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A History of Epidemiologic Methods and Concepts Review

Book Review: History of Epidemiologic Methods and Concepts. Editor Alfredo Morabia.
For the connoisseur of epidemiology this textbook is a delight with fascinating vignettes of different prominent figures and their contribution to the origins and evolution of epidemiology and its methods. Contributors include many prominent figures currently active in the field as well as budding and fledgling epidemiologists. The book describes changes in a major field of study, in this case epidemiology, as related to a) the changing definition of epidemiology from a study of infectious disease processes only to the current consideration of any health process, b) changing qualifications needed in the past and present to be an epidemiologist c) and the evolving concept of what is a cause d) and the evolving concept of the case-control and cohort study. In addition, the book makes a brief and interesting case as to what constitutes an epidemiologist today relative to someone who is bright and can rattle off many of the concepts without actually taking many formal courses. Through it all, the pervasive nature of epidemiology as a study related to public health and its improvement can be noted from genesis to the present. This is consistent with the idea that epidemiology is a study of populations and group comparisons in contrast to the physicians focus on the individual.
The book is divided into two parts. The first half of about 125 pages is devoted to the editor's overview of the history of epidemiologic concepts and methods. The concept of the case-control study design as considered through the eyes of the cohort study is particularly informative and reminds us that the cohort study is often conceptualized from the perspective of the more idealized randomized clinical trial. The randomized clinical trial is then often conceptualized from the perspective of the more idealized counterfactual. The author discusses many other topics including the origin of population thinking and comparison of groups, both concepts needed before epidemiology could advance at all to a formal science.
The second half of the book is a collection of papers by prominent past and current epidemiologists that discuss risks, rates, the history of confounding and bias, the history of the case-control and cohort studies, vital statistics and review briefly eight 20th century textbooks on epidemiology. This section adds further flavor to the continuing evolution of knowledge in epidemiology and reminds us that epidemiology in the not too distant future will probably be much different in many ways from what it is currently.
All in all, this book is a great read for those interested in the history of epidemiology, those interested in the evolution of study design concepts related to the case-control and cohort study, and those interested in the evolution of many concepts in epidemiology such as bias, confounding, risks, rates, etc. The ecologic study design, the cross-sectional study, and the randomized controlled study are not covered in this text.
Gene R. Pesola, M.D., M.P.H.
Associate Attending
Medicine (Section of Pulmonary/Critical Care)
Harlem Hospital/Columbia University
New York, N.Y.

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