Miettinen Olli S
Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, Canada.
Eur J Epidemiol. 2004;19(8):713-8. doi: 10.1023/b:ejep.0000036617.83737.74.
In our etiologic research, we epidemiologists need to leave behind the concepts of 'cohort' study and 'case-control' study and adopt that of the etiologic study as the singular substitute for these. We then need to realize that the etiologic study is well suited to be viewed as paradigmal for intervention studies. We finally need to become serious about object design before methods design in both etiologic and intervention research. Once these developments have occurred, we'll be ready for truly meaningful research to advance the knowledge base of both types of causality-oriented 'gnosis' in the practice of clinical medicine, etiognosis and intervention-prognosis; and descriptive-prognostic study we'll see as inherent in any intervention-prognostic study. As for diagnostic research, then, we need to come to see it as nothing but a special case of our familiar descriptive prevalence research. Because of this readily attainable theoretical readiness peculiar to us research epidemiologists, and for other reasons besides, only we can assume the central role in the production of the knowledge base for scientific medicine. We consequently have the obligation to assume this larger and higher, meta-epidemiologic mission--and some even higher ones besides.
在我们的病因学研究中，我们流行病学家需要摒弃“队列”研究和“病例对照”研究的概念，采用病因学研究的概念作为这些概念的单一替代。然后我们需要认识到，病因学研究非常适合被视为干预研究的范例。最后，在病因学研究和干预研究中，我们需要在方法设计之前认真对待对象设计。一旦这些进展实现，我们就准备好进行真正有意义的研究，以推进临床医学实践中两种因果关系导向的“诊断”（病因诊断和干预预后诊断）的知识基础；并且我们将把描述性预后研究视为任何干预预后研究中固有的内容。至于诊断研究，我们需要将其视为我们熟悉的描述性患病率研究的一个特例。由于我们研究流行病学家特有的这种易于实现的理论准备，以及其他原因，只有我们能够在科学医学知识库的产生中发挥核心作用。因此，我们有义务承担这个更大、更高的元流行病学使命——甚至还有一些更高的使命。
