## Epidemiology: An IntroductionIn the past thirty years epidemiology has matured from a fledgling scientific field into a vibrant discipline that brings together the biological and social sciences, and in doing so draws upon disciplines ranging from statistics and survey sampling to the philosophy of science. These areas of knowledge have converged into a modern theory of epidemiology that has been slow to penetrate into textbooks, particularly at the introductory level. Epidemiology: An Introduction closes the gap. It begins with a brief, lucid discussion of causal thinking and causal inference and then takes the reader through the elements of epidemiology, focusing on the measures of disease occurrence and causal effects. With these building blocks in place, the reader learns how to design, analyze and interpret problems that epidemiologists face, including confounding, the role of chance, and the exploration of interactions. All these topics are layered on the foundation of basic principles presented in simple language, with numerous examples and questions for further thought. |

### From inside the book

Results 1-5 of 92

Page viii

These are subjects to be explored in more advanced courses, but their

presentation here in elementary terms lays the groundwork for advanced

also draws a boundary between the

...

These are subjects to be explored in more advanced courses, but their

presentation here in elementary terms lays the groundwork for advanced

**study**. Italso draws a boundary between the

**epidemiologic**approach to these topics and...

Page ix

Introduction to Epidemiologic Thinking, 1 What Is Causation? 8 Measuring

Disease Occurrence and Causal Effects, 24 Types of

Biases in Study Design, 94 Random Error and the Role of Statistics, 113

Analyzing ...

Introduction to Epidemiologic Thinking, 1 What Is Causation? 8 Measuring

Disease Occurrence and Causal Effects, 24 Types of

**Epidemiologic Study**, 57Biases in Study Design, 94 Random Error and the Role of Statistics, 113

Analyzing ...

Page 1

This book presents the basic concepts and methods of

considered the core science of public health,

the distribution and determinants of disease frequency" or, put even more simply,

...

This book presents the basic concepts and methods of

**epidemiology**. Oftenconsidered the core science of public health,

**epidemiology**involves “the**study**ofthe distribution and determinants of disease frequency" or, put even more simply,

...

Page 2

Confounding occurs commonly in

following mortality data, summarized from a

of residents of Whickham, England, in the period 1972–1974 and then tracked

the ...

Confounding occurs commonly in

**epidemiologic**comparisons. Consider thefollowing mortality data, summarized from a

**study**that looked at smoking habitsof residents of Whickham, England, in the period 1972–1974 and then tracked

the ...

Page 3

It is theoretically possible that all or many of the smokers quit soon after the

scenario is implausible, and without evidence for these changes in smoking

behavior, ...

It is theoretically possible that all or many of the smokers quit soon after the

**survey**and that many of the nonsmokers started Smoking. While possible, thisscenario is implausible, and without evidence for these changes in smoking

behavior, ...

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### Contents

1 | |

8 | |

3 Measuring Disease Occurrence and Causal Effects | 24 |

4 Types of Epidemiologic Study | 57 |

5 Biases in Study Design | 94 |

6 Random Error and the Role of Statistics | 113 |

7 Analyzing Simple Epidemiologic Data | 130 |

8 Controlling Confounding by Stratifying Data | 144 |

9 Measuring Interactions | 168 |

10 Using Regression Models in Epidemiologic Analysis | 181 |

11 Epidemiology in Clinical Settings | 198 |

Appendix | 218 |

Index | 221 |

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### Common terms and phrases

age categories asbestos attributable fraction average baseline bias biologic interaction birth order breast cancer calculate case-control data case-control study causal causal mechanism Chapter cigarette smoking clinical clozapine cohort study compared component causes confidence interval confidence limits control confounding control series crude data curve data in Table dence rate denominator described distribution epidemic epidemiologic epidemiologic study equation 3–1 evaluation example experiment exposed and unexposed exposed group Figure flutamide follow-up formula imbalance incidence proportion incidence rate ratio inference laryngeal cancer leukemia lung cancer measure misclassification mortality rate myocardial infarction nonsmokers null hypothesis obtain occur odds ratio outcome patients person person-time person-years placebo pooled estimate population at risk predict prevalence random error randomized trial rate difference relation result risk data risk difference risk factor risk of death risk ratio Rothman sampling screening source population specific standard strata stratified analysis Suppose tamoxifen tion tolbutamide treatment value function variable women