| |
Society for
Epidemiologic Research (SER) Presidential Addresses
1982:Jennifer
Kelsey
On Achievements and Challenges, Cincinnati, Ohio
Outgoing SER President Addresses
Cincinnati Gathering on Maintaining Quality of Work
Epidemiology as a discipline has
gained in stature, but epidemiologists must strive to achieve accuracy
and maintain quality in their work if this new stature is to be
preserved. This, according to outgoing SER president Jennifer Kelsey,
is the main challenge facing epidemiologists today.
As has become traditional, Dr. Kelsey made her remarks on the “State
of the Discipline” before some 700 epidemiologists gathered on the
opening morning of the 15th annual SER meeting in Cincinnati’s
Convention Center. She listed many areas of progress for both the
profession and the discipline, but likewise identified a number of
problems which she perceives as deserving of increased attention.
The Good News
The first sign of progress noted
by Dr. Kelsey is the growing membership of the SER itself, which now
has approximately 2000 members. Other signs of vitality are the sound
reputation of the American Journal of Epidemiology, the proliferation
of private consulting groups in epidemiology, the election of
epidemiologists to the National Academy of Sciences, and the growing
interest in epidemiology on the part of the news media (Dr. Kelsey
expressed some doubt about whether or not to list this latter
occurrence as a positive or negative development). Equally encouraging
in the mind of the outgoing president was the promulgation of more
favorable regulations for the protection of human subjects, and the
inclusion of epidemiologists as equal members of interdisciplinary
teams.
The Concerns
In additional remarks, Dr.
Kelsey focused on the responsibilities which epidemiologists have, and
she warned that when people have too much to do, the quality of their
work may be sacrificed.
She noted that epidemiology now has a credibility problem,
particularly in the area of cancer etiology, stemming from the
identification “week after week of cause after cause.” She urged
caution in making findings known.
Dr. Kelsey also cautioned against an over dependence on existing data
sources rather than the collection of new data. On the use of
multivariate statistical techniques, she urged colleagues to fully
evaluate biologically, methodologically, and statistically any
associations found before assuming causality. Finally, she noted
problems with measurement which prohibit the interpretation of
findings because some factors cannot be measured satisfactorily or
because some confounders cannot be measured at all. She called for
work to develop better methods of measurement.
By way of summary, Dr. Kelsey repeated that epidemiologists have
gained in stature and are now listened to. However, the main challenge
has become to maintain the quality of epidemiologic work and to strive
for accuracy in reaching conclusions.
Postscript 2000
Most of the concerns I had then
still pertain. We still need to be concerned about the quality of our
work and we still have a credibility problem. However, there are many
more high-quality existing sources of data available now than there
were then, so I would recommend using existing sources of data in
combination with the collection of new data. In many instances, better
methods of measurement are now available with the emphasis on
biological markers, but we do not always know the meaning of what we
are measuring. Our field is, of course, now somewhat dominated by the
inclusion of genetic markers in our studies, but the public health and
clinical importance of many of these markers has yet to become
apparent. Only time will tell the extent to which this change in
emphasis to genetic epidemiology will affect the health of populations
in the United States as well as in other parts of the world where
public health needs are greatest.
|
|
