Am J Epidemiol 2004; 159:1106.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
BOOK REVIEWS |
Epidemiologic Methods: Studying the Occurrence of Illness
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205
By Thomas D. Koepsell and Noel S. Weiss
ISBN 0-19-515078-3, Oxford University Press, New York, New York (Telephone: 800-451-7556, Fax: 919-677-1303, Website: http://www.oup-usa.org), 2003, 528 pp., $59.95 (hardcover)
Professors Koepsell and Weiss capture the reader immediately in chapter 1 of their new text with a case study about epidemic blindness in children. Epidemiologic Methods is an introductory text targeted to the broad audience of "people who intend to conduct epidemiologic research..." (1, preface p. v). Koepsell and Weiss add to the growing field of solid introductory texts by providing a distinct perspective based on numerous years of teaching and research experience.
The structure of the balance of the text is as follows. Chapters 2–4 discuss the fundamental issues of disease and disease frequency from the epidemiologic perspective. Chapters 5 and 6 provide an overview of study design and sources of data, respectively. Chapter 7 introduces the epidemiologic concepts of person, place, and time. Chapter 8 discusses some issues in causal inference. Chapter 9 details measures of excess risk. Chapters 10 and 11 discuss two central issues in epidemiologic research: measurement error and confounding, respectively. Chapters 12 through 15 detail specific epidemiologic study designs, namely, randomized trials and ecologic, cohort, and case-control studies. A brief chapter 16 introduces induction and latent periods, while chapter 17 points the reader toward strategies to improve the sensitivity of epidemiologic studies. Chapters 18–20 are devoted to the issues of screening, outbreak investigation, and policy, respectively.
The central epidemiologic concept of time is threaded all the way through this text, from the conceptual distinction of disease events and states to the definition of rates and proportions and the description of methods based on person-time. The use of epidemiologic methods as a tool for decision making also pervades this text. Relevant examples from the biomedical literature are peppered liberally from cover to cover. In addition, exercises (with answers) are provided at the end of every chapter beyond the first. The chapter on enhancing the sensitivity of epidemiologic studies is particularly interesting and unique: Koepsell and Weiss describe the disaggregation of heterogeneous exposures, heterogeneous disease entities, and subjects affected to different degrees in an effort to sharpen estimates of exposure-disease relations. Also of note is the section on simultaneously studying more than one level of measurement in the chapter on ecologic studies.
There are necessarily some shortcomings. First, there are a lack of attention to underscoring the cohort study as a basis for epidemiologic study design and little treatment of novel epidemiologic designs, such as the case-cohort and case-crossover designs. Second, there is scarce attention given to data quality or practical issues of analysis in the presence of missing data. Third, a unifying structure for the discussion of bias remains elusive, such that the chapters on measurement error and confounding appear somewhat disjointed. Notwithstanding these shortcomings, we believe that Professors Koepsell and Weiss have done the field of epidemiology a service. Epidemiologic Methods is a pragmatic and well-organized reader.
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 TOP REFERENCES |
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- Koepsell TD, Weiss NS. Epidemiologic methods: studying the occurence of illness. New York, NY: Oxford University Press, 2003.
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