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Classical epidemiology
Clinical assessment of
individuals one by one
(exposure, risk, diagnosis, etc.)
Health problem identication
Inference on the disease in
the community
Study of time factors
Possibility of control
Study of place factors
Priority for intervention
Clinical epidemiology
(classical epidemiology in reverse direction)
Experience and knowledge of:
- Epidemiology of the disease
at the community level
- Basic epidemiologic
- Characteristics of patients
under care
Application and inference
on a particular patient
and/or groups of patients
under care in a given
clinical setting and
Decision making for the entire
course of care
Figure 2.12 Directions of reasoning in fundamental and clinical epidemiology.
(Redrawn with modifications from Jenicek, M., Foundations of Evidence-Based
Medicine , The Parthenon Publishing Group/CRC Press, Boca Raton/London/
New York/Washington, 2003; Jenicek, M., Epidemiology. The Logic of Modern
Medicine EPIMED International, Montréal, 1995.)
Table 2.4 Fundamental Prerequisites and Assessment Criteria of the Cause-Effect
Individual cause-effect criteria under scrutiny
Assumptions or prerequisites
(what should be confirmed before any causal criteria apply)
Possible roles in argumentation: grounds, rebuttals.
•Exclusion of randomness
•Consistency of results with prediction (conditional)
•Even observational studies respect as much as possible the same logic and
similar precautions as used in experimental research
•Studies are based on clinimetrically valid data
•Data are subject to unbiased observations, comparisons, and analysis
Uncontrollable and unint erpretable factors are ideally absent from the study
Criteria of causation
(for a study already performed)
Possible roles in argumentation: Backing, warrant, claim.
Argumentation for causality is based on the high quality evidence-backed building
blocks of an argument and a proper connection between them.
( Continued )
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