In Getting Risk Right: Understanding the Science of Elusive Health Risks…looking across the current landscape of environmental epidemiologic research and communication of its findings, [Dr. Geoffrey Kabat] sees shining successes, illustrated by the establishment of human papillomavirus as the cause of cervical cancer and of specific herbal remedies as causes of nephropathy. He contrasts those 2 case studies with 2 heavily studied and far murkier topics—cellular phones and endocrine dis- ruptors. Addressing a wide audience, Kabat shows that it is difficult to find real causes of disease and critical to insist on scientific rigor in looking for them. He urges his fellow epi- demiologists to use higher standards, including quantitative attention to dose-specific risks, explicit recognition of uncertainty, and sensible weighing of plausible harms and benefits. Journal readers may weigh the evidence on a particular topic differently, but they will agree with the clarion call for rigor and reason.
The problems Kabat describes are enormous and not “just academic.” Bad public policy is enacted and valuable research energy wasted because some epidemiologic topics stay active long after they have been settled.
We know that journalists and, certainly, the public tend to think that a “study is a study” and “an association is an association.” But, as epidemiologists, we should be more critical than we have been, especially in areas [in which] the study design and methods are weak and, at the same time, [in which] due to “human interest,” results are likely to attract the public’s attention. So, when one reviews studies [in which] the meth- odology is weaker, it is imperative to keep this “big picture” consideration in mind. My impression is that it is often lost sight of.
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