EPIDEMIOLOGY – CURRENT PERSPECTIVES ON RESEARCH AND PRACTICE Edited by Nuno Lunet Epidemiology – Current Perspectives on Research and Practice Edited by Nuno Lunet Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Dragana Manestar Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Epidemiology – Current Perspectives on Research and Practice, Edited by Nuno Lunet p. cm. ISBN 978-953-51-0382-0 Contents Preface IX Chapter 1 Changing Contexts in Epidemiologic Research – Thoughts of Young Epidemiologists on Major Challenges for the Next Decades 1 Ana Azevedo, Leda Chatzi, Tobias Pischon and Lorenzo Richiardi Chapter 2 Frameworks for Causal Inference in Epidemiology 13 Raquel Lucas Chapter 3 Causal Diagrams and Three Pairs of Biases Eyal Shahar and Doron J. Shahar 31 Chapter 4 Qualitative Research in Epidemiology 63 Susana Silva and Sílvia Fraga Chapter 5 Between Epidemiology and Basic Genetic Research – Systems Epidemiology 85 Eiliv Lund Chapter 6 Molecular Epidemiology of Parasitic Diseases: The Chagas Disease Model 95 Juan David Ramírez and Felipe Guhl Chapter 7 Viral Evolutionary Ecology: Conceptual Basis of a New Scientific Approach for Understanding Viral Emergence 119 J. Usme-Ciro, R. Hoyos-López and J.C. Gallego-Gómez Chapter 8 Overview of Pharmacoepidemiological Databases in the Assessment of Medicines Under Real-Life Conditions 131 Carla Torre and Ana Paula Martins VI Contents Chapter 9 Role of Epidemiological Data Within the Drug Development Lifecycle: A Chronic Migraine Case Study 155 Aubrey Manack, Catherine C. Turkel and Haley Kaplowitz Chapter 10 Clinical Epidemiology: Principles Revisited in an Approach to Study Heart Failure 171 Ana Azevedo Chapter 11 The Use of Systematic Review and Meta-Analysis in Modern Epidemiology 195 Nuno Lunet Preface The dictionary of epidemiology of the International Epidemiological Association defines epidemiology as “the study of the occurrence and distribution of health- related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems”. This definition is currently well accepted and encompasses the activities that characterize epidemiology as an autonomous scientific discipline, as well as the use of epidemiological knowledge and tools to support the evidence based practice of public health and medicine. The contribution of epidemiology to discoveries with a major impact on the health of the populations led to the recognition of its importance by the remaining scientific community and lay people, and to the anticipation for new discoveries. This poses stimulant intellectual challenges and research objectives that require the use of ever finer methodologies and longer times than the competing scientific disciplines and the public opinion may be willing to concede for their accomplishment. In parallel, the epidemiologists’ tools and way of understanding health and disease are applied to resolve the everyday concerns of deciders in different health-related areas, and a sound and proficient use of the epidemiological methods is needed to meet their expectations. This special issue resulted from the invitation made to selected authors to contribute with an overview of a specific subject of their choice, and is based on a collection of papers chosen to exemplify some of the interests, uses and views of the epidemiology across different areas of research and practice. Rather than the comprehensiveness and coherence of a conventional textbook, readers will find a set of independent chapters, each of them of a great interest in their own specialized areas within epidemiology. Taken together, they illustrate the contrast between the attempt to extend the limits of applicability of epidemiological research, and the “regular” scientific activity in this field or an applied epidemiology. X Preface I believe that epidemiologists with different levels of expertise and interests will be able to find informative and inspiring readings among the chapters of this book. Nuno Lunet Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Institute of Public Health – University of Porto (ISPUP), Portugal [...]... 10 Epidemiology – Current Perspectives on Research and Practice communication to the population and scientific dialogue with other researchers and clinicians Also, they need to conquer a position in funding agencies and as consultants for policy makers, and be available for these tasks over time The need to reinforce the professional image of epidemiologists could be met by as good a formal education... J.,Gotzsche, P C & Vandenbroucke, J P (2007) The strengthening the reporting of observational studies in epidemiology (strobe) statement: Guidelines for reporting observational studies Lancet, Vol.370, No.9596, pp.1453-1457, 1474-547X (Electronic) 12 Epidemiology – Current Perspectives on Research and Practice Willison, D J (1998) Health services research and personal health information: Privacy concerns, new... countries, legislations on confidentiality are defined with little consideration on their impact on medical and public health research, thus favouring personal privacy above societal benefits The four principles of protection of a research participant are autonomy (selfdetermination), beneficence (maximal benefit), nonmalfeasance (minimal harm), and justice (distribution of benefits and harms across groups... Hospital, Denmark 13Department of Epidemiology and Biostatistics, National Institute for Health Development, Estonia 2 Epidemiology – Current Perspectives on Research and Practice Two major developments have changed the scientific and societal contexts in which epidemiology operates: the extraordinary advances in molecular genetics, cell and developmental biology and a shift towards social philosophies... priority to the research questions with the highest scientific interest and/ or public health impact This is however not a trivial task and we should recognise that the decision on what to study is affected by a large number of factors, many of which are not under our direct control 6 Epidemiology – Current Perspectives on Research and Practice 4 Emerging opportunities and challenges in epidemiology: ... information about oneself) and confidentiality (the obligation of a second party to not reveal private information about an individual to a third party without the permission of the person concerned) (Willison, 1998) Confidentiality and privacy issues are emerging limiting factors (for both new data collection and use of available databases) that can have important effects on shaping research agenda and public... causal inference and whose avoidance and discussion are at the core of epidemiologic research In practical terms, stating that causality is the best explanation for an observed association is equivalent to ruling out, with reasonable confidence, alternative explanations such as reverse causation, selection bias, information bias, confounding and chance The formalization and discussion of these alternative... change in area of research cannot be achieved in short time, while it needs long-term programming and a supportive research environment and infrastructure Changing Contexts in Epidemiologic Research – Thoughts of Young Epidemiologists on Major Challenges for the Next Decades 5 The research environment, the interaction with colleagues and their expertises and the facilities available at the research institute... society has conditioned and channelled science Societal reaction also influences the translation of epidemiology into public health Many of the 20th century beliefs regarding the relation between epidemiology and society turned out to be only halftruths: 1) epidemiology would lead to prevention, 2) prevention was better than cure, 3) social justice would be achieved through prevention and 4) epidemiology. .. epidemiologists’ professional image in the society in general to win its trust 6 Conclusion Research has been strongly influenced by a random and passive intersection between biotechnology, infrastructures and available methods Young epidemiologists must reinforce their knowledge on the substantive issues they are researching and promote an active interaction between biology and society Translational research is . EPIDEMIOLOGY – CURRENT PERSPECTIVES ON RESEARCH AND PRACTICE Edited by Nuno Lunet Epidemiology – Current Perspectives on Research and Practice Edited. free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Epidemiology – Current Perspectives on Research and Practice, . Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK 11 Department of Epidemiology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Netherlands