Modern Epidemiologic Principles And Concepts

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Modern Epidemiologic Principles And Concepts

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Author : Laurens Holmes, Jr
language : en
Publisher: Laurens Holmes, Jr
Release Date : 2025-03-04

Modern Epidemiologic Principles And Concepts written by Laurens Holmes, Jr and has been published by Laurens Holmes, Jr this book supported file pdf, txt, epub, kindle and other format this book has been release on 2025-03-04 with Medical categories.

Modern Epidemiologic Principles & Concepts - Study Design, Conduct and Application We often conceive epidemiology in either simplistic or complex terms, and neither of these is accurate. To illustrate this, the complexities in epidemiology could be achieved by considering a study to determine the correlation between serum lipid profile as total cholesterol, HDL, LDL, triglyceride, and total body fatness or obesity measured by BMI in children. Two laboratories measured serum lipid profiles, and one observed a correlation with BMI, while the other did not. Which is the reliable finding? To address this question, one needs to examine the context of blood drawing since fasting blood level may provide a better indicator of serum lipid. Epidemiologic studies could be easily derailed given the inability to identify and address possible confounding. Therefore, understanding the principles and concepts used in epidemiologic studies designed and conducted to answer clinical research questions facilitates e accurate and reliable findings in these areas. Another similar example in a health fair setting involves geography and health, termed health-o-graphy. The risk of dying in one zip code A was 59.5 per 100,000, and in the other zip code B was 35.4 per 100,000. There is a common sense and non-epidemiologic tendency to conclude that there is an increased risk of dying in zip code A. To arrive at such inference, one must first find out the age distribution of these two zip codes since advancing age is associated with increased mortality. Indeed, zip code A is comparable to the United States population while, zip code B is the Mexican population. These two examples are indicative of the need to understand epidemiologic concepts such as confounding by age or effect measure modification prior to undertaking clinical research. This textbook describes the basics of research in medical and clinical settings, as well as the concepts and application of epidemiologic designs in research. Design transcends statistical techniques, and no matter how sophisticated statistical modeling, errors of design/sampling cannot be corrected. The author of this textbook has presented a complex field in a very simplified and reader-friendly manner with the intent that such a presentation will facilitate the understanding of the design process and epidemiologic thinking in clinical research. Additionally, this book provides a very basic explanation of how to examine the data collected for research conduct for the possibility of confounders and how to address such confounders, thus disentangling such effects for reliable and valid inference. Research is presented as an exercise around measurement, with measurement error inevitable in its conduct, hence the inherent uncertainties of all findings in clinical and medical research. Modern Epidemiologic Principles and Concepts for Clinicians covers research conceptualization, namely research objectives, questions, hypothesis, design, implementation, data collection, analysis, results, and interpretation. While the primary focus of epidemiology is to assess the relationship between exposure (risk or predisposing factor) and outcome (disease or health-related event), the causal association is presented in a simplified manner, including the role of quantitative evidence synthesis (QES) in causal inference. Epidemiology has evolved over the past three decades, resulting in several fields being developed. This text presents, in brief, the perspectives and future of epidemiology in the era of the molecular basis of medicine, “big data,” “3Ts,” and systems science. Epidemiologic evidence is more reliable if conceptualized and conducted within the context of translational, transdisciplinary, and team science. With molecular epidemiology, we are better equipped with tools to identify molecular biologic indicators of risk as well as biologic alterations in the early stages of disease, and with 3 Ts and systems science, we are more capable of providing accurate and reliable inference on causality and outcomes research. Further, the author argues that unless sampling error and confounding are identified and addressed, clinical research findings will remain largely inconsistent, implying an inconsequential epidemiologic approach. Appropriate knowledge of research conceptualization, design, and statistical inference is essential for conducting clinical and biomedical research. This knowledge is acquired through the understanding of epidemiologic/observational (non-experimental) and experimental designs and the choice of the appropriate test statistic for statistical inference. However, regardless of how sophisticated the statistical technique employed for statistical inference is, study conceptualization and design are the building blocks of valid scientific evidence. Since clinical research is performed to improve patients’ care, it remains relevant to assess not only the statistical significance but the clinical and biologic importance of the findings, for clinical decision-making in the care of an individual patient. Therefore, the aim of this book is to provide clinicians, biomedical researchers, graduate students in research methodology, students of public health, and all those involved in clinical/biomedical research with a simplified but concise overview of the principles and practice of epidemiology. In addition, the author stresses common flaws in the conduct, analysis, and interpretation of epidemiologic studies. Valid and reliable scientific research is that which considers the following elements in arriving at the truth from the data, namely biological relevance, clinical importance, and statistical stability and precision (statistical inference based on the p-value and the 90, 95, and 99 percent confidence interval). The interpretation of results of new research must rely on factual association or effect and the alternative explanation, namely systematic error, random error (precision), confounding, and effect measure modifier. Therefore, unless these perspectives are disentangled, the results from any given research cannot be considered reliable. However, even with this disentanglement, all study findings remain inconclusive with some degree of uncertainty. This book presents a comprehensive guide on how to conduct clinical and medical research—mainly research question formulation, study implementation, hypothesis testing using appropriate test statistics to analyze the data, and results interpretation. In so doing, it attempts to illustrate the basic concepts used in study conceptualization, epidemiologic design, and appropriate test statistics for statistical inference from the data. Therefore, though statistical inference is emphasized throughout the presentation in this text, equal emphasis is placed on clinical relevance or importance and biological relevance in the interpretation of the study results. Specifically, this book describes in basic terms and concepts how to conduct clinical and medical research using epidemiologic designs. The author presents epidemiology as the main profession in the trans-disciplinary approach to the understanding of complex ecologic models of disease and health. Clinicians, even those without preliminary or infantile knowledge of epidemiologic designs, could benefit immensely from what, when, where, who, and how studies are conceptualized, data collected as planned with the scale of measurement of the outcome and independent variables, data edited, cleaned and processed prior to analysis, appropriate analysis based on statistical assumptions and rationale, results tabulation for scientific appraisal, results interpretation and inference. Unlike most epidemiologic texts, this is the first book that attempts to simplify complex epidemiologic methods for users of epidemiologic research, namely clinicians and allied health researchers. Additionally, it is rare to find a book with integrates of basic research methodology into epidemiologic designs. Finally, research innovation and the current challenges of epidemiology are presented in this book to reflect the currency of the materials and the approach, as well as the responses to the challenges of epidemiology today namely, “big data”, accountability, and policy. A study could be statistically significant but biologically and clinically irrelevant since the statistical stability of a study does not rule out bias and confounding. The p-value is deemphasized, while the use of effect size or magnitude and confidence intervals in the interpretation of results for application in clinical decision-making is recommended. The use of p-value could lead to an erroneous interpretation of the effectiveness of treatment. For example, studies with large sample sizes and very little or insignificant effects of no clinical importance may be statistically significant, while studies with small samples though a large magnitude of effects are labeled “negative result.” Such results are due to low statistical power and increasing variability, hence the inability to pass the arbitrary litmus test of the 5 percent significance level. Epidemiology Conceptualized Epidemiologic investigation and practice are as old as the history of modern medicine. It dates back to Hippocrates (circa 2,400 years ago). In recommending the appropriate practice of medicine, Hippocrates appealed to the physicians’ ability to understand the role of environmental factors in predisposition to disease and health in the community. During the Middle Ages and the Renaissance, epidemiologic principles continued to influence the practice of medicine, as demonstrated in De Morbis Artificum (1713) by Ramazinni and the works on scrotal cancer in relation to chimney sweeps by Percival Pott in 1775. With the works of John Snow, a British physician (1854), on cholera mortality in London, the era of scientific epidemiology began. By examining the distribution/pattern of mortality and cholera in London, Snow postulated that cholera was caused by contaminated water. Epidemiology Today – Epigenomic Epidemiology There are several definitions of epidemiology, but a practical definition is necessary for the understanding of this science and art. Epidemiology is the basic science of public health. The objective of this profession is to assess the distribution and determinants of disease, disabilities, injuries, natural disasters (tsunamis, hurricanes, tornados, and earthquakes), and health-related events at the population level. Epidemiologic investigation or research focuses on a specific population. The basic issue is to assess the groups of people at higher risk: women, children, men, pregnant women, teenagers, whites, African Americans, Hispanics, Asians, poor, affluent, gay, lesbians, married, single, older individuals, etc. Epidemiology also examines how the frequency of the disease or the event of interest changes over time. In addition, epidemiology examines the variation of the disease of interest from place to place. Simply, descriptive epidemiology attempts to address the distribution of disease with respect to “who,” “when,” and “where.” For example, cancer epidemiologists attempt to describe the occurrence of prostate cancer by observing the differences in populations by age, socioeconomic status, occupation, geographic locale, race/ethnicity, etc. Epidemiology also attempts to address the association between the disease and exposure. For example, why are some men at high risk for prostate cancer? Does race/ethnicity increase the risk for prostate cancer? Simply, is the association causal or spurious? This process involves the effort to determine whether a factor (exposure) is associated with the disease (outcome). In the example of prostate cancer, such exposure includes a high-fat diet, race/ethnicity, advancing age, pesticides, family history of prostate cancer, and so on. Whether or not the association is factual or a result of chance remains the focus of epidemiologic research. The questions to be raised are as follows: Is prostate cancer associated with pesticides? Does pesticide cause prostate cancer? Epidemiology often goes beyond disease-exposure association or relationship to establish a causal association. In this process of causal inference, it depends on certain criteria, one of which is the strength or magnitude of association, leading to the recommendation of preventive measures. However, complete knowledge of the causal mechanism is not necessary prior to preventive measures for disease control. Further, findings from epidemiologic research facilitate the prioritization of health issues and the development and implementation of intervention programs for disease control and health promotion. Epidemiology today reflects the application of gene and environment interaction in disease causation, morbidity, prognosis, survival, and mortality in subpopulation health outcomes. The knowledge and understanding of subpopulation differentials in DNA methylation of specific genes and histone modification allows for the application of abnormal transcriptomes, impaired gene expression, protein synthesis dysfunctionality, and abnormal cellular functionality. This book is conceptually organized into three sections. Section I deals with research methods, section II epidemiologic designs, as well as causal inference and perspectives in epidemiology, while section III delves into perspectives, epidemiologic challenges, and special topics in epidemiology, namely epidemiologic tree, challenges, emerging fields, the consequentialist perspective of epidemiology and epidemiologic role in health and healthcare policy formulation, as well as epigenomic epidemiology and epigenomic determinants of health (EDH). Throughout this book, attempts are made to describe the research methods and non-experimental as well as experimental designs. Section I comprises research methods with an attempt to describe the following: Research objectives and purposes, Research questions, Hypothesis statements: null and alternative, Rationales for research, clinical reasoning, and diagnostic tests, as well as Study conceptualization and conduct—research question, data collection, data management, hypothesis testing, data analysis. Section II comprises the epidemiologic study designs with an attempt to describe the basic notion of epidemiology and the designs used in clinical research: The notion of epidemiology and the measures of disease occurrence and frequency and the measure of disease association, Ecologic and cross-sectional designs, Case-control studies, Cohort studies: prospective, retrospective, and am bidirectional, Clinical trials or experimental designs, and, Quantitative evidence synthesis (QES), systematic review, scientific study appraisal, and causal inference. Section III consists of perspectives, challenges, and special topics in epidemiology to illustrate the purposive role of epidemiology in facilitating the goal of public health, mainly disease control and health promotion. Additionally, this section presents the integrative dimension of epidemiology as well as novel epidemiology as epigenomic epidemiology: Epidemiologic perspectives: advances, challenges, emerging fields and the future, Consequentialism epidemiology, and Role of epidemiology in health and healthcare policy formulation. Specifically, this section addresses the gene and environment interaction in disease causation, prognosis, and survival. Significantly, section I chapters deals with the basic descriptions of scientific research at the clinical and population levels and how the knowledge gained from the population could be applied to the understanding of individual patients in the future. In these two chapters, an attempt is made to discuss clinical reasoning and the use of diagnostic tests (sensitivity and specificity) in clinical decision-making. The notions, numbers needed to treat (NNT), and numbers needed to harm (NNH) are discussed later in the chapter on causal inference. The last chapter in this section delves into clinical research conceptualization, design involving subject recruitment, variable ascertainment, data collection, data management, data analysis, and the outline of the research proposal. In section II, epidemiologic principles and methods are presented with the intent to stress the importance of careful design in conducting clinical and biomedical research. Epidemiology remains the basic science of clinical medicine and public health that deals with disease, disabilities, injury, and health-related events distributions and determinants and the application of this knowledge to the control and prevention of disease, disabilities, injuries, and related health events at the population level. Depending on the research question and whether or not the outcome (disease or event of interest) has occurred prior to the commencement of the study or if the investigator assigns subjects to treatment or control, an appropriate design is selected for the clinical research. The measures of effects or point estimates are discussed with concrete examples to illustrate the application of epidemiologic principles in arriving at a reliable and valid result. Designs are illustrated with flow charts, figures, and boxes for distinctions and similarities. The hierarchy of study design is demonstrated with randomized clinical trials (RCT) and the associated Meta-Analysis and quantitative evidence synthesis as the design that yields the most reliable and valid evidence from data. Though RCTs are considered the “gold standard” of clinical research, it is sometimes not feasible to use this design because of ethical considerations, hence the alternative need for prospective cohort design. Interpreting research findings is equally as essential as conducting the study itself. Interpretation of research findings must be informative and constructive in order to identify future research needs. A research result cannot be considered valid unless we disentangle the role of bias and confounding from a statistically significant finding, as a result, can be statistically significant and yet driven by measurement, selection, and information bias as well as confounding. While my background in basic medical sciences and clinical medicine (internal medicine) allows me to appreciate the importance of biologic and clinical relevance in the interpretation of research findings, biostatisticians without similar training must look beyond random variation (p-value and confidence interval) in the interpretation and utilization of clinical research findings. Therefore, quantifying the random error with a p-value (a meaningful null hypothesis with a strong case against the null hypothesis requires the use of a significance level) without a confidence interval deprives the reader of the ability to assess the clinical importance of the range of values in the interval. Using Fisher’s arbitrary p-value cutoff point for type I error (alpha level) tolerance, a p-value of 0.05 need not provide strong evidence against the null hypothesis, but p less than 0.0001 does.[i] The precise p-value should be presented without reference to arbitrary thresholds. Therefore, results of clinical and biomedical research should not be presented as “significant” or “non-significant” but should be interpreted in the context of the type of study and other available evidence. Secondly, systematic error and confounding should always be considered for findings with low p-values, as well as the potential for effect measure modifiers (if any) in the explanation of the results. Neyman and Pearson describe their accurate observation: No test based upon a theory of probability can by itself provide any valuable evidence of the truth or falsehood of a hypothesis. But we may look at the purpose of tests from another viewpoint. Without hoping to know whether each separate hypothesis is true or false, we may search for rules to govern our behavior with regard to them, in following which we ensure that, in the long run of experience, we shall not often be wrong. This text is expected to provide practical knowledge to clinicians, biomedical researchers, and public health scientists, implying all researchers use biological and biochemical specimens or samples, in an attempt to understand health and disease processes at cellular, clinical, and population levels. Additionally, all those who translate such data from bench to clinics in an attempt to improve the health and well-being of the patients seen by healthcare providers. Further, this book describes in basic terms and concepts how to conduct clinical and biomedical research using epidemiologic designs. The author presents epidemiology as the main discipline, so to speak, in the trans-disciplinary approach to the understanding of complex ecologic models of disease and health. Clinicians, even those without preliminary or infantile knowledge of epidemiologic designs, could benefit immensely from what, when, where, who, and how studies are conceptualized, data collected as planned with the scale of measurement of the outcome and independent variables, data edited, cleaned and processed prior to analysis, appropriate analysis based on statistical assumptions and rationale, results tabulation for scientific appraisal, results interpretation and inference. Unlike most epidemiologic texts, this is one of the few books that attempts to simplify complex epidemiologic methods for users of epidemiologic research, namely clinicians. Additionally, it is extremely rare to access a book with an integration of basic research methodology into epidemiologic designs. Finally, research innovation and the current challenges of epidemiology are presented in this book to reflect the currency of the materials and the approach.

Concise Epidemiologic Principles And Concepts

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Author : Laurens Holmes Jr.
language : en
Publisher: AuthorHouse
Release Date : 2013-09-11

Concise Epidemiologic Principles And Concepts written by Laurens Holmes Jr. and has been published by AuthorHouse this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-09-11 with Education categories.

This textbook describes the basics of research in medical, clinical, and biomedical settings as well as the concepts and application of epidemiologic designs in research conduct. Design transcends statistical techniques, and no matter how sophisticated a statistical modeling, errors of design/sampling cannot be corrected. The authors of this textbook have presented a complex field in a very simplified and reader-friendly manner with the intent that such presentation will facilitate the understanding of design process and epidemiologic thinking in clinical and biomedical research. Covers these relevant topics in epidemiology: Case-Cohort Design Prospective Case-Control Quantitative Evidence Synthesis (QES) Instant Cohort Design & Case-Crossover Design Effect Modification & Interaction Epidemiologic Tree - Molecular Epidemiology & Health Disparities Epidemiologic Challenge Big Data, mHealth, Social Media 3 Ts - Team Science, Transdisciplinary Research, Translational Research Bias, Random error, Confounding Systems Science & Evidence Discovery Research is presented as an exercise around measurement, with measurement error inevitable in its conducthence the inherent uncertainties of all findings in clinical and biomedical research. Concise Epidemiologic Principles and Concepts covers research conceptualization, namely research objectives, questions, hypothesis, design, implementation, data collection, analysis, results, and interpretation. While the primary focus of epidemiology is to assess the relationship between exposure (risk or predisposing factor) and outcome (disease or health-related event), causal association is presented in a simplified manner, including the role of quantitative evidence synthesis (meta-analysis) in causal inference. Epidemiology has evolved over the past three decades resulting in several fields being developed. This text presents in brief the perspectives and future of epidemiology in the era of the molecular basis of medicine. With molecular epidemiology, we are better equipped with tools to identify molecular biologic indicators of risk as well as biologic alterations in the early stages of disease.

Concise Epidemiologic Principle And Concepts Second Edition

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Author : Laurens Holmes, Jr
language : en
Publisher: Laurens Holmes, Jr
Release Date : 2025-03-20

Concise Epidemiologic Principle And Concepts Second Edition written by Laurens Holmes, Jr and has been published by Laurens Holmes, Jr this book supported file pdf, txt, epub, kindle and other format this book has been release on 2025-03-20 with Medical categories.

Concise Epidemiologic Principles and Concepts - Aberrant Epigenomic Modulations Implication We often conceive epidemiology in either simplistic or complex terms, and neither of these is accurate. To illustrate this, the complexities in epidemiology could be achieved by considering a study to determine the correlation between serum lipid profile as total cholesterol, HDL, LDL, triglyceride, and total body fatness or obesity measured by BMI in children. Two laboratories measured serum lipid profiles, and one observed a correlation with BMI, while the other did not. Which is the reliable finding? To address this question, one needs to examine the context of blood drawing since fasting blood level may provide a better indicator of serum lipid. Epidemiologic studies could be easily derailed given the inability to identify and address possible confounding. Therefore, understanding the principles and concepts used in epidemiologic studies designed and conducted to answer clinical research questions facilitates e accurate and reliable findings in these areas. Another similar example in a health fair setting involves geography and health, termed health-o-graphy. The risk of dying in one zip code A was 59.5 per 100,000, and in the other zip code B was 35.4 per 100,000. There is a common sense and non-epidemiologic tendency to conclude that there is an increased risk of dying in zip code A. To arrive at such inference, one must first find out the age distribution of these two zip codes since advancing age is associated with increased mortality. Indeed, zip code A is comparable to the United States population while, zip code B is the Mexican population. These two examples are indicative of the need to understand epidemiologic concepts such as confounding by age or effect measure modification prior to undertaking clinical research. This textbook describes the basics of research in medical and clinical settings, as well as the concepts and application of epidemiologic designs in research. Design transcends statistical techniques, and no matter how sophisticated statistical modeling, errors of design/sampling cannot be corrected. The author of this textbook has presented a complex field in a very simplified and reader-friendly manner with the intent that such a presentation will facilitate the understanding of the design process and epidemiologic thinking in clinical research. Additionally, this book provides a very basic explanation of how to examine the data collected for research conduct for the possibility of confounders and how to address such confounders, thus disentangling such effects for reliable and valid inference. Research is presented as an exercise around measurement, with measurement error inevitable in its conduct, hence the inherent uncertainties of all findings in clinical and medical research. Concise Epidemiologic Principles and Concepts (Second Edition) for Clinicians covers research conceptualization, namely research objectives, questions, hypothesis, design, implementation, data collection, analysis, results, and interpretation. While the primary focus of epidemiology is to assess the relationship between exposure (risk or predisposing factor) and outcome (disease or health-related event), the causal association is presented in a simplified manner, including the role of quantitative evidence synthesis (QES) in causal inference. Epidemiology has evolved over the past three decades, resulting in several fields being developed. This text presents, in brief, the perspectives and future of epidemiology in the era of the molecular basis of medicine, “3Ts,” and systems science, as well as Epigenomic Epidemiology. Epidemiologic evidence is more reliable if conceptualized and conducted within the context of translational, transdisciplinary, and team science. With molecular epidemiology, we are better equipped with tools to identify molecular biologic indicators of risk as well as biologic alterations in the early stages of disease, and with 3 Ts and systems science, we are more capable of providing accurate and reliable inference on causality and outcomes research. Further, the author argues that unless sampling error and confounding are identified and addressed, clinical research findings will remain largely inconsistent, implying an inconsequential epidemiologic approach. Appropriate knowledge of research conceptualization, design, and statistical inference is essential for conducting clinical and biomedical research. This knowledge is acquired through the understanding of epidemiologic/observational (non-experimental) and experimental designs and the choice of the appropriate test statistic for statistical inference. However, regardless of how sophisticated the statistical technique employed for statistical inference is, study conceptualization and design are the building blocks of valid scientific evidence. Since clinical research is performed to improve patients’ care, it remains relevant to assess not only the statistical significance but the clinical and biologic importance of the findings, for clinical decision-making in the care of an individual patient. Therefore, the aim of this book is to provide clinicians, biomedical researchers, graduate students in research methodology, students of public health, and all those involved in clinical/biomedical research with a simplified but concise overview of the principles and practice of epidemiology. In addition, the author stresses common flaws in the conduct, analysis, and interpretation of epidemiologic studies. Valid and reliable scientific research is that which considers the following elements in arriving at the truth from the data, namely biological relevance, clinical importance, and statistical stability and precision (statistical inference based on the p-value and the 90, 95, and 99 percent confidence interval). The interpretation of results of new research must rely on factual association or effect and the alternative explanation, namely systematic error, random error (precision), confounding, and effect measure modifier. Therefore, unless these perspectives are disentangled, the results from any given research cannot be considered reliable. However, even with this disentanglement, all study findings remain inconclusive with some degree of uncertainty. This book presents a comprehensive guide on how to conduct clinical and medical research—mainly research question formulation, study implementation, hypothesis testing using appropriate test statistics to analyze the data, and results interpretation. In so doing, it attempts to illustrate the basic concepts used in study conceptualization, epidemiologic design, and appropriate test statistics for statistical inference from the data. Therefore, though statistical inference is emphasized throughout the presentation in this text, equal emphasis is placed on clinical relevance or importance and biological relevance in the interpretation of the study results. Specifically, this book describes in basic terms and concepts how to conduct clinical and medical research using epidemiologic designs. The author presents epidemiology as the main profession in the trans-disciplinary approach to the understanding of complex ecologic models of disease and health. Clinicians, even those without preliminary or infantile knowledge of epidemiologic designs, could benefit immensely from what, when, where, who, and how studies are conceptualized, data collected as planned with the scale of measurement of the outcome and independent variables, data edited, cleaned and processed prior to analysis, appropriate analysis based on statistical assumptions and rationale, results tabulation for scientific appraisal, results interpretation and inference. Unlike most epidemiologic texts, this is the first book that attempts to simplify complex epidemiologic methods for users of epidemiologic research, namely clinicians and allied health researchers. Additionally, it is rare to find a book with integrates of basic research methodology into epidemiologic designs. Finally, research innovation and the current challenges of epidemiology are presented in this book to reflect the currency of the materials and the approach, as well as the responses to the challenges of epidemiology today namely, epigenomic epidemiology in environmental and gene interaction disease determinants. Epidemiology Conceptualized - Epidemiologic investigation and practice are as old as the history of modern medicine. It dates back to Hippocrates (circa 2,400 years ago). In recommending the appropriate practice of medicine, Hippocrates appealed to the physicians’ ability to understand the role of environmental factors in predisposition to disease and health in the community. During the Middle Ages and the Renaissance, epidemiologic principles continued to influence the practice of medicine, as demonstrated in De Morbis Artificum (1713) by Ramazinni and the works on scrotal cancer in relation to chimney sweeps by Percival Pott in 1775. With the works of John Snow, a British physician (1854), on cholera mortality in London, the era of scientific epidemiology began. By examining the distribution/pattern of mortality and cholera in London, Snow postulated that cholera was caused by contaminated water. Epidemiology Today – Epigenomic Epidemiology There are several definitions of epidemiology, but a practical definition is necessary for the understanding of this science and art. Epidemiology is the basic science of public health. The objective of this profession is to assess the distribution and determinants of disease, disabilities, injuries, natural disasters (tsunamis, hurricanes, tornados, and earthquakes), and health- related events at the population level. Epidemiologic investigation or research focuses on a specific population. The basic issue is to assess the groups of people at higher risk: women, children, men, pregnant women, teenagers, whites, African Americans, Hispanics, Asians, poor, affluent, gay, lesbians, married, single, older individuals, etc. Epidemiology also examines how the frequency of the disease or the event of interest changes over time. In addition, epidemiology examines the variation of the disease of interest from place to place. Simply, descriptive epidemiology attempts to address the distribution of disease with respect to “who,” “when,” and “where.” For example, cancer epidemiologists attempt to describe the occurrence of prostate cancer by observing the differences in populations by age, socioeconomic status, occupation, geographic locale, race/ethnicity, etc. Epidemiology also attempts to address the association between the disease and exposure. For example, why are some men at high risk for prostate cancer? Does race/ethnicity increase the risk for prostate cancer? Simply, is the association causal or spurious? This process involves the effort to determine whether a factor (exposure) is associated with the disease (outcome). In the example of prostate cancer, such exposure includes a high-fat diet, race/ethnicity, advancing age, pesticides, family history of prostate cancer, and so on. Whether or not the association is factual or a result of chance remains the focus of epidemiologic research. The questions to be raised are as follows: Is prostate cancer associated with pesticides? Does pesticide cause prostate cancer? Epidemiology often goes beyond disease-exposure association or relationship to establish a causal association. In this process of causal inference, it depends on certain criteria, one of which is the strength or magnitude of association, leading to the recommendation of preventive measures. However, complete knowledge of the causal mechanism is not necessary prior to preventive measures for disease control. Further, findings from epidemiologic research facilitate the prioritization of health issues and the development and implementation of intervention programs for disease control and health promotion. Epidemiology today reflects the application of gene and environment interaction in disease causation, morbidity, prognosis, survival, and mortality in subpopulation health outcomes. The knowledge and understanding of subpopulation differentials in DNA methylation of specific genes and histone modification allows for the application of abnormal transcriptomes, impaired gene expression, protein synthesis dysfunctionality, and abnormal cellular functionality.

Applied Epidemiologic Principles And Concepts

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Author : Laurens Holmes, Jr.
language : en
Publisher: CRC Press
Release Date : 2017-12-14

Applied Epidemiologic Principles And Concepts written by Laurens Holmes, Jr. and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-12-14 with Medical categories.

This book provides practical knowledge to clinicians and biomedical researchers using biological and biochemical specimen/samples in order to understand health and disease processes at cellular, clinical, and population levels. Concepts and techniques provided will help researchers design and conduct studies, then translate data from bench to clinics in attempt to improve the health of patients and populations. This book presents the extreme complexity of epidemiologic research in a concise manner that will address the issue of confounders, thus allowing for more valid inferences and yielding results that are more reliable and accurate.

Modern Infectious Disease Epidemiology

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Author : Alexander Krämer
language : en
Publisher: Springer Science & Business Media
Release Date : 2010-01-23

Modern Infectious Disease Epidemiology written by Alexander Krämer and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-01-23 with Medical categories.

Hardly a day goes by without news headlines concerning infectious disease threats. Currently the spectre of a pandemic of influenza A|H1N1 is raising its head, and heated debates are taking place about the pro’s and con’s of vaccinating young girls against human papilloma virus. For an evidence-based and responsible communication of infectious disease topics to avoid misunderstandings and overreaction of the public, we need solid scientific knowledge and an understanding of all aspects of infectious diseases and their control. The aim of our book is to present the reader with the general picture and the main ideas of the subject. The book introduces the reader to methodological aspects of epidemiology that are specific for infectious diseases and provides insight into the epidemiology of some classes of infectious diseases characterized by their main modes of transmission. This choice of topics bridges the gap between scientific research on the clinical, biological, mathematical, social and economic aspects of infectious diseases and their applications in public health. The book will help the reader to understand the impact of infectious diseases on modern society and the instruments that policy makers have at their disposal to deal with these challenges. It is written for students of the health sciences, both of curative medicine and public health, and for experts that are active in these and related domains, and it may be of interest for the educated layman since the technical level is kept relatively low.

Concise Epidemiologic Principles And Concepts Second Edition

DOWNLOAD
Author : Laurens Holmes, Jr
language : en
Publisher: Laurens Holmes, Jr
Release Date : 2025-03-19

Concise Epidemiologic Principles And Concepts Second Edition written by Laurens Holmes, Jr and has been published by Laurens Holmes, Jr this book supported file pdf, txt, epub, kindle and other format this book has been release on 2025-03-19 with Medical categories.

Concise Epidemiologic Principles & Concepts - Study Design, Conduct and Application We often conceive epidemiology in either simplistic or complex terms, and neither of these is accurate. To illustrate this, the complexities in epidemiology could be achieved by considering a study to determine the correlation between serum lipid profile as total cholesterol, HDL, LDL, triglyceride, and total body fatness or obesity measured by BMI in children. Two laboratories measured serum lipid profiles, and one observed a correlation with BMI, while the other did not. Which is the reliable finding? To address this question, one needs to examine the context of blood drawing since fasting blood level may provide a better indicator of serum lipid. Epidemiologic studies could be easily derailed given the inability to identify and address possible confounding. Therefore, understanding the principles and concepts used in epidemiologic studies designed and conducted to answer clinical research questions facilitates e accurate and reliable findings in these areas. Another similar example in a health fair setting involves geography and health, termed health-o-graphy. The risk of dying in one zip code A was 59.5 per 100,000, and in the other zip code B was 35.4 per 100,000. There is a common sense and non-epidemiologic tendency to conclude that there is an increased risk of dying in zip code A. To arrive at such inference, one must first find out the age distribution of these two zip codes since advancing age is associated with increased mortality. Indeed, zip code A is comparable to the United States population while, zip code B is the Mexican population. These two examples are indicative of the need to understand epidemiologic concepts such as confounding by age or effect measure modification prior to undertaking clinical research. This textbook describes the basics of research in medical and clinical settings, as well as the concepts and application of epidemiologic designs in research. Design transcends statistical techniques, and no matter how sophisticated statistical modeling, errors of design/sampling cannot be corrected. The author of this textbook has presented a complex field in a very simplified and reader-friendly manner with the intent that such a presentation will facilitate the understanding of the design process and epidemiologic thinking in clinical research. Additionally, this book provides a very basic explanation of how to examine the data collected for research conduct for the possibility of confounders and how to address such confounders, thus disentangling such effects for reliable and valid inference. Research is presented as an exercise around measurement, with measurement error inevitable in its conduct, hence the inherent uncertainties of all findings in clinical and medical research. Concise Epidemiologic Principles and Concepts (Second Edition) for Clinicians covers research conceptualization, namely research objectives, questions, hypothesis, design, implementation, data collection, analysis, results, and interpretation. While the primary focus of epidemiology is to assess the relationship between exposure (risk or predisposing factor) and outcome (disease or health-related event), the causal association is presented in a simplified manner, including the role of quantitative evidence synthesis (QES) in causal inference. Epidemiology has evolved over the past three decades, resulting in several fields being developed. This text presents, in brief, the perspectives and future of epidemiology in the era of the molecular basis of medicine, “3Ts,” and systems science, as well as Epigenomic Epidemiology. Epidemiologic evidence is more reliable if conceptualized and conducted within the context of translational, transdisciplinary, and team science. With molecular epidemiology, we are better equipped with tools to identify molecular biologic indicators of risk as well as biologic alterations in the early stages of disease, and with 3 Ts and systems science, we are more capable of providing accurate and reliable inference on causality and outcomes research. Further, the author argues that unless sampling error and confounding are identified and addressed, clinical research findings will remain largely inconsistent, implying an inconsequential epidemiologic approach. Appropriate knowledge of research conceptualization, design, and statistical inference is essential for conducting clinical and biomedical research. This knowledge is acquired through the understanding of epidemiologic/observational (non-experimental) and experimental designs and the choice of the appropriate test statistic for statistical inference. However, regardless of how sophisticated the statistical technique employed for statistical inference is, study conceptualization and design are the building blocks of valid scientific evidence. Since clinical research is performed to improve patients’ care, it remains relevant to assess not only the statistical significance but the clinical and biologic importance of the findings, for clinical decision-making in the care of an individual patient. Therefore, the aim of this book is to provide clinicians, biomedical researchers, graduate students in research methodology, students of public health, and all those involved in clinical/biomedical research with a simplified but concise overview of the principles and practice of epidemiology. In addition, the author stresses common flaws in the conduct, analysis, and interpretation of epidemiologic studies. Valid and reliable scientific research is that which considers the following elements in arriving at the truth from the data, namely biological relevance, clinical importance, and statistical stability and precision (statistical inference based on the p-value and the 90, 95, and 99 percent confidence interval). The interpretation of results of new research must rely on factual association or effect and the alternative explanation, namely systematic error, random error (precision), confounding, and effect measure modifier. Therefore, unless these perspectives are disentangled, the results from any given research cannot be considered reliable. However, even with this disentanglement, all study findings remain inconclusive with some degree of uncertainty. This book presents a comprehensive guide on how to conduct clinical and medical research—mainly research question formulation, study implementation, hypothesis testing using appropriate test statistics to analyze the data, and results interpretation. In so doing, it attempts to illustrate the basic concepts used in study conceptualization, epidemiologic design, and appropriate test statistics for statistical inference from the data. Therefore, though statistical inference is emphasized throughout the presentation in this text, equal emphasis is placed on clinical relevance or importance and biological relevance in the interpretation of the study results. Specifically, this book describes in basic terms and concepts how to conduct clinical and medical research using epidemiologic designs. The author presents epidemiology as the main profession in the trans-disciplinary approach to the understanding of complex ecologic models of disease and health. Clinicians, even those without preliminary or infantile knowledge of epidemiologic designs, could benefit immensely from what, when, where, who, and how studies are conceptualized, data collected as planned with the scale of measurement of the outcome and independent variables, data edited, cleaned and processed prior to analysis, appropriate analysis based on statistical assumptions and rationale, results tabulation for scientific appraisal, results interpretation and inference. Unlike most epidemiologic texts, this is the first book that attempts to simplify complex epidemiologic methods for users of epidemiologic research, namely clinicians and allied health researchers. Additionally, it is rare to find a book with integrates of basic research methodology into epidemiologic designs. Finally, research innovation and the current challenges of epidemiology are presented in this book to reflect the currency of the materials and the approach, as well as the responses to the challenges of epidemiology today namely, epigenomic epidemiology in environmental and gene interaction disease determinants. A study could be statistically significant but biologically and clinically irrelevant since the statistical stability of a study does not rule out bias and confounding. The p-value is deemphasized, while the use of effect size or magnitude and confidence intervals in the interpretation of results for application in clinical decision- making is recommended. The use of p-value could lead to an erroneous interpretation of the effectiveness of treatment. For example, studies with large sample sizes and very little or insignificant effects of no clinical importance may be statistically significant, while studies with small samples though a large magnitude of effects are labeled “negative result.”i Such results are due to low statistical power and increasing variability, hence the inability to pass the arbitrary litmus test of the 5 percent significance level. Epidemiology Conceptualized Epidemiologic investigation and practice are as old as the history of modern medicine. It dates back to Hippocrates (circa 2,400 years ago). In recommending the appropriate practice of medicine, Hippocrates appealed to the physicians’ ability to understand the role of environmental factors in predisposition to disease and health in the community. During the Middle Ages and the Renaissance, epidemiologic principles continued to influence the practice of medicine, as demonstrated in De Morbis Artificum (1713) by Ramazinni and the works on scrotal cancer in relation to chimney sweeps by Percival Pott in 1775. With the works of John Snow, a British physician (1854), on cholera mortality in London, the era of scientific epidemiology began. By examining the distribution/pattern of mortality and cholera in London, Snow postulated that cholera was caused by contaminated water. Epidemiology Today – Epigenomic Epidemiology There are several definitions of epidemiology, but a practical definition is necessary for the understanding of this science and art. Epidemiology is the basic science of public health. The objective of this profession is to assess the distribution and determinants of disease, disabilities, injuries, natural disasters (tsunamis, hurricanes, tornados, and earthquakes), and health- related events at the population level. Epidemiologic investigation or research focuses on a specific population. The basic issue is to assess the groups of people at higher risk: women, children, men, pregnant women, teenagers, whites, African Americans, Hispanics, Asians, poor, affluent, gay, lesbians, married, single, older individuals, etc. Epidemiology also examines how the frequency of the disease or the event of interest changes over time. In addition, epidemiology examines the variation of the disease of interest from place to place. Simply, descriptive epidemiology attempts to address the distribution of disease with respect to “who,” “when,” and “where.” For example, cancer epidemiologists attempt to describe the occurrence of prostate cancer by observing the differences in populations by age, socioeconomic status, occupation, geographic locale, race/ethnicity, etc. Epidemiology also attempts to address the association between the disease and exposure. For example, why are some men at high risk for prostate cancer? Does race/ethnicity increase the risk for prostate cancer? Simply, is the association causal or spurious? This process involves the effort to determine whether a factor (exposure) is associated with the disease (outcome). In the example of prostate cancer, such exposure includes a high-fat diet, race/ethnicity, advancing age, pesticides, family history of prostate cancer, and so on. Whether or not the association is factual or a result of chance remains the focus of epidemiologic research. The questions to be raised are as follows: Is prostate cancer associated with pesticides? Does pesticide cause prostate cancer? Epidemiology often goes beyond disease-exposure association or relationship to establish a causal association. In this process of causal inference, it depends on certain criteria, one of which is the strength or magnitude of association, leading to the recommendation of preventive measures. However, complete knowledge of the causal mechanism is not necessary prior to preventive measures for disease control. Further, findings from epidemiologic research facilitate the prioritization of health issues and the development and implementation of intervention programs for disease control and health promotion. Epidemiology today reflects the application of gene and environment interaction in disease causation, morbidity, prognosis, survival, and mortality in subpopulation health outcomes. The knowledge and understanding of subpopulation differentials in DNA methylation of specific genes and histone modification allows for the application of abnormal transcriptomes, impaired gene expression, protein synthesis dysfunctionality, and abnormal cellular functionality. This book is conceptually organized into three sections. Section I deals with research methods, section II epidemiologic designs, as well as causal inference and perspectives in epidemiology, while section III delves into perspectives, epidemiologic challenges, and special topics in epidemiology, namely epidemiologic tree, challenges, emerging fields, the consequentialist perspective of epidemiology and epidemiologic role in health and healthcare policy formulation, as well as epigenomic epidemiology and epigenomic determinants of health (EDH). Throughout this book, attempts are made to describe the research methods and non- experimental as well as experimental designs. Section I comprises research methods with an attempt to describe the following: Research objectives and purposes, Research questions, Hypothesis statements: null and alternative, Rationales for research, clinical reasoning, and diagnostic tests, as well as Study conceptualization and conduct—research question, data collection, data management, hypothesis testing, data analysis.

The Development Of Modern Epidemiology

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Author : Walter W Holland
language : en
Publisher: OUP Oxford
Release Date : 2007-04-05

The Development Of Modern Epidemiology written by Walter W Holland and has been published by OUP Oxford this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007-04-05 with Medical categories.

This book marks the 50th anniversary of the foundation of the International Epidemiological Association (IEA). It is a unique compendium by the world's leading epidemiologists of how the field has developed, and how it can be (and has been) applied to the control of common conditions and threats to public health. Five distinct sections guide the reader through the wealth of material: · Gives an historical account of the concepts and ideas, and current importance of epidemiology to global health issues and to organisations such as the WHO. · Illustrates the advances and contributions to epidemiologic knowledge and the control of disease in specific areas such as cancer, cardiovascular disease, respiratory disease, tuberculosis, maternal and child health, non-biologic disorders such as war and disasters, and new infectious diseases. · Outlines the use of epidemiology in areas such as public health, health services, occupational and environmental medicine, social epidemiology and nutrition. · Discusses methodological developments such as statistics, information sources, investigation of disease outbreaks and clinical epidemiology. · Looks at how the subject has developed internationally, with perspectives on regions such as the Americas, Poland, Spain, Eastern Mediterranean, New Zealand, China, Thailand and Japan. This remarkable insight into how epidemiology has developed is essential reading for both existing and aspiring epidemiologists.

Modern Epidemiology

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Author : Kenneth J. Rothman
language : en
Publisher: Lippincott Williams & Wilkins
Release Date : 2008

Modern Epidemiology written by Kenneth J. Rothman and has been published by Lippincott Williams & Wilkins this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Medical categories.

The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research. The book covers a broad range of concepts and methods, such as basic measures of disease frequency and associations, study design, field methods, threats to validity, and assessing precision. It also covers advanced topics in data analysis such as Bayesian analysis, bias analysis, and hierarchical regression. Chapters examine specific areas of research such as disease surveillance, ecologic studies, social epidemiology, infectious disease epidemiology, genetic and molecular epidemiology, nutritional epidemiology, environmental epidemiology, reproductive epidemiology, and clinical epidemiology.

Concepts Of Epidemiology

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Author : Raj S. Bhopal
language : en
Publisher: Oxford University Press
Release Date : 2016-09-08

Concepts Of Epidemiology written by Raj S. Bhopal and has been published by Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-09-08 with Medical categories.

Epidemiology is a population science that underpins health improvement and health care, by exploring and establishing the pattern, frequency, trends, and causes of a disease. Concepts of Epidemiology comprehensively describes the application of core epidemiological concepts and principles to readers interested in population health research, policy making, health service planning, health promotion, and clinical care. The book provides an overview of study designs and practical framework for the epidemiological analyses of diseases, including accounting for error and bias within studies. It discusses the ways in which epidemiological data are presented, explains the distinction between association and causation, as well as relative and absolute risks, and considers the theoretical and ethical basis of epidemiology both in the past and the future. This new edition places even greater emphasis on interactive learning. Each chapter includes learning objectives, theoretical and numerical exercises, questions and answers, a summary of the key points, and exemplar panels to illustrate the concepts and methods under consideration. Written in an accessible and engaging style, with a specialized glossary to explain and define technical terminology, Concepts of Epidemiology is ideal for postgraduate students in epidemiology, public health, and health policy. It is also perfect for clinicians, undergraduate students and researchers in medicine, nursing and other health disciplines who wish to improve their understanding of fundamental epidemiological concepts.

Epidemiology

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Author : William A. Oleckno
language : en
Publisher: Waveland Press
Release Date : 2008-01-18

Epidemiology written by William A. Oleckno and has been published by Waveland Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-01-18 with Medical categories.

Comprehensive in its coverage and suitable for graduate or upper-division undergraduate students in a wide range of health-related disciplines, this latest offering by William A. Oleckno is a full-scale, pedagogically rich introduction to fundamental ideas and procedures in epidemiology. The text covers the major concepts, principles, methods, and applications of both conventional and modern epidemiology using clear language and frequent examples to illustrate important points and facilitate understanding. While Oleckno provides thorough treatment of the more customary aspects of conventional and modern epidemiology, he also introduces several important design and analytical issues that are only rarely approached in fundamental epidemiology textbooks. Concepts as diverse as competing risks, maturation, futility, and the prevalence and bias effects in the context of screening are just a few examples of the broad range of concepts covered in this text. A comprehensive glossary contains detailed definitions of over 700 terms used throughout the 14 chapters comprising the textbook. Aspiring public health professionals will appreciate the solid basis they gain from Epidemiology: Concepts and Methods and will want to keep a copy close by as a valuable reference throughout their careers.