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Society for Epidemiologic Research (SER) Presidential Addresses
 

1983:Paul Stolley
On Faith, Evidence, and The Epidemiologist, Winnepeg, Manitoba

Outgoing SER president and University of Pennsylvania epidemiologist Paul Stolley delivered the traditional departing address to more than 600 epidemiologists assembled in Winnipeg, Manitoba for the 16th annual meeting of the Society for Epidemiologic Research. Dr. Stolley argued for greater reliance on the whole body of actual scientific evidence in settling controversies and was critical of epidemiologists who criticize or dismiss important epidemiologic findings because of real or imagined minor flaws. Excerpts from his talk are presented below.


“...My brief talk today will be an attempt to sustain the modest proposal that epidemiologists should persist in their efforts to substitute evidence for faith in scientific controversy, to whatever extent possible...


Pseudo-Science

A curious phenomenon has been introduced into scientific controversy involving epidemiologists during the last decade... I should call this phenomenon a variant of pseudo-science; it is characterized by an inability or unwillingness to synthesize available data coming from all fields that bear on the problem at hand and instead placing extraordinary importance upon small defects in study designs. Thus a convincing group of studies might relate the toxic shock syndrome to the introduction and the use of the highly absorbent tampons... Nevertheless, a group of investigators, either acting independently or sometimes hired by the company at risk, begin a kind of “witch-hunt” for alleged bias and confounding in order to challenge the findings. Biases that may be only postulated are somehow given a reality before their actual existence is even demonstrated.


Social Responsibility

The charitable view of some of the activities of so-called epidemiologists in this regard would be to say that they are perhaps excessively iconoclastic...
That is not to say that all findings should not be scrutinized and challenged, but this should be done with a sense of social responsibility. There is a decided conceptual difference between posing a test to challenge a hypothesis and applying the test. A hypothesis does not fail a test just because it is speculated that it will. A group of case-control studies, for example, are not invalid because certain biases that might have occurred are postulated. It may well be that some severe biases misled the investigator; but merely raising these possibilities does not destroy the validity of the study...


The Scientific Spirit

So it is clear that life is becoming increasingly complex for epidemiologists. We will increasingly be engaged in public controversy, will be working with industry, and will be asked to participate in heated scientific debates about risk or benefit.


It is hoped that the scientific spirit and a reliance on evidence will guide us through the turbulent times we face. To quote the philosopher Bertrand Russell, ‘the scientific state of mind is neither skeptical or dogmatic. The skeptic holds that the truth is undiscoverable; while the dogmatist holds that the truth is already discovered. The scientist holds that the truth is discoverable though not yet discovered (at any rate, not in the matters which are under investigation). But even to say that the truth is discoverable is to say rather more than the scientist believes, since he does not conceive his discoveries as final and absolute. Absence of finality is of the essence of the scientific spirit. In the welter of conflicting fanaticisms, one of the few unifying forces is scientific truthfulness, by which I mean the habit of basing our beliefs upon observations and inferences as impersonal and as much divested of local and temperamental bias as is possible for human beings!”


Published July 1983 vPostscript 2000

In 1983, I was concerned with the problem of the “epidemiologist-for-hire” who thought it professional and ethical to create the “best defense” for an indicted product or risk exposure in the manner of a lawyer. This problem has probably not improved as many recent examples can attest. My current concern with our field is derived from the drastic changes we have seen in university life so that sharing of data, openness and free flow of scientific information is threatened by university/private sector financial arrangements and the desire of the universities to gain patent rights. This spills over onto epidemiology where creating private businesses as a result of scientific discovery is glorified by the euphemistic term “technology transfer” or “translational research.”


The net result of this lamentable application of the business model to the university is a stifling of data sharing and collaboration, free exchange and an exaltation of priority of discovery and patentability. The elevation of much of the scientifically deficient “alternative medicine” has everything to do with money and little to do with actually improving the health of the public. We now have medical schools practicing homeopathy, endowing named chairs to self-proclaimed guru/healers who use their own rules of evidence while the school catalog prattles about its curriculum in “evidence-based medicine.” I await with trepidation the first Division of Astrological Healing. Sadly, much of this was predicted by the sociologist/economist Thorstein Veblen in his 1919 book, The Higher Learning in America.

 
 

 
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