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Hopkins Bloomberg School Of Public Health Launches Translational Epidemiology Initiative

Key Is Asking The Right Questions To Begin With, Says Director

Concerned about the prevailing trend in epidemiology to focus more on methods and less on health problems, faculty at the Johns Hopkins Bloomberg School of Public Health have launched a Translational Epidemiology Initiative (TEI). “While it’s important to use the right methods, it’s more important to ask the right questions in the first place,” according to David Dowdy, Hopkins epidemiologist and newly appointed Director of the TEI at the school.

Why Hopkins?

Hopkins has a long history of employing faculty who have interest and experience in translating epidemiology into practice and policy actions, and this new initiative is an outgrowth of that long history. By creating this initiative, Hopkins organizers hope to provide more opportunities for faculty members immersed in their own subspecialties and with an interest in translation to work together to promote even greater focus on translation.

Training Students

The School hopes to attract students interested in translation and solving health problems and to create a curriculum which excites them as much or more than new methods do at present. Epidemiology is not about giving someone a measure of association and leaving it to others to do something about it, says Dowdy. His goal is to help train epidemiologists who ask questions that can make a difference and are interested in applying these findings to real world problems.

Vacuum

According to Dowdy, a translational epidemiologist takes a broader view of issues and does not work in a vacuum. He or she has relationships with clinicians, policymakers, the media, and government officials who can talk together and over time find ways to use results in a productive way.

Dowdy told the Monitor he is not afraid that translational epidemiologists will be less objective as scientists. There is no such thing as being completely objective, he said, and translational epidemiologists need to balance the competing pressures to be good scientists and to be effective in solving health problems. What’s needed is a broader appreciation of what it takes to function well in addressing health questions, according to Dowdy.

Immediate Goals

Currently the TEI at Hopkins includes approximately 10 faculty who meet almost every month. Some students and post-docs have been engaged, and the group’s priorities are to produce a manuscript laying out the case for their work, organizing a symposium on the translation topic similar to an earlier one held at Hopkins in July 1998 (https://tinyurl.com/ya4f349q), planning activities for the upcoming SER meeting, and examining the existing curriculum to look for opportunities to get students excited.

Challenges

The challenges in accelerating this initiative according to Dowdy include the fact that everyone is already very busy or committed and they have difficulty taking on more work. Another challenge is to make a strong and cohesive case for translation as a focus area. It has a broad scope and includes many diverse activities under one umbrella. There is need to develop a stronger intellectual underpinning to what Sandro Galea at Boston University has called “an epidemiology of consequence.”
 

Some think of epidemiology as a narrow field and they have narrow skills which they seek to hone sharply. Since many of the easiest epidemiological questions have already been answered, many epidemiologists are now employing an increasingly specialized set of skills to find increasingly small effect sizes. The members of the TEI would like to see more focus on acquiring and using a broader skill set to interface with a broad group of problem-solving partners on big questions that are harder to answer.

Favorable Factors

 One factor in favor of the initiative is the sense among some epidemiologists that epidemiology needs to be seen as a relevant discipline, as a field which asks and answers questions of consequence. This view may be in jeopardy now. Other developments which might buttress the TEI are the growth of the field of implementation science, and the fact that new research methods are being created to more effectively address some of the questions of consequence Dowdy refers to.

Among the Hopkins faculty currently participating in the Translational Epidemiology Initiative are: Stefan Baral, Amber D'Souza, Stephan Ehrhardt, John Jackson, Catherine Lesko, Colleen Hanrahan, Moyses Szklo, and Mara McAdams DeMarco as well as David Dowdy.  ■


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