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Science Article Critical of Epidemiology Triggers Responses Among Epidemiologists (2 of 6)

The Science article entitled “Epidemiology Faces Its Limits” which appeared in the July 14 issue has engendered discussion within the epidemiology community. A special seminar was held on the subject at Johns Hopkins, a commentary by Ernst Wynder, the editor of Preventive Medicine and head of the American Health Foundation, is scheduled to be published in the American Journal of Epidemiology, and a letter to the editors of Science has been published from the International Society for Environmental Epidemiology. This follows an earlier letter by many of the epidemiologists quoted in the article and other interested readers.

In an interview with the Epi Monitor, Wynder explained that he was angered by the Science piece and prompted to write a commentary. He attributes some of the shortcomings listed in the article not to epidemiology but to poor application of its methods. “We must not throw out the baby with the bath water,” he said. Wynder is not one who believes investigators need to find an odds ratio of 3 or 4 for the findings to be significant.  Even an odds ratio of 1.2 or 1.3 could be important if good work was done, he said.

Wynder noted that journals and investigators have a strong bias in favor of positive findings and will put a “positive” spin on their results to get attention for their papers. “Epidemiologists are like politicians,” he said, “we want the most spin—a positive one when the risk factors relate to disease and a negative one when the risk factors are environmental. This gives epidemiology a black eye.”

When asked about remedies, Wynder stressed the importance of interpreting all findings in the light of the criteria for causation. If we are more careful, epidemiology will not fail us, he said. Also, he called for reviewers to use checklists in examining papers to make sure they pay attention to details.

In his letter to Science, Allan Smith, President of the ISEE, noted that “many good points were raised in the article, but that it focused primarily on problems.” He called for Science to publish an article which presents the strengths and achievements of environmental epidemiology.”

Published February 1996  v

 

 
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