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Epidemiology for the uninitiated, 5th edition
  1. R L Maynard

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    David Coggon, Geoffrey Rose, David G P Barker (pp 73; £12.95), 2003. London: BMJ Books. ISBN 0 7279 1604 1

    This well known, short, introductory text has established its place in the literature of epidemiology. The first edition appeared in 1979 and it has been updated regularly. As an introduction it can be warmly recommended.

    The authors have set out to explain what epidemiology is and how epidemiological studies should be conducted and interpreted in just 70 pages: a hard task. The chapters are short but cover the field in unexpected detail. Emphasis is placed on why certain study designs are applicable to certain problems and on the strengths and weaknesses of individual approaches. Mathematical details are not included and the innumerate have little to fear. Hard thinking is, however, needed! The emphasis placed on excluding, as far as possible, causes of bias is very necessary. This is stressed for each design considered: even experienced workers might learn something from this. Of course, no book as short as this can explore difficult areas in depth and in places this has led the authors into employing a didactic approach; one can find points for further discussion. Consider, for example, the following statement (page 17):

    “Confounding determines the extent to which observed associations are causal”

    Discuss—as the examiners used to say in the days of essay based examinations. Of course, the statement as it stands is incorrect and the authors explain the real effects of confounding clearly.

    This is not a cook-book of how to do epidemiological studies but I would have liked to have read a chapter entitled:

    “Problems likely to be solved by epidemiological studies and problems unlikely to be solved”,

    with some examples. The authors might like to consider this for the next edition which will certainly be called for in a few years time.

    In summary then, an admirable introduction that should be read by all medical students and, again, by all contemplating undertaking an epidemiological study.

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