The authors of Medical Epidemiology are pleased to introduce the
fourth edition of this book. Much has transpired in the field of
epidemiology since the publication of the previous edition of this book just
a few years ago. In September and October of 2001, several letters
containing powders with spores of Bacillus anthracis were mailed in
the United States, resulting in 22 cases of anthrax and five deaths. This
episode emphasized the potential threat to human health that can arise when
biological agents are used as weapons by terrorists. It also underscored the
role that epidemiology can play in investigating and controlling such
Not much more than a year later, the
world witnessed the dramatic emergence of a novel coronavirus, resulting in
an epidemic new illness, Severe Acute Respiratory Syndrome (SARS). The rapid
spread of this infection around the globe was aided by the highly contagious
nature of this disease and the frequency of international travel. Through
global cooperation, epidemiology once again proved to be critical in
identifying and controlling an emerging infectious disease.
Accordingly, this new edition of Medical Epidemiology
appears at a time when there is great focus on the role of epidemiology in
studying both natural and man-made influences on human health. Moreover, the
fast pace of external events reminds us of the importance of presenting the
most current information possible. As with previous editions, we have
updated information on patterns of disease occurrence and presented new
self-assessment questions at the end of each chapter.
Although this book has been extensively revised, it
remains faithful to the original intent of the authors—to provide a
text that would serve the basic needs of medical students, as well as
students of other health disciplines, such as public health, nursing,
pharmacy, and dentistry. It is written concisely and can be used as a course
textbook or as a stand-alone study guide.
The aim of this book is to provide the reader with an overview of the
principles and concepts of epidemiology. In so doing, it attempts to
illustrate the complementary relationship between population-based science
and the care of patients. Specific topic areas include:
• Measuring disease frequency
patterns of disease occurrence
• Investigating outbreaks of
• Assessing the utility of diagnostic tests
Testing the effectiveness of treatments
• Identifying the causes
• Predicting the outcome of illness
Decision-making about treatment strategies
• Summarizing evidence
on clinical questions
Upon completion of this
book, the reader should be able to calculate and interpret basic
epidemiologic measures, recognize the various epidemiologic study designs
with their respective advantages and limitations, understand the concepts of
variability and bias, and characterize the means by which clinical evidence
can be systematically summarized for decision-making.
APPROACH AND FEATURES
From the first edition
of this book to the present version, the authors have taken the viewpoint
that epidemiology should be both an understandable and interesting topic for
students of the health professions. In order to introduce the topic in that
manner, the following elements are emphasized:
Conceptual topics are explained in nontechnical language.
Liberal use is made of illustrations to facilitate comprehension and
retention of material.
• The most current information available is
presented on disease patterns and risk factors.
• Key concepts are
highlighted for emphasis, with summaries at the beginning and end of each
• The relationship between population-based science and
patient care is demonstrated through patient profiles.
• A full
range of clinical areas of application is shown, including infectious
diseases, cancer, Alzheimer's disease, and perinatal disorders.
Critical formulas and equations are provided without undue emphasis on the
mathematical applications of epidemiology.
• Questions are
provided in standardized test format at the end of each chapter to help the
student assess their knowledge and prepare for examinations.
updated glossary is provided to help the student master the vocabulary of
If the response to the first three
editions of this book is any indication, this approach is appealing to
students of the health professions. The authors hope that the present
edition continues to satisfy the demand for an engaging introductory text in
Raymond S. Greenberg, MD, PhD
Charleston, South Carolina