Epidemiological studies are classified into descriptive, analytical, and experimental or clinical trials. Descriptive studies quantify the distribution of disease or characteristics of individuals within defined populations such as a geographic area or an occupational group. This distribution is often related to the characteristics of both the individual such as age, race, and sex and the environment. Analytical studies are of two broad types, retrospective or case-control and longitudinal or prospective. The goal of analytical studies is to determine the relationship between a defined independent variable or a risk factor, and a disease or dependent variable, or certain other characteristics of the individual. The variables initially measured are called the independent variables and the outcome, dependent variables. The experimental or clinical trials modify the independent variables in order to determine the effects on a dependent variable or outcome. The science of epidemiology deals primarily with the determinants of epidemics and the evaluation of methods of their control and prevention. The epidemiological methods are useful for the study of most diseases whether traditional acute, usually infectious diseases, or the longer-incubation-period, chronic diseases. The descriptive and analytical studies are of primary importance in determining the magnitude of the epidemic in relationship to time, place, and personal characteristics and the identification of probable risk factors of disease. Most of the interest in behavioral variables relates to diseases that have relatively long incubation periods, are difficult to accurately measure, and are often believed to have a “multifactorial” etiology. Often the estimated relative risk of any single variable is low and may be inconsistent from study to study. Many of these diseases have a relatively long incubation period prior to apparent clinical disease. Many also may have a relatively high prevalence of inapparent as compared to clinical disease. During the long incubation period, physiological changes may occur that result in modification of other risk factors for the disease. For example, weight loss and certain nutritional changes may occur years before the diagnosis of cancer. It is possible that metabolic changes at the cellular level may be the reasons for some of these early physiologic changes such as the weight loss. The subsequent weight loss as well as other nutritional changes and the cellular metabolic abnormalities then result in a substantial fall in the serum cholesterol levels. Measurement prospectively in a population study then is noted to have an inverse relationship with the subsequent risk of cancer (Sherwin et al., 1987). The longer the time between cholesterol measurement and either the incidence or death from cancer, the weaker is the relationship between cholesterol and cancer.


Coronary Heart Disease Smoking Cessation Usual Care Intervention Trial Coronary Heart Disease Mortality 
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Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • Lewis H. Kuller
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of PittsburghPittsburghUSA
  2. 2.Graduate School of Public HealthPittsburghUSA

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