Talk:Epidemiology

message: I respectfully suggest adding Syndemic under See also. (I came across the article and am trying to clean up/un-orphan it....)
--w3steve
-- I've added some clinical areas of epik but there are, of course many others. At some point someone's really going to have to put this list in alphabetical order...?
Felinity 21:55, 11 January 2007 (UTC)
replies: text: Please see below for response to this and the next comment. 81.111.172.198 22:47, 3 November 2005 (UTC)
thread_title: I

message: It claims that Hippocrates was the father of medicine. In actuality Hippocrates said that the African high-genius Imhotep Imhotep (who also designed the major pyramid in Egypt aand was a polymath worshipped in Greece for thousands of years) was the greatest doctor ever.   Racism and a total hate of African accomplishments is pervasive on Wikipedia. I am often blocked for correcting racist, sexist articles, and will probably be blocked very soon for attempting to provide the general public/readers with an unbiased account re medicine, etc.   --172.58.153.230 (talk) 11:47, 27 February 2016 (UTC)
thread_title: The article is biased.

message: I'm tagging this until it is changed to meet NPOV standards.
This is the last paragraph of Epidemiology as Casual Inference section, while it could be a good example, the way it is written is slightly POV as you can see for yourself:
::By way of example, it is often cited that epidemiology has proven there is no link between MMR vaccine and regressive autism. For the United States, this would require a large randomized controlled trial, powered to detect the reported incidence of 1:160. Such a trial would establish that vaccines are (or are not) the cause of regressive Autistic Spectrum Disorders. The trial would need to be randomized ideally into three arms--a control group that receives no vaccinations, another group on the full US Centers for Disease Control immunization schedule, and a third that gets only the MMR vaccine. However, such a study has never be done and currently seems unlikely it ever will be. Accordingly, the matter would have to be established by other means, like cohort studies (where, for example, unvaccinated Amish children could serve as the control group) and/or adverse drug reaction challenge-dechallenge-rechallenge case reports.
I don't have a position on the MMR Vaccine controversey, as I don't know that much about it, but I do know that this paragraph clearly is implying that there are people who hold the position that there is no link between MMR vaccine and regressive autism and that those people are wrong. It seems to me to be clearly POV. The example serves as a good example, but I think it should be reworded so as not to be taking sides in the controversey. --Brentt 08:32, 12 October 2005 (UTC)
replies: text: I agree with what Brentt is saying. This passage is written like a research proposal and is a good example but not necessarily appropriate for Wikipedia and I see it as POV as original research.--MrNiceGuy1113 (talk) 16:27, 1 May 2012 (UTC)
thread_title: MMR Vaccine and autism NPOV (Tagged for NPOV)

message: I don't know who wrote the original article here on Wiki, but I do agree that it seems as if this section has been written with an inherent hidden agenda. 
To start with, giving the example of gravity vs. smoking and lung cancer is merely an illustration of the difference between a deterministic vs. a stochastic model. Taking the first google hit on a search yields the following explanation of the difference between stochastic and deterministic models: http://www.bio.vu.nl/thb/course/tb/tb/node28.html 
I'm not clear as to whether the comparison of the smoking-cancer association to gravity-balls falling downward is either necessary or appropriate in an article about epidemiology. If the point, however, is that only deterministic models are causal, and that stochastic models can not be, then there is a problem here.
The idea that causality can only be assessed through randomized clinical trials (RCTs) is complete and utter rubbish. No one conducted an RCT to establish the irrefutable association between  smoking and lung cancer (and Chronic Obstructive Pulmonary Disorder, and a myriad of cardiovascular diseases). There is an entire literature available on the utility and necessity for observational study and their invaluable contributions to science. 
~Felinity, Epidemiologist at large.
:You are quite right that RCTs may be great for treatments but are rubbish for causality. Multivariate analysis is a crude tool to suggest pathogenetic links, but the actual causality is in translational science. Here, the mechanism of epidemiologically indentified risk factors is applied to animal models, cell cultures or DNA. The proof from these studies confirms the veracity of the epidemiological link, or disproves it (in which the epidemiological link may have been caused by a confounder). JFW | T@lk 23:24, 18 December 2005 (UTC)
thread_title:  Causal inference section.... I have a problem with it. 

message: A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism.  Kreesten Meldgaard Madsen, M.D., Anders Hviid, M.Sc., Mogens Vestergaard, M.D., Diana Schendel, Ph.D., Jan Wohlfahrt, M.Sc., Poul Thorsen, M.D., Jørn Olsen, M.D., and Mads Melbye, M.D. NEJM, 347(19):1477-1482. 
This study came from Denmark.  This study also did not find an association with Autism and MMR.  The results are in the article, but table 2 has the major conclusions. In this trial they compared the development of Autism in children that received the MMR vaccine and those that did not.  There was no difference in the risk of developing autism. In addition, there was no increase of Autism in the first 6 months following MMR administration. Kd4ttc 02:03, 30 January 2006 (UTC)
thread_title: A study from Denmark

message: Using this article to somehow argue for or against the existence of an MMR/Autism link is entirely unencyclopedic. (This does not mean I am convinced there is no link. I would be quite interested in e.g. the results of studies as mentioned above: ... like cohort studies (where, for example, unvaccinated Amish children could serve as the control group). AvB ÷ talk 14:10, 30 January 2006 (UTC)
replies: text: Yes. And it would be good, too, to move the discussion off to somewhere where there is a wider audience with interest in the Autism/MMR issue. Kd4ttc 22:32, 30 January 2006 (UTC)
thread_title: Applause for the removal of the MMR/Autism epidemiology example

message: The article is sparse on the methods and models used in modern epidemiology. This means:
* Finding a representative sample and minimising selection bias and other sources of bias
* Forms of study, e.g. case report, case-control study, multivariate analysis
* Quantitative measures, the p value and the 95% confidence interval, the importance of the odds ratio
Ideally, someone with a grounding in epidemiology should be writing this and providing the most reliable sources. I've asked Felinity ("epidemiologist at large", above) by email, but response is still awaited. JFW | T@lk 18:07, 25 January 2006 (UTC)
replies: text: There are a couple of referenced sources in case-control study from the International Journal of Epidemiology which state the controversy quite well, IM(L)O.  Lawlor et. al. and Pettiti.  I thinkt he controversy arises precisely because epidemiology is not a mechanism for proving cause, only for drawing inference.  If you don't like the inference you tend to shoot the messenger, but honest epidemiologists (i.e. the ones I've met) don't use words like "prove" or "establish", they use qualified terms like "suggest" and "support".  People are, I think, seduced by the fact that observational epidemiology helped establish the link between tobacco and smoking, but they forget that (a) there is a very strong association, much stronger than the association claimed with things like MMR and autism, and (b) it was backed bya  whole raft of other kinds of evidence.  I am not an expert, mind, just an amateur student of the game (my colelague Richard Keatinge is an epidemiologist). - Just zis  Guy, you know? [T]/[C]  AfD? 19:07, 25 January 2006 (UTC)
replies: text: Guy, can't you ask Richard to start editing Wikipedia? He'll receive a warm welcome, fresh coffee and a jar of trolls. JFW | T@lk 23:54, 25 January 2006 (UTC)
replies: text: Hard ot get him to do anything much outside work these days, he's rather busy. - Just zis  Guy, you know? [T]/[C]  AfD? 23:33, 29 January 2006 (UTC)
thread_title:  Tools and methods 

message: Greetings.  I'm new here, so please forgive me if I've misformatted something.  The current listing of the "Hill Criteria" seems to reinforce the commonly held notion that Hill gave these 9 criteria as bullet-points in a presentation (or carved them into stone as a list).  Compared to the distilled criteria, the full text of his speech  may give one a very different view of causal inference in epidemiology.  The distilled form of his speech has been occasionally used (distorted, misinterpreted) to attack epidemiologic studies with results counter to someone's economic interests.  I think it should be made clear, with a link to the full text, that Sir Bradford-Hill never gave the criteria as listed.Epiguy 15:12, 26 March 2007 (UTC)
replies: text: I agree with your point. I think that is reasonably well outlined in the last paragraph, including reference to an article that elucidates your concerns. Perhaps it should go before the list. Also, the full text of his speech is linked, but not in-line (but APA, which is more what I'm used to). But perhaps that should also be fixed up. - Limegreen  00:42, 27 March 2007 (UTC)
thread_title:  Bradford-Hill Guidelines 

message: I have created a new article, Eradication of infectious diseases, that could use a lot of work if anyone is interested. I am by no means an expert on medicine or epidemiology and the article would really benefit from the expertise of other editors. --Ginkgo100talk 18:02, 30 November 2007 (UTC)
thread_title:  New article 

message: I have removed the following two sentences because they did not appear to belong in the Etymology section.
:It is also applied to studies of micro-organisms (microbial epidemiology). Epidemiology is also patterns of disease occurrence. From knowing information, such as who is getting the disease, when did they get the disease and where is the disease occurring will help epidemiologists infer why the disease is occurring.
If someone who knows more about epidemiology believes they belong please add them back in the appropriate place  Jons63 (talk) 12:45, 27 February 2008 (UTC)
thread_title:  Etymology 

message: A request for comments has been filed concerning the conduct of . Jagged 85 is one of the main contributors to Wikipedia (over 67,000 edits, he's ranked 198 in the number of edits), and practically all of his edits have to do with Islamic science, technology and philosophy. This editor has persistently misused sources here over several years. This editor's contributions are always well provided with citations, but examination of these sources often reveals either a blatant misrepresentation of those sources or a selective interpretation, going beyond any reasonable interpretation of the authors' intent. I searched the page history, and found 2 edits by Jagged 85 in December 2007. Tobby72 (talk) 21:10, 7 June 2010 (UTC)
replies: text: That's an old and archived RfC. The point is still valid though, and his contribs need to be doublechecked. Tobby72 (talk) 21:11, 10 June 2010 (UTC)
thread_title:  Misuse of sources 

message: A study concludes "Some data suggest that [A] may be linked with an increased risk of [B]... (but) large prospective cohort studies (...) are needed to provide definitive answers". Is it correct to interpret this as meaning "Current evidence that [A] may be linked with an increased risk of [B] is insufficient to be useful"? LeadSongDog come howl! 15:33, 18 June 2010 (UTC)
replies: text: "Useful" has no specific meaning, useful for what? The word that resembles that is "insignificant", but when authors think the results are insignificant they qualify it that way: "not significant".--Nutriveg (talk) 21:24, 18 June 2010 (UTC)
thread_title:  Interpretation, please 

message: Hi. The case series section, final paragraph, uses the term "poisson regression processes". Should that be "poison"? I am entirely unqualified to judge, can someone have a look? --bodnotbod (talk) 15:03, 3 August 2010 (UTC)
replies: text:  I changed it to a capitalized Poisson (a mathematician for whom a certain statistical distribution is named after). Poison would have been amusing though. :) CHF (talk) 00:28, 19 October 2010 (UTC)
thread_title:  Is "poisson" meant? Or should it be "poison"? 

message: Could you please add a few studies to give an example of what epidemiology actually concerns. Something major that concerns the world, like lung cancer related to smoking, pollution, etc. Thanks!! P.S. I was unexperienced about this subject so that's why I suggested it. :)  — Preceding unsigned comment added by 203.190.254.200 (talk) 05:42, 28 June 2011 (UTC)
thread_title: Add a study please

message: Clinical Epidemiology (in the list of areas) links straight back to this here article. The following reference may be useful .  If you accept the referenced definitions then the concept net is Clinical Activities (CA) or 'medicine' -> Clinical Epidemiology (CE) defined as epidemiological methods applied to CA -> Evidence Based Medicine (leveraging CE results to improve the CA), in a virtuous circle or positive feedback loop.
Some of this is mentioned/implied in the lead, but the flow of concepts is nowhere explicit.  Do we need a separate CE article or can CE be mentioned as one use of Epidemiological methods? A decision will help with edit discussions on Evidence Based Medicine(talk) Shannock9 (talk) 17:36, 24 September 2012 (UTC)
replies: text: I suppose there could be historical arguments for keeping the disciplines separate , I feel it would make good editorial sense first to develop this page with a Clinical epidemiology subsection as part of The practice (per summary style). —MistyMorn (talk) 11:46, 25 September 2012 (UTC)
replies: text: I support creating a CE article.--Sscientist (talk) 22:52, 21 September 2013 (UTC)
thread_title: Clinical Epidemiology

message: The original Snow-map has experienced several updates and edited versions have been published with the attribute "original". In fact the original map has no dots but bars see: http://www.ph.ucla.edu/epi/snow/snowmap1_1854_lge.htm  — Preceding unsigned comment added by 131.220.35.59 (talk) 05:38, 2 October 2013 (UTC)
thread_title: Snow map

message: We need a clear presentation of mathematical models of epidemiology. This article is all words. Unless there is an article that I can't find.  The page on mathematical models doesn't seem rich enough. Limit-theorem (talk) 15:54, 19 October 2014 (UTC)
thread_title: Mathematical Structure of Epidemiology

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message: * A New Statistic Reveals Why America's COVID-19 Numbers Are Flat — 16 April 2020
According to the Tracking Project's figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a "test-positivity rate" of nearly 20 percent. That is "very high," Jason Andrews, an infectious-disease professor at Stanford, told us.
Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection.
The above article in The Atlantic used the word "positivity" a total of 32 times. 
And yet a Google search for: epidemiology "positivity" wikipedia brings up the following pages: 
* psychological resilience
* optimism bias
* major depressive disorder
as three of the top five results.
For an epidemiological context, this leaves result #3
* coronavirus disease 2019 
with a single use of the term positivity rate: 
In Santa Clara County, 45 out of 3,000 individuals tested positive (1.5%) for antibodies. This rate was 50–85x higher than what was expected based on the number of confirmed cases, suggesting a large number of asymptomatic infections, or not a random sampling of people joining the trial. However, there was a relevant statistical possibility that the used test has a similar false positivity rate, and therefor the test has yet to be run on thousands of pre-COVID-19 samples to claim certainty about this level of sensitivity.
And result #5 
* typhoid fever
also with a single use of the term: 
If the patient's serum is carrying antibodies against those antigens then they get attached to them forming clumping which indicated the positivity of the test.
Somewhere in our epidemiology coverage, I think we ought to formally define this term. 
Despite The Atlantic hammering this term hard, the term doesn't appear to be particularly mainstream within the field, but I did find this one glossary entry from the Ontario HIV Institute: 
* Positivity rate
; Positivity rate : The percent of HIV diagnostic tests with a confirmed HIV-positive result. Test positivity rates can provide insight into which sub-populations have a higher level of HIV risk. However, positivity rates should be interpreted with caution as they are influenced by both HIV risk as well as the number and types of people getting tested and it is difficult to disentangle these effects.
[Edit] What happens when you don't attend to your definition structure: 
This article previously used an incorrect epidemiological term to describe the number of cases of a disease in a population. The correct term is prevalence, not incidence.
— MaxEnt 16:29, 20 April 2020 (UTC)
thread_title:  Definition of term: positivity rate