To Advance Epidemiology

Stallones, Reuel A.

doi:10.1146/annurev.pu.01.050180.000441

Cited by 81 publications

(27 citation statements)

References 21 publications

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“…HYPOTHESIS TESTING Another source of dissatisfaction concerns the "black box" of epidemiology in the chronic disease era (62)(63)(64). The black box metaphor connotes that risk factor-disease associations are afforded priority over the linkages between them (62,79).…”

Section: Production Of Knowledgementioning

confidence: 99%

“…The interactions among individuals and the interplay between individuals and the environment fall outside the scope and the grasp of most research. Inattention to context leads to a limited and precarious knowledge base for public health action (1,28,35,45,64,80).…”

Section: The Purview Of Epidemiologymentioning

confidence: 99%

“…Several recent proposals hold in common a desire to broaden the scope of inquiry in two dimensions especially. First, the search for causes would pursue multiple levels of organization, extending study both to macrolevels beyond (3,28,40,45,64,80) and to microlevels within the individual (40,46). Second, it would elaborate the time dimension to emphasize both histories of individual development and the history of society.…”

Section: Toward a New Paradigm: Multiple Levels And The Passage Of Timementioning

confidence: 99%

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A Future for Epidemiology?

Schwartz

Süsser

Susser

1999

Annu. Rev. Public Health

135

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This paper considers ways of thinking about causes and prevention that could guide epidemiology beyond the present era. Discontent with modern epidemiology, in the face of its substantial achievements, is taken as a sign that the guiding principles of the discipline warrant reconsideration. To begin this task, current practices are placed within an historical perspective, in a review of the dominant ideas of successive eras in epidemiology. Then the premises and constraints of the present era of chronic disease epidemiology, with its risk factor paradigm, are specified. Finally, elements of a causal paradigm for an emerging era are proposed. This paradigm encourages thinking about causes at multiple levels of organization and within the historical context of both societies and individuals. The proposed approach aims to preserve and build on the contributions of past eras, as well as the present one.

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Section: Production Of Knowledgementioning

confidence: 99%

Section: The Purview Of Epidemiologymentioning

confidence: 99%

Section: Toward a New Paradigm: Multiple Levels And The Passage Of Timementioning

confidence: 99%

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A Future for Epidemiology?

Schwartz

Süsser

Susser

1999

Annu. Rev. Public Health

135

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“…The statistical tools fo r dealing with the data generated by these studies are now largely in place; the challenge and the obligation will be to use them prudently (7,59). Even though a number of lines of enquiry have become decidedly more complex in the past few decades (witness fo r exam ple the current thinldng on cholesterol and heart disease), by and large, questions still tend to be posed one dimension at a time.…”

Section: Discussionmentioning

confidence: 99%

Appropriate uses of Multivariate Analysis

Hanley¹

1983

Annu. Rev. Public Health

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“…-a territory we call the pathogenetic level of disease (Figure 3). Epidemiology, with the exception of molecular epidemiology, generally examines variables at the level of the person and above (including the group, the society, etc (Stallones 1980). Disease causation, however, can involve any organizational level, so the territory we define as the etiologic level of disease spans the entire spectrum of levels.…”

Section: Assumption #1mentioning

confidence: 99%

Evidence, illness, and causation: An epidemiological perspective on the Russo–Williamson Thesis

Fiorentino

Dammann

2015

Studies in History and Philosophy of Science Part C: Studies in

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According to the Russo-Williamson thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine (EBM) can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence (previously known as difference-making evidence) provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions.

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To Advance Epidemiology

Cited by 81 publications

References 21 publications

A Future for Epidemiology?

A Future for Epidemiology?

Appropriate uses of Multivariate Analysis

Evidence, illness, and causation: An epidemiological perspective on the Russo–Williamson Thesis

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