Causation, bias and confounding: a hitchhiker's guide to the epidemiological galaxy. Part 3: Principles of causality in epidemiological research: statistical stability, dose- and duration-response effects, internal and external consistency, analogy and biological plausibility

2008 ◽  
Vol 34 (4) ◽  
pp. 261-264 ◽  
Author(s):  
Samuel Shapiro
2002 ◽  
Vol 21 (1) ◽  
pp. 83-100 ◽  
Author(s):  
Jonathan I. Robison ◽  
Gregory Kline

In health education and promotion, “risk factors” for disease gathered from epidemiological research form the basis from which the majority of recommendations to individuals for lifestyle change are made. Unfortunately, many health practitioners are unaware that this type of research was never intended to be applied to individuals. The result is ongoing public confusion and anxiety concerning health recommendations and a loss of credibility for health professionals. This article: 1) briefly reviews the most commonly encountered limitations inherent in epidemiological research; 2) explores the problems and potential negative consequences of incorrectly applying epidemiological research in health education and promotion; and 3) makes recommendations to help health practitioners more skillfully interpret and incorporate into their work findings from epidemiological research.


Author(s):  
Margit L. Bleecker

This chapter describes neurologic disorders related primarily to occupational exposures along with presenting signs and symptoms. Acute or subacute occupational exposure to high levels of neurotoxic compounds, which occurred in the past and resulted in unique presentations of neurological disorders, occur infrequently today. Sections include the evaluation of toxic neuropathies and the approach to neurobehavioral impairment along with the cognitive domains commonly affected with exposure to neurointoxicants. A section describes the approach to a patient with exposure to neurointoxicants that includes the need for a temporal association between exposure and effect, a dose-effect relationship, biological plausibility, and other causes eliminated Effects of selected neurotoxins are described, including carbon monoxide, lead, organic solvents, and manganese.


Author(s):  
Donald L. Bliwise ◽  
Michael K. Scullin

Possible associations between sleep and cognition are provocative across different domains and hold the promise of prevention or reversibility. A vast array of studies has been reported. Evidence is suggestive but hardly definitive. We provide an overview of this literature, adopting the framework of Hill’s perspective on epidemiological causation. With rare exception, formal meta-analyses have yet to appear. Apparent consistency of findings suggests relationships, but the diversity of findings involving specific components of cognitive function raises interpretative caution. Large effect sizes have been noted, but small-to-moderate effects predominate. Natural history data are similarly enticing, and studies of biological plausibility and gradient indicate likely neurobiological substrates. Perhaps the ultimate population-health criterion, demonstration of reversibility of impairment, remains elusive at best. This area offers an exciting topic for future work.


2000 ◽  
Vol 9 (3) ◽  
pp. 171-189 ◽  
Author(s):  
Mark Woodward ◽  
Jean Nursten ◽  
Paul Williams ◽  
Doug Badger

SummaryObjective – This paper reviews 28 studies on the epidemiology of homicide committed by mentally disordered people, taken from recent international academic literature. Methods – The studies included were identified as part of a wider systematic review of the epidemiology of offending combined with mental disorder. The main databases searched were Embase, Medline, HealthStar, Psyclit, Mental Health Abstracts, Applied Social Sciences Index and Abstracts, and Criminology Penology and Police Science Abstracts. A comprehensive search was made for studies published since 1990, supplemented with key studies from the 1980s identified through citation tracing and personal contacts. Results – A summary is given in tabular form of the content and quality of each study. There is then discussion of the studies in eight categories: descriptive studies, studies of trends, comparative studies amongst homicide offenders, amongst prisoners and including general populations, studies of homicide of relatives, follow-up studies, and studies of recidivism. Conclusions – There is an association of homicide with mental disorder, most particularly with certain manifestations of schizophrenia, antisocial personality disorder and drug or alcohol abuse. However, the quality of epidemiological research in this area is not adequate to answer key questions, and prediction of potential for homicide remains elusive. Further research is needed.


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