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• Instructions for online access
• Cover image
• Title page
• Table of Contents
• Notes to Instructors
• Copyright
• In Memoriam
• Preface
• Acknowledgments
• Section I: The Epidemiologic Approach to Disease and Intervention
• Introduction
• Chapter 1: Introduction
• What Is Epidemiology?
• Objectives of Epidemiology
• Epidemiology and Prevention
• Epidemiology and Clinical Practice
• Epidemiologic Approach
• From Observations to Preventive Actions
• When the Frequency of a Disease Declines, Who Deserves the Credit?
• Integrating Prevention and Treatment
• Conclusion
• Chapter 2: The Dynamics of Disease Transmission
• Modes of Transmission
• Clinical and Subclinical Disease
• Carrier Status
• Endemic, Epidemic, and Pandemic
• Disease Outbreaks
• Immunity and Susceptibility
• Herd Immunity
• Incubation Period
• Attack Rate
• Exploring Occurrence of Disease
• Outbreak Investigation
• Conclusion
• Review Questions for Chapter 2
• Chapter 3: The Occurrence of Disease: I. Disease Surveillance and Measures of Morbidity
• Surveillance
• Stages of Disease in an Individual and in a Population
• Measures of Morbidity
• Conclusion
• Review Questions for Chapter 3
• Chapter 4: The Occurrence of Disease: II. Mortality and Other Measures of Disease Impact
• Measures of Mortality
• Comparing Mortality in Different Populations
• Other Measures of the Impact of Disease
• Conclusion
• Review Questions for Chapter 4
• Chapter 5: Assessing the Validity and Reliability of Diagnostic and Screening Tests
• Biologic Variation of Human Populations
• Validity of Screening Tests
• Use of Multiple Tests
• Predictive Value of a Test
• Reliability (Repeatability) of Tests
• Relationship Between Validity and Reliability
• Conclusion
• Appendices to Chapter 5
• Review Questions for Chapter 5
• Chapter 6: The Natural History of Disease: Ways of Expressing Prognosis
• Case-Fatality
• Person-Years
• Five-Year Survival
• Observed Survival
• The Kaplan-Meier Method
• Assumptions Made in Using Life Tables and Kaplan-Meier Method
• Apparent Effects on Prognosis of Improvements in Diagnosis
• Median Survival Time
• Relative Survival
• Generalizability of Survival Data
• Conclusion
• Review Questions for Chapter 6
• Section II: Using Epidemiology to Identify the Cause of Disease
• Introduction
• Chapter 7: Observational Studies
• Case Reports and Case Series
• Ecologic Studies
• Cross-Sectional Studies
• Case-Control Studies
• Conclusion
• Review Questions for Chapter 7
• Chapter 8: Cohort Studies
• Design of a Cohort Study
• Selection of Study Populations
• Types of Cohort Studies
• Examples of Cohort Studies
• Cohort Studies for Investigating Childhood Health and Disease
• Potential Biases in Cohort Studies
• When Is a Cohort Study Warranted?
• Case-Control Studies Based Within a Defined Cohort
• Conclusion
• Review Questions for Chapter 8
• Chapter 9: Comparing Cohort and Case-Control Studies
• Chapter 10: Assessing Preventive and Therapeutic Measures: Randomized Trials
• Selection of Subjects
• Allocating Subjects to Treatment Groups Without Randomization
• Allocating Subjects Using Randomization
• Data Collection on Subjects
• Crossover
• Factorial Design
• Noncompliance
• Conclusion
• Chapter 11: Randomized Trials: Some Further Issues
• Sample Size
• Recruitment and Retention of Study Participants
• Ways of Expressing the Results of Randomized Trials
• Interpreting the Results of Randomized Trials
• Four Phases in Testing New Drugs in the United States
• Five Major Randomized Trials in the United States
• Randomized Trials for Evaluating Widely Accepted Interventions
• Registration of Clinical Trials
• Ethical Considerations
• Conclusion
• Epilogue
• Review Questions for Chapters 10 and 11
• Chapter 12: Estimating Risk: Is There an Association?
• Absolute Risk
• How Do We Determine Whether a Certain Disease Is Associated With a Certain Exposure?
• Relative Risk
• Odds Ratio (Relative Odds)
• Conclusion
• Review Questions for Chapter 12
• Appendix to Chapter 12
• Chapter 13: More on Risk: Estimating the Potential for Prevention
• Attributable Risk
• Comparison of Relative Risk and Attributable Risk
• Conclusion
• Review Questions for Chapter 13
• Appendix to Chapter 13: Levin’s Formula for the Attributable Risk for the Total Population
• Chapter 14: From Association to Causation: Deriving Inferences From Epidemiologic Studies
• Approaches for Studying Disease Etiology
• Types of Associations
• Types of Causal Relationships
• Evidence for a Causal Relationship
• Guidelines for Judging Whether an Observed Association Is Causal
• Deriving Causal Inferences: Two Examples
• Modifications of the Guidelines for Causal Inferences
• Conclusion
• Review Questions for Chapter 14
• Chapter 15: More on Causal Inference: Bias, Confounding, and Interaction
• Bias
• Confounding
• Interaction
• Conclusion
• Review Questions for Chapter 15
• Chapter 16: Identifying the Roles of Genetic and Environmental Factors in Disease Causation
• Traditional Genetics
• Complex Diseases
• Time Trends in Disease Incidence
• Linkage Analysis in Family Studies
• Interaction Between Genetic and Environmental Risk Factors
• Precision Medicine
• Prospects for the Future
• Conclusion
• Review Questions for Chapter 16
• Glossary of Genetic Terms for Chapter 16
• Section III: Applying Epidemiology to Evaluation and Policy
• Introduction
• Chapter 17: Using Epidemiology to Evaluate Health Services
• Studies of Process and Outcome
• Efficacy, Effectiveness, and Efficiency
• Measures of Outcome
• Comparing Epidemiologic Studies of Disease Etiology and Epidemiologic Research Evaluating Effectiveness of Health Services
• Evaluation Using Group Data
• Evaluation Using Individual Data
• Conclusion
• Review Questions for Chapter 17
• Chapter 18: Epidemiologic Approach to Evaluating Screening Programs
• Natural History of Disease
• Pattern of Disease Progression
• Methodologic Issues
• Study Designs for Evaluating Screening: Nonrandomized and Randomized Studies
• Problems in Assessing the Sensitivity and Specificity of Screening Tests
• Interpreting Study Results That Show No Benefit of Screening
• Cost-Benefit Analysis of Screening
• Conclusion
• Review Questions for Chapter 18
• Chapter 19: Epidemiology and Public Policy
• Epidemiology and Prevention
• Population Approaches Versus High-Risk Approaches to Prevention
• Epidemiology and Clinical Medicine: Hormone Replacement Therapy in Postmenopausal Women
• Risk Assessment
• Meta-Analysis
• Publication Bias
• Epidemiology in the Courts
• Sources and Impact of Uncertainty
• Policy Issues Regarding Risk: What Should the Objectives Be?
• Conclusion
• Chapter 20: Ethical and Professional Issues in Epidemiology
• Ethical Issues in Epidemiology
• Investigators’ Obligations to Study Subjects
• Protecting Privacy and Confidentiality
• Access to Data
• Race and Ethnicity in Epidemiologic Studies
• Conflict of Interest
• Interpreting Findings
• Conclusion
• Answers to Review Questions
• Chapter 1
• Chapter 2
• Chapter 3
• Chapter 4
• Chapter 5
• Chapter 6
• Chapter 7
• Chapter 8
• Chapter 9
• Chapters 10 and 11
• Chapter 12
• Chapter 13
• Chapter 14
• Chapter 15
• Chapter 16
• Chapter 17
• Chapter 18
• Chapters 19 and 20
• Index