Celentano David D - Gordis Epidemiology E-Book

th Edition

David D. Celentano, ScD, MHS

Dr. Charles Armstrong Chair and Professor

Department of Epidemiology

Johns Hopkins Bloomberg School of Public Health

Baltimore, Maryland

Moyses Szklo, MD, MPH, DrPH

University Distinguished Professor

Department of Epidemiology

Johns Hopkins Bloomberg School of Public Health

Baltimore, Maryland

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GORDIS EPIDEMIOLOGY, SIXTH EDITION ISBN: 978-0-323-55229-5

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Cover credit:

An original watercolor Remembering Baltimore by

Haroutune K. Armenian, MD, DrPH

Professor Emeritus

Department of Epidemiology

Johns Hopkins Bloomberg School of Public Health

Printed in Canada

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Leon Gordis MD, MPH, DrPH

19342015

Epidemiology is one of the foundational disciplines underlying public health. Clinical research relies heavily on epidemiologic methods and contemporary medical care research, particularly in comparative effectiveness studies and statistical approaches to big data (as in the use of the electronic medical record for health studies). As Dr. Leon Gordis wrote in his preface to the fifth edition, Epidemiology is the basic science of disease prevention and plays major roles in developing and evaluating public policy relating to health and to social and legal issues. There are many uses of epidemiology today. The majority of epidemiologic research focuses on establishing etiologic associations between putative risks and health outcomes. However, epidemiology is also widely used in the evaluation of primary and secondary prevention programs, comparisons of interventions, and the evaluation of policy at the population level. Epidemiologic findings commonly find their way into public media, providing the public and policy makers with data to guide personal decisions regarding their behavior. Increasingly, the scrutiny focused on epidemiology may cause researchers and practitioners some discomfort, as the interpretation of basic epidemiologic principles can be subject to considerable error. Our task is to make the thinking underlying epidemiology transparent.

This book is intended to be a basic introduction to the definitions, logic, and use of the epidemiologic method to elucidate factors influencing health and disease. We have tried to illustrate the principles with examples of how epidemiology is applied in the real world. The examples selected include both classic examples from the early days of the development of the discipline of epidemiology to contemporary examples. Where appropriate, we draw on examples pertaining to clinical practice.

Upon the passing of Dr. Gordis in 2015, the sixth edition of this book has been revised by two new authors, both of whom worked with and under Professor Gordis and have been actively engaged in teaching epidemiology at Johns Hopkins for over four decades. We have generally retained the structure and organization of the previous edition. In the fifth edition, learning objectives were inserted in most chapters, and we have revised these and updated the examples throughout. Additional new review questions have been added to most chapters. A significant change has been to the presentation and order of the methods in epidemiology that were previously presented at the end of Section I and more extensively in Section II. Rather than leading with the randomized trial (or the experimental design) and then comparing observational study design to the gold standard, we have organized the presentation of epidemiologic methods along a study continuum from clinical observation, to case-series, to the use of ecologic studies, and then to cross-sectional investigations as the foundational approach to epidemiologic hypothesis development. We then follow with case-control and cohort designs, leading up to the randomized trial. This more organically follows the development, in our opinion, of how epidemiologic observations and hypotheses are developed in the daily practice of doing epidemiology.

As with the previous edition, the sixth edition consists of three sections. Section I addresses how epidemiology is used to understand health and the development of diseases in populations as well as the basis for interventions to influence the natural history of disease. The first six chapters provide the conceptual framework underlying the discipline of epidemiology and present many of the basic principles of the discipline. presents how the natural history of disease can be used to best express disease prognosis, using examples of case-fatality and survivorship.