornfield provided the documentation for using the exposure odds ratio to estimate the disease odds ratio in what is now called the case-non case study. The rare disease assumption indicates that this OR is close to RR when the disease is rare among both exposed and not exposed. Since the 1980s the driving force in developing the case-control study has been to develop a design where the exposure odds ratio would estimate the RR or IRR without any rare disease assumption. The key is that controls are sampled at random ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The WHO Health for All by the year 2000 program was very ambitious and had a tight deadline. The success of the program may be questionable but it did help many countries to start formulating health goals for the population, rather than planning all health care activities on treatment indicators. The Millennium Development Goals follow this tradition. This time the goals are fewer and less detailed and some of them have a deadline (2015). All the stated goals are related to health, some by targeting health determinants, others more directly by targeting child mortality, maternal health and certain infectious diseases. The health goals will be achieved if social inequalities within and between countries are reduced by improving the conditions for the poor. Some of the health goals can even be reached should that not be the case. [Evans et al, 2005a; Evans ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Studies that relate common exposures with life-threatening diseases tend to be received with great interest from public media and shape the public’s conception of epidemiology. Interphone is one of these studies and its first part of the combined Interphone study on mobile phone use and brain cancer was recently published in The Journal . The results are difficult to interpret and apparently even the authors disagree among themselves. Most of the findings show reassuring results, in fact protective ORs below one but these are disregarded by the authors. For intensive use over longer time periods there are indications of an association between the exposure and the studied brain cancers (glioma and meningioma), supported by the location of the brain tumors ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Readers of the European Journal of Epidemiology will be aware of the debate this Journal started by inviting O.S. Miettinen to provide a review of our dictionary 1. Miettinen’slatest response in this debate is as always interesting reading, written in a hyped language that matches true novel pieces of writing in the scientific literature 2. It is partly English, partly Latin but mostly a fascinating use of familiar and unfamiliar words. Miettinen is alive and he is doing fine. Miettinen criticizes our (IEA’s) choice of editors of the dictionary (John Last and now Miquel Porta) and he thinks it should be the drivers of the development of our discipline (Greenland and Robins are mentioned – Sander Greenland is actually an associate editor of the dictionary’s 5th edition), but then why not Miettinen himself?Was he too modest to suggest this although modesty is not one ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog"; Epidemiologists, like other scientists, make mistakes. In our search for learning about causal links between environmental or genetic factors and diseases we study associations as they occur in populations that provide access to data. We know that these associations have many reasons; most of these are not the causes we seek. Much attention (too much) has been given to random errors and P-values in decision making. Most errors are related to bias and confounding, not insufficient sample size. Our findings are not true or false, rather more or less plausible. Our objectives should not be to accept or reject often rather meaningless null-hypotheses. Add to this the problem of publication bias. Results are published or not published partly as a function of the results we obtain. Censoring is driven by the investigators, the editors, the peer reviewers and others. This problem is real ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Many countries perform routine newborn screening tests based on blood samples taken from the child shortly after birth. Blood that was not used in the screening has been stored in many places and used for research related to birth defect and related to prenatal causes of adult diseases. Use of these samples has for example shown that schizophrenia may be caused by pre or perinatal infections. Many would agree that these samples provide an extremely valuable research resource that often has been paid for by public funds. A Texan lawsuit recently ordered destruction of 5.3 million such blood samples, stored without the parents’ consent (1). Many fear that a similar practice could spread to other similar biobanks. The case was brought by a not for profit civil rights organization on behalf of five parents who claimed that their infants’ blood had been stored ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Readers of medical journals know that only few papers are published without one or more p-values. Some of these readers believe they understand the meaning of these p-values. They are usually wrong as are most of the editors or peer-reviewers. The better educated epidemiologist knows that p-values are complicated to interpret. Very few actually know how they can be interpreted and under which conditions these interpretations apply. Why then provide p-values in scientific papers? Many would say “let’s drop the statistics altogether”. Others would argue the p-value is a useful statistic and one should educate users of what p-values are and what they are not. Sander Greenland suggests that public health society should endorse a number of statements of what p-values are not and ask societies to endorse the statements (enclosed). We generally agree with Greenland’s statements, but feel that there should be ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";The Nobel Prize is without doubt the most prestigious prize in science, not because of the amount of money the prize winner is given, but because of its history and the care the committee takes in selecting the best candidates given the principles laid down in its foundation. These principles go back to Nobel’s will signed in 1895 and the time may have come to bring these principles in line with how research is done now. Some of us pointed out that leaving out the epidemiologists among the group of scientists who received the Nobel Prize in 2009 (Zur Hausen, Barré-Sinoussi and Montagnier) did not properly reflect how the causes of cancer of the cervix and AIDS were identified (Epidemiology 2009; (20) 5: pp632-634). H.O. Adami, a long term member of the Nobel Prize Committee and renowned epidemiologist explained in the same issue ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";CIOMS has recently made their revised version of these guidelines available on the net but it is unclear if they are willing to accept amendments in the light of comments from the international epidemiological community. This Rapid Response is intended to provide IEA members with the encouragement to discuss the documents with the CIOMS and with their local ethic committees. The provisional text is available at www.cioms.ch/080221feb_2008.pdf.  Please contact CIOMS quickly if you have comments. This revised version is much improved on earlier versions. The document details several important areas that are badly needed for epidemiologists: Guidelines concerning ethical committee review of multicentre studies Research on anonymous data or data that has been encrypted Use of incentives for participation in studies Internet data collection Long-term prospective studies and renewal of consent to participate Informing participants about study findings The general statements CIOMS make in the documents are often good but the ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Certification of epidemiologists has been discussed from time to time and some have adopted such a policy and others have been reluctant for the reason that many good epidemiologists have achieved their skills in unorthodox ways. Success in science often depends upon many other things that the ability to pass exams and do what the professor tells you to do. The STROBE (strengthening the reporting of observational studies in epidemiology) statements suggest adopting certain standards for reporting non experimental epidemiologic studies. Should we endorse these statements and try to harmonize our writing even more than it is at present? At a talk at UCLA Somerset Maugham once said: ‘There are 3 rules for writing a novel. Unfortunately, nobody knows what they are.’ In reality he meant ‘fortunately’. Here we get a whole set of rules; a full checklist. It will certainly make our papers more ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Epidemiologists who are not entirely newcomers to the discipline will remember the debate G Taubes activated by his Science paper in 1995 ‘epidemiology faces its limits’. Now he is back with a paper written to a much larger audience called ‘do we really know what makes us unhealthy’, published in The New York Times, September 16, 2007. The history this time is about hormone use and menopause, sometimes misleadingly called hormonal replacement therapy (HRT), as if a reduction in estrogen level after menopause is a mistake made by nature that has to be replaced (corrected). Taubes is right that the general wisdom among many clinicians was that these drugs were beneficial for older women in reducing their risk of heart diseases and osteoporosis. He fails to tell that many epidemiologists, however, remained sceptical. Most epidemiologists recalled from their basic training the discussion from ...

var hupso_services_t=new Array("Twitter","Facebook","Google Plus","Pinterest","Linkedin","StumbleUpon","Digg","Reddit","Bebo","Delicious");var hupso_toolbar_size_t="small";var hupso_image_folder_url = "";var hupso_title_t="EpiBlog";Most epidemiologists will know that the occurrence of many diseases is driven by complex social factors and political conditions operating through health behaviours, exposure to risk factors, and ultimately through molecular mechanisms. In this stream of causation many epidemiologists are rafting quickly downstream towards molecular epidemiology or nano-epidemiology (at least the internet domain name has been taken). Research funding is downstream from seeking the primordial social and political causes of diseases which requires the study of macrostructures but is focusing on understanding the micro cosmos of biology. The reasons for these shifts may be good or bad – not only the devil, but also the money, is in the detail. Using Aristotelian terminology we are neglecting studies on the final and efficient causes to study the material and formal causes and that will come at a price. First, it is not certain that ...