More of the same epidemiology?

Untitled Document

EDITORIAL

More of the same epidemiology?

The future of Epidemiology is a recurring theme of journals and conferences. The latest focus of this debate is the type of research question that guides epidemiological research. The focus on etiological issues must be set aside in favor of results that can support effective public health interventions (Kuller LH. Am J Epidemiol 2013; 177:279-80; Glass TA et al. Annu Rev Public Health 2013; 34:61-75). Rather than confirming associations between physical activity, diet, smoking and cardiovascular diseases, we need assessments of effective measures to alter the population distribution of these risk factors. Etiological research represents only one stage in the research agenda, which must then move on to results that can effectively be translated into public policy.

Articles on Epidemiology constitute the largest share of submissions to Cadernos de Saúde Pública/Reports in Public Health. In most cases, these articles: report the results of cross-sectional studies; test causal associations between multiple factors and a defined outcome; adopt the p-value as the essential criterion for selecting variables; and follow overly simplified theoretical models. They take detailed care in data planning, collection, and processing, but contribute little to the advancement of scientific knowledge and have limited social impact.

Interestingly, there is a common pattern in the investigation of causal hypotheses. There is, of course, nothing wrong with that, but in science we cannot content ourselves with well-established approaches. Epidemiology can now draw on a widely diversified arsenal of analytical tools, ranging from directed acyclic graphs, or DAG, useful for modeling determination chains based on counterfactual logic, to a set of techniques and methods for the study of complex phenomena, comprising a domain called Systems Science.

This Editorial does not afford us enough space with which to conduct an in-depth reflection on the origins of this behavior. Still, one inevitably wonders whether this is yet another unwanted effect of "publish-or-perish". Innovation takes time, effort and, particularly, taking risks without fear of making mistakes (Alberts B, Science 2013; 340:787). We urgently need to break the vicious cycle of "more of the same". As Editors of CSP, we hope to publish articles that explore socially relevant issues in a creative and diversified manner.

Marilia Sá Carvalho

Claudia Travassos

Cláudia Medina Coeli

Editors

Mais do mesmo?

O futuro da Epidemiologia é tema recorrentemente debatido em congressos e periódicos da área. O foco recente desse debate aborda o tipo de pergunta que orienta a pesquisa epidemiológica. A ênfase em questões etiológicas deve ser substituída pela busca de orientações para as intervenções em Saúde Pública (Kuller LH. Am J Epidemiol 2013; 177:279-80; Glass TA et al. Annu Rev Public Health 2013; 34:61-75). Mais importante do que confirmar reiteradamente a associação entre atividade física, padrões de dieta e tabagismo com as doenças cardiovasculares, precisamos de avaliações sobre medidas efetivas que levem a mudanças na distribuição populacional destes fatores de risco. É preciso ter em mente que a pesquisa etiológica representa apenas uma etapa de uma agenda de investigação, que deve avançar na busca de resultados que possam de fato ser traduzidos na implementação de políticas públicas.

Publication Dates

• Publication in this collection
  08 Nov 2013
• Date of issue
  Nov 2013