Epidemiological Practices in Research on Small Effects by Hans Hoffmeister (auth.), Professor Dr. Hans Hoffmeister,

By Hans Hoffmeister (auth.), Professor Dr. Hans Hoffmeister, Professor Dr. Moyses Szklo, Michael Thamm (eds.)

In smooth societies, epidemiology is more and more faced with the detection and review of small dangers, particularly from environmental exposures and diverse life. The query arises, if for instance, the hazards from residential magnetic box publicity and youth leukaemia, or dietry fats consumption and breast melanoma are genuine, or in the event that they can appropriately be regarded as artefacts, on account of methodological limits of epidemiology? an increasing number of conflicting effects are produced and are placing most people in a nation of uncertainty, which, if public strain is robust adequate, may perhaps lead to political motion with out the mandatory sound medical justification. consequently, techniques must be built, to minimise the "noise" in epidemiological stories, with a view to get a clearer photo of the true influencing components, and to lessen the opportunity of fake effects. in accordance with a global convention in this subject, attended by way of many of the world's major epidemiologists, this booklet is providing an outline of the most problems researchers could stumble upon while learning small dangers. it's also providing tips on find out how to continue while small hazards are below learn so one can keep away from spurious results.

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I have been concerned with the illness experience and health service usage of doctors in the United Kingdom. I was concerned that doctors were not receiving good medical care. Doctors have the third highest SMR for suicide. We undertook a small prevalence investigation, in which we questioned about 800 doctors in three districts about their illness experience and the services they received in the previous year. We used management consultants of the same age and sex as a control group. We reckoned that management consultants have similar terms of employment as doctors, and are also exposed to stressful situations.

Our risk measurements are connected by defmition. They are not independent. ' 26 Figure 1 Risc-Pictogramm Relative Risc RR and incidence 10 in their relation to the Attributable Risk A t r--::========~~:=-In __ Populalion: 10 8 Log (A) 8 7 -----~:_::_::;---III ]

Haenszel gave a course in cancer epidemiology in Oslo. Among their exercises was one on the relationship between serum cholesterol and coronary heart disease. The simplest way to adjust, if you have a linear relationship and can approximate the intraindividual variation, is to tum the slope. With our Norwegian data from around 1960 we ended up with roughly a 40% increase in the relative risks. However, it is not easy to measure such an increase directly. It is more difficult today than in the past.

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