An ambitious and sweeping set of broad recommendations and more specific actions to transform cancer epidemiology research, training, and practice have been published by an ad hoc group of investigators convened under the auspices of the National Cancer Institute. Many of these investigators, such as Julie Buring, Muin Khoury, Margaret Spitz, and Robert Hoover are among the best known names in epidemiology today.

According to Khoury, a  strong rationale for the workshop is the need to make epidemiology more impactful on population health outcomes in a time of unprecedented scientific discoveries and technological developments and resource constraints for scientific research.   Describing their work as a “collective intellectual discourse” carried out at an interdisciplinary workshop and through multiple other means online, the authors believe their statements apply to the whole field of epidemiology.

The recommendations are targeted to the research community, funding agencies and professional organizations. While the recommendations may not be controversial because they seek to be responsive to trends already evident in several areas of society and science more generally, the authors acknowledge that further deliberation is called for. The Epi Monitor invites your comments and will publish the feedback obtained. The NCI also invites your comments directly on its “cancer epidemiology matters blog” at: http://tinyurl.com/ah2g3fo

The 8 broad recommendations are

1. Extend the reach of epidemiology.

This recommendation calls for recognizing a whole spectrum of epidemiologic activities beyond an initial discovery. It calls for a more balanced portfolio of epidemiologic research that addresses more directly the development and evaluation of interventions that can improve the public’s health, as well as dissemination and outcome evaluation in real world settings. Epidemiology as a field has a major role in developing and understanding the use of data for both clinical and public health practice.
 

2. Transform the practice of epidemiology.

This recommendation focuses on opening up access to data and the research process so that more people can use data, more can collaborate in using data, and greater transparency and associated credibility can be achieved.

“The time is right to ensure greater credibility of all epidemiologic studies by adopting a reproducibility culture through greater sharing of data, protocols, and analyses,” according to the authors.
 

3. Expand cohort studies across the lifespan including multiple health outcomes

This recommendation is targeted at getting more out of cohort studies by studying more outcomes and by combining different cohorts. It is a plea to accomplish more by coordinating and collaborating with more investigators and for funding agencies to synergize resources across multiple diseases and health outcomes. Cohorts can also be a great resource for developing predictive and diagnostic tests, embedding clinical trials and for other translational activities.

4. Develop, evaluate, and use novel technologies appropriately

The advent of genomic and other technologies provide tremendous opportunities for epidemiologic investigations. However, there are multiple challenges which come with new technologies and new ways of measuring exposures. Many of these challenges cannot be resolved at the time studies are done. The authors advocate careful attention to the collection and handling of specimens for future evaluation as one strategy to use in mitigating this problem.
 

5. Integrate “big data” science into the practice of epidemiology.

Here the authors are clear about the challenge and how much needs to be learned. “The unquestionable reality of 21^st century epidemiology is the tsunami of data spanning the spectrum of genomic, molecular, clinical, epidemiologic, environmental, and digital information…we currently do not have a firm grasp on how to systematically and efficiently tackle the data deluge.” 
 

6. Expand knowledge integration to drive research, policy, and practice.

What is knowledge integration? It involves managing information from different sources, systematically synthesizing that knowledge, and using that knowledge in engaging stakeholders and in creating influence on policy and practice. In short, knowledge integration means making more effective use of what we know by interacting differently with data and with the persons responsible for making things happen with data.
 

7. Transform training of 21^st century epidemiologists.

What is a 21^st century epidemiologist? According to the authors, it is someone with a problem-solving, action-oriented approach. It is someone who does not leave the translation of research results to others. In short, a 21^st century epidemiologist is one who is a truly applied scientist. This call for action is reminiscent of the call for a new subspecialty in epidemiology issued by David Dowdy and Madhukar Pai in a paper published in Epidemiology last year. The paper was covered in an article in the October 2012 issue of The Epi Monitor. 
 

8. Optimize the use of resources for epidemiologic studies.

Here the authors call for researchers to be more resourceful and practice the art of bricolage, a French word which Webster defines as construction (as of a sculpture or a structure of ideas) achieved by using whatever comes to hand. The authors call it “creativity under constraints”.

At the same time, funding agencies need to maximize the use of resources in a time of fiscal constraint.  Part of this recommendation involves jettisoning research studies which are not being productive to make room for funding new ones, creating new funding mechanisms, producing more enlightened review teams, and creating the incentives for researchers to behave differently in more productive ways. 

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