Snippets From the Past: Is Flint, Michigan, the Birthplace of the Case-Control Study?

Abstract

In the summer of 1924, an outbreak of scarlet fever occurred in Flint, Michigan. Unable to trace it to the usual causes, particularly fresh milk, the Michigan Department of Health used a novel approach to disentangle the enigma: The 116 cases of scarlet fever were compared with 117 "controls" selected from neighbors of the quarantined cases and from patients at the City Health Center who had been treated for ailments unrelated to scarlet fever. The extraordinary culprit was ice cream, which had a frequent/occasional/none consumption prevalence of 60%, 34%, and 6% among the cases and 24%, 51%, and 25% among the controls, respectively. The 1925 report reads, "Detailed epidemiological investigation, by means of case histories and control histories on well persons, confirmed early suspicions and established the fact that the epidemic was spread by ice cream" (Am J Hyg. 1925;5(5):669-681). This forgotten epidemiologic study is the oldest study using the case-control design to have been resurrected thus far. The case-control study design may have been conceived simultaneously, but independently and for different purposes, in England (Janet Lane-Claypon's 1926 report on the determinants of breast cancer) and the United States.

Snippets From the Past: Cohort Analysis of Disease Rates--Another Piece in a Seemingly Still Incomplete Puzzle

“…The second reason for circumspection is that potential troves have not yet been fully explored. It would be warranted to systematically search the American Journal of Public Health and other relevant sources before 1929, as I am doing for the American Journal of Hygiene (10,34,35), before jumping to the conclusion that Bigelow and Doering were the first to use the term cohort to characterize agespecific rates organized by year-of-birth. However, to the best of my knowledge, they are.…”

Snippets From the Past: Imaginative Designs—Separating Hereditary From Environmental Effects in pre-DNA Times

“…He made it a principle not to co-sign the papers of his students, which he had not written himself (18,19). However, this rheumatic fever study (and probably another one by Ramsey, as discussed in a previous article (20)) proves that he was familiar with the conduct of case-control studies.…”

El diseño observacional larvario

“…Otros investigadores le dan importancia al estudio realizado en Flint (Michigan) sobre un brote de escarlatina 46 . George H. Ramsey dirigió aquella investigación que señaló a los helados como causantes vehiculares de la infección y que tuvo un diseño de casos y controles.…”