Collaboration of clinical epidemiologists, social and behavioral scientists, and health services researchers is needed to complement the more basic sciences. The first step is to enhance our awareness of the possibilities and challenges in studying symptoms. The papers in this supplement were selected to cover a broad spectrum of topics that would engage clinicians, teachers, and researchers alike. Aronowitz opens with a historical perspective that highlights some recurrent themes relevant to modern practice. The distinction between history repeating itself and the emergence of a new syndrome is critical.
Symptoms are ancient and universal, yet new illnesses do periodically appear.
The history of medicine can help separate what is truly new from what is simply resurfacing. Five selected symptoms are each reviewed by an investigator who has conducted research on that particular symptom. Irwin and colleagues review a series of studies that culminate in a practical algorithm for treating cough as well as one model for symptoms research. Bytzer and Talley likewise synthesize an elegant and rigorous series of studies on dyspepsia that provides useful guidance for both the clinician and investigator. Sloane has investigated the causes and outcomes of dizziness in both primary care and specialty practice and provides an update of what we currently know and where we should be heading.