Identification of Syndromes
This use again relates directly to clinical medicine. Broad descriptive clinical and pathological categories often include very different elements. Their different statistical distribution, and their different behaviour among the population, may make it possible to distinguish such elements from each other, and thus help to identify characteristic syndromes. Consider the mortality from 'peptic ulcer' in 1921-23 (Figure 6 ). Clearly there were at least two conditions to be studiedconditions with possibly different causes. My own main interest in this field is in trying to disentangle coronary heart disease form coronary atheroma, by study of their different distributions in the population today, and their different histories in the past 40 years.
Social class differences in ‘peptic ulcer´ mortality in Males, England and Wales, 19212318
Table 3 illustrates again from cardiovascular disease. The common lumping together of coronary and cerebrovascular lesions as 'atherosclerosis' is not very strongly justified in clinical or pathological terms. Nor do the two conditions always behave similarly epidemiologically: the recent vital statistics are quite different; and this small experience among doctors ( Table 3 ) is interesting. The natural history of conditions as group phenomena may thus help to define syndromes. The vast unknown field of chronic chest diseasemiddle-aged men with respiratory symptomstoday offers particular opportunities for this application of the epidemiological method.(The reverse is also truethat the epidemiological method may help to show or to confirm that apparently disparate phenomena are connected, by drawing attention to their related behaviour in the populationfor example, malformation and rubella, rheumatic fever and streptococcal infection, zoster and chicken pox. However, I cannot think of any satisfactory illustrations from the non-infectious diseases.)
Int J Epidemiol. 2007;36(6):1165-1172. © 2007 Oxford University Press
Copyright 2007 International Epidemiological Association. Published by Oxford University Press. All rights reserved.
Read in opening a discussion at the Section of Preventive Medicine and Infectious Diseases at the Annual Meeting of the British Medical Association, Glasgow, 1954, and since expanded. First published BMJ 1955;2:395-401. Reprinted with permission.
Cite this: Uses of Epidemiology - Medscape - Dec 01, 2007.