Armenian Haroutune K
Department of Epidemiology, the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Am J Epidemiol. 2009 Jan 15;169(2):127-31. doi: 10.1093/aje/kwn311. Epub 2008 Nov 12.
As a scientific discipline, epidemiology has helped liberate the practice of public health and medicine from dogmatic thinking over the past century. This commentary highlights some integrating principles to explain why epidemiology is a problem-solving discipline. The first of these is that epidemiology is an information science. Epidemiology generates information for decision-making at all levels of the health-care system, including information for both individuals and the general public. Although all scientific disciplines produce data that may be used for decision-making, there is more immediacy for the decisions in epidemiology. The second principle is that epidemiology operates within an environment of complex systems. Etiologic factors operate in complex systems, and the use of a systems analysis approach in investigating health problems must be considered. The third principle is that epidemiology is not just a scientific discipline but a professional practice area as well. Epidemiology has a solid disciplinary scientific base, and its practice requires well-grounded academic preparation. Its objectives are very much within the public-social domain, and a well-defined, outcome-oriented, prevention-based philosophy steers its practice. In a number of universities, epidemiology is taught today as a research discipline rather than as an operational, problem-solving one. In conclusion, this commentary emphasizes the need to accept the fact that epidemiology has as much of a social role as a scientific one. Public health action, problem solving, and a sense of mission are what brings many students to epidemiology. A problem-solving, action-oriented epidemiology is consistent with that sense of mission.
作为一门科学学科，流行病学在过去一个世纪里帮助公共卫生和医学实践摆脱了教条式思维。本评论强调了一些整合原则，以解释为什么流行病学是一门解决问题的学科。首先，流行病学是一门信息科学。流行病学为医疗保健系统各级的决策生成信息，包括为个人和公众提供的信息。虽然所有科学学科都会产生可用于决策的数据，但流行病学中的决策更具即时性。第二个原则是，流行病学在复杂系统的环境中运作。病因因素在复杂系统中起作用，因此在调查健康问题时必须考虑使用系统分析方法。第三个原则是，流行病学不仅是一门科学学科，也是一个专业实践领域。流行病学有坚实的学科科学基础，其实践需要有扎实的学术准备。其目标很大程度上处于公共社会领域，一种明确界定的、以结果为导向的、基于预防的理念指导着其实践。在许多大学中，如今流行病学是作为一门研究学科而非一门操作性的、解决问题的学科来教授的。总之，本评论强调需要接受这样一个事实，即流行病学具有与科学角色同样重要的社会角色。公共卫生行动、解决问题的能力和使命感是吸引许多学生投身流行病学的原因。一种解决问题、以行动为导向的流行病学与那种使命感是一致的。
