Clinical Epidemiology and Its Relevance for Public Health in Developing Countries

Abstract

literature search engines that will let us find evidence for the sustain of our activities in the healthcare systems, and in some cases without even looking for them, like with the applications from Google Reader and the RSS/XML, or obtaining portals dedicated to Evidence Based Medicine, or programs such as the statistical calculator Epidat which can simplify our statistical analysis, without even mentioning the multiple statistical softwares available [7]. Other concepts to consider are social epidemiology, which have been gaining ground these last decades and backing up the analysis of the social determinants of health status. This approach has generated big expectation for its integration and multidisciplinary character, but it's not free of skepticism that relates it with the idealism of a politics' strategic instrument [8]. However, social epidemiology, like field of clinical epidemiology, is based on the positivist paradigm and uses the statistical methods as analysis foundation. Besides, it is important to mention that currently, it has been generated a whole new research line based on the approach of the social determinants, where it is critical the usage of multilevel statistical models and new technologies that pose a new challenge to young researchers [9]. According to what it is stated, the current medical science tendency is focused in the generation of evidence that contributed in its development and has an impact in the patients' health. This approach, of EBM, is expressed mainly in the care, in relation to drugs and medical devices, though it is admitted that community interventions through Public Health deserve to be recognized as significant events that have had an impact in the population's health [10]. In this way, it is necessary to recognize the existence of research that s directed to make evidence of the impact of Public Health's diverse activities. Evidence Based Public Health keeps the cause-effect logic, and allows adding the determinants of health, such as lifestyles, culture and environment, to the scientific context that often is what characterizes the good or bad execution of an intervention. Evidence Based Public Health is a new tendency that is joining efforts to offer the best information for an efficient politics decision making [11]. When it is oriented to the research of a population's health issues whether in the community or the hospital sphere, it contributes remarkably to the solution of very different local and regional realities, thus making a progress in Public Health, especially in out developing countries. 2. Differences between clinical epidemiology and field epidemiology 2.1. Classic or field epidemiology Epidemiology is an old discipline with roots on scientific and rational structures, based on experience, on what is real. It is of great importance for Public Health and its impact for clinical medicine has risen in the last decades [12]. The comparison between clinical epidemiology and field epidemiology may demonstrate similarities and differences that can result...

The General Practitioner as a Clinical Epidemiologist: Three Metaphors to Explain the Fundamental Concepts

“…That is, clinical epidemiology has its main element in the solution of the treatment and management of diseases, contributing to the identification of risk factors for certain diseases and to date being the fundamental part of Evidence-Based Medicine. So, it becomes important the teaching of clinical epidemiology to help in the education of professionals to get a judicious capacity and the rational use of the best alternatives in diagnosis and treatment, through a critical evaluation of the literature, and help stimulate the training of researchers, because it is implicit that the execution of clinical epidemiology will lead to the development of research [7].…”

Clinical epidemiology in developing countries: Current situation and suggestions for the Indian context

“…CE services also should be considered as a part of all public health activities along with clinical epidemiological approach being used as a basic analytical tool by all clinicians at the bedside. 18 Each practitioner should be asking the relevant clinical question about the patient and all practice to be transformed into EBM activity. As there is considerable resource limitation in developed country settings, the efficiency and equity considerations are more important concerns in the Indian context.…”

Relevance of developing public health service cadres alongside a more prevention oriented Indian health system: an overview

“…7 So, with doctors with clinical excellence, we need a workforce well versed in different aspects of disease epidemiology, health management, health finance and health economic analysis and moreover someone with leadership or managerial capabilities to look over and act as a bridge between the different sectors of health. 8,9 In a symposium on providing affordable and accessible healthcare, eminent public health expert Dr. T. Sundararaman said that a public health cadre's job responsibilities include largely organising public interventions, addressing social and environmental determinants of health, and taking managerial roles in the delivery of healthcare services, particularly primary healthcare. 9 Any health system must deliver, first preventive services aiming to decrease exposure to diseases via implementation of measures like ensuring clean water and sanitation.…”