The future of epidemiologyBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7055.436 (Published 24 August 1996) Cite this as: BMJ 1996;313:436
- Dimitrios Trichopoulus, Professor
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
It's bright, but epidemiology and publicity can be a dangerous mix
Few can challenge the assertion that epidemiology has been central in the control of infectious diseases, nor that it has contributed more than any other discipline in the identification of causes of cardiovascular diseases (from the classic to the more recently identified)1 2 and several forms of cancer (from tobacco smoking and occupational carcinogens to several infectious agents).3 4 5 However, concern has recently arisen that epidemiology has either exhausted its potential or, worse, is generating conflicting results that confuse the public and disorient policy makers.
The argument about stagnation is hardly justified. The clarification of the role of blood lipids and the documentation of the effects of aspirin, ethanol, homocysteine, and factor V Leiden mutation are major recent breakthroughs in cardiovascular epidemiology, as is the identification of hepatitis viruses B and C and certain strains of human papillomavirus as definitive human carcinogens. Even a result that has been so consistent as to become boring—the protection provided by vegetables and fruits against several forms of cancer6—was not universally accepted 20 years ago. …