Steinbach M
Med Interne. 1978 Jul-Sep;16(3):297-304.
Chronic disease epidemiology emerged from a methodological necessity, namely to break the deadlock of the medical science faced with a sudden upsurge of these diseases, especially cardiovascular, after the Second World War. The author analyses the shortcomings of clinical investigation in contrast with the epidemiological approach, the qualitative and quantitative prerequisites of the latter, as well as its methodological instruments, pointing out misunderstandings and improper uses of some terms i.e., epidemiology is not one and the same thing as ecology; epidemiology precludes passive detection; the environmental agent is not identical to the risk factor; the risk factor is not diagnostic. It is worth making these distinctions in order to enhance the value of epidemiology as a first step toward prevention.
慢性病流行病学源于一种方法学上的必要性,即打破第二次世界大战后这些疾病,尤其是心血管疾病突然激增时医学所面临的僵局。作者分析了临床研究与流行病学方法相比的不足之处、流行病学方法的定性和定量前提条件及其方法学工具,指出了一些术语的误解和不当使用,即流行病学与生态学并非同一回事;流行病学排除被动检测;环境因素与风险因素不同;风险因素不具有诊断性。进行这些区分很有必要,以便提高流行病学作为预防第一步的价值。