MLS054 Lesson2

MLS 054: Biostatistics and Epidemiology
Introduction to
Epidemiology
Lesson 2
Epidemiology and Biostatistics
✨ Epidemiology and biostatistics are the basic sciences of public

health
✨ Public health investigations use quantitative methods, which
combine the two disciplines of epidemiology and biostatistics
✨ Epidemiology is about the understanding of disease development
and the methods used to uncover the etiology, progression, and
treatment of the disease.
✨ Information (data) is collected to investigate a question.
✨ The methods and tools of biostatistics are used to analyze the data
to aid decision making.
✨ Epidemiology is the study of the distribution and determinants of
health, disease, or injury in human populations and the application
of this study to the control of health problems
Examples
⭐ National and local surveillance system (cancer, AIDS,

occurrence of E. coli O157:H7 outbreak)
⭐ Cohort study to investigate the association of cell phone use
and the development of brain tumors
⭐ Discovering the reliable risk factors for contacting Covid-19
virus
Epidemiological Principles and Methods are applied in:
✨ Clinical research
✨ Disease prevention
✨ Health promotion
✨ Health protection
✨ Health services research
Pioneers of Epidemiology
✨ The Greek physician Hippocrates is known as the father of medicine,

and was the first epidemiologist. Hippocrates sought a logic to
sickness. He is the first person known to have examined the
relationships between the occurrence of disease and environmental
influences. Hippocrates believed sickness of the human body to be
caused by an imbalance of the four Humors (air, fire, water, and
earth “atoms”). The cure to the sickness was to remove or add the
humor in question to balance the body. This belief led to the
application of bloodletting and dieting in medicine.
✨ Graunt, along with Sir William Petty, developed early human

statistical and census methods that provided a framework for
modern demography. He is credited with producing and widely
distributing the first life table, giving probabilities of survival to each
age. This was remarkable considering the Bills of Mortality did not
include age of death, thus Graunt used his knowledge of
mathematics to create such a table. Graunt is also considered as
one of the first experts in epidemiology, since his famous book was
concerned mostly with public health statistics.
✨ John Graunt’s application of theory to data was one of the first

instances of descriptive statistics. Some of Graunt’s tables are the
only resource for population data for certain periods of time, due to
lost records in the Great Fire of London. After the publication of
Graunt’s work, France began to collect more descriptive and
consistent censuses, though it is unknown if there was a direct
connection between these two events. Graunt’s work is still used
today to study population trends and mortality.
✨ James Lind was a physician in the early 18th century, when scurvy
was a major problem among sailors on long sea voyages. At that
time, the cause of scurvy was not known. Bad air, congenital laziness
and indigestible food were all suggested as possible causes. Lind
observed that the sailors’ diet was very poor, consisting of biscuits
and salted fish or meat.
✨ In 1747 he conducted an experiment at sea with 12 patients suffering

from scurvy. Lind’s experiment is an early example of interventional
epidemiology (also known as experimental epidemiology). Lind
divided his population into groups and allocated different
treatments to each. Effectively Lind allocated a specific exposure
(type of food supplement) to each group and then observed the
outcome (whether or not scurvy improved)
✨ What was particularly important was that he had comparison or

“control” groups of patients who did not receive the intervention of
interest, which meant that he could compare the outcome in those
who received the intervention to those who did not.
✨ William Farr’s contributions to epidemiology were both broad and

deep. His creation of a vital statistics system, role in the formation of
the International Classification of Diseases, and prominence in
resolving the mode of communication of cholera in Victorian
England were each seminal to modern epidemiology. The same can
be said for his development of the concept of surveillance.
✨ John Snow, English physician known for his seminal studies of

cholera and widely viewed as the father of contemporary
epidemiology. His best-known studies include his investigation of
London’s Broad Street pump outbreak, which occurred in 1854, and
his “Grand Experiment,” a study comparing waterborne cholera
cases in two regions of the city - one receiving
sewage-contaminated water and the other receiving relatively
clean water. Snow’s innovative reasoning and approach to the
control of this deadly disease remain valid and are considered
exemplary for epidemiologists throughout the world. Snow’s
reputation in anesthesiology, specifically in regard to his knowledge
of ether and chloroform, was considerable, such that he was asked
to administer chloroform to Queen Victoria when she gave birth in
1853 to Prince Leopold and in 1857 to Princess Beatrice.
✨ Wade Frost - his work included studies of the epidemiology of

poliomyelitis, influenza, diphtheria, and tuberculosis. In 1906, Frost
assisted in the first successful arrest of a yellow fever epidemic in
the United States. He also helped field investigations regarding
typhoid outbreaks and water pollution by applying his knowledge of
microbiology laboratory techniques.
✨ Bradford Hill is widely known for pioneering the “Bradford Hill” criteria
for determining a causal association.
✨ Hill had a distinguished career in research and teaching and as an

author of a very successful textbook, Principles of Medical Statistics,
he is famous for two landmark studies. He was the statistician on the
Medical Research Council Streptomycin in Tuberculosis Trials
Committee and their study evaluating the use of streptomycin in
treating tuberculosis, is generally accepted as the first randomised
clinical trial. The use of randomisation in agricultural experiments
had been pioneered by Ronald Aylmer Fisher. The second study was
rather a series of studies with Richard Doll on smoking and lung
cancer. The first paper, published in 1950, was a case-control study
comparing lung cancer patients with matched controls, Doll and Hill
also started a long-term prospective study of smoking and health.
This was an investigation of the smoking habits and health of 40,701
British doctors for several years (British doctors study)
✨ Sir William Richard Shaboe Doll was a British physician who became
an epidemiologist in the mid-20th century and made important
contributions to that discipline. He was a pioneer in research linking
smoking to health problems. With Ernst Wynder, Bradford Hill and
Evarts Graham, he was credited with being the first to prove that
smoking caused lung cancer and increased the risk of heart
disease. (German studies had suggested a link as early as the 1920s
but were forgotten or ignored until the 1990s. He also carried out
pioneering work on the relationship between radiation and leukemia
as well as that between asbestos and lung cancer, and alcohol and
breast cancer.
Scope of Epidemiology
1. Causation of disease
2. Natural history of disease
3. Health status of the population
4. Evaluation of interventions
Ultimate Aim of Epidemiology
1. To eliminate or reduce the health problems of the community

2. To promote the health and well-being of the society as a whole
Aims and Objectives of Epidemiology
1. To describe the distribution and magnitude of health and disease

problems in the population.
2. To identify etiological factors (risk factors) in the pathogenesis of
disease
3. To provide data essential to the planning, implementation, and
evaluation of services for the prevention, control and treatment of
disease and setting among those services
Core Epidemiologic Functions
1. Public health surveillance

2. Field investigation
3. Analytic studies
4. Evaluation
5. Linkages
6. Policy development

MLS054 Lesson2

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

MLS054 Lesson2

Uploaded by

Copyright:

Available Formats

MLS 054: Biostatistics and Epidemiology

Epidemiology and Biostatistics

✨ Epidemiology and biostatistics are the basic sciences of public

⭐ National and local surveillance system (cancer, AIDS,

Epidemiological Principles and Methods are applied in:

✨ The Greek physician Hippocrates is known as the father of medicine,

✨ Graunt, along with Sir William Petty, developed early human

✨ John Graunt’s application of theory to data was one of the first

✨ In 1747 he conducted an experiment at sea with 12 patients suffering

✨ What was particularly important was that he had comparison or

✨ William Farr’s contributions to epidemiology were both broad and

✨ John Snow, English physician known for his seminal studies of

✨ Wade Frost - his work included studies of the epidemiology of

✨ Hill had a distinguished career in research and teaching and as an

Ultimate Aim of Epidemiology

1. To eliminate or reduce the health problems of the community

Aims and Objectives of Epidemiology

1. To describe the distribution and magnitude of health and disease

Core Epidemiologic Functions

1. Public health surveillance

You might also like