Sick individuals and sick populations
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Aetiology confronts two distinct issues: the determinant of individual cases, and the determinants of incidence rate: if exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it.Abstract:
Aetiology confronts two distinct issues: the determinants of individual cases, and the determinants of incidence rate. If exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it: they will only identify markers of susceptibility. The corresponding strategies in control are the 'high-risk' approach, which seeks to protect susceptible individuals, and the population approach, which seeks to control the causes of incidence. The two approaches are not usually in competition, but the prior concern should always be to discover and control the causes of incidence.read more
Citations
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Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk
TL;DR: The results of this prospective validation provide evidence for the validity of the Risk Index in predicting individuals' risks of cancers, and offer support for future applications of this risk appraisal tool.
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Osteoporosis and the Global Competition for Health Care Resources
TL;DR: Efforts to implement public health measures are needed, but the targeted approach to assessment and treatment of high‐risk individuals must also be refined.
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Why the Scots die younger: Synthesizing the evidence
TL;DR: The reasons for the high Scottish mortality between 1950 and 1980 are unclear, but may be linked to particular industrial, employment, housing and cultural patterns.
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Ancestry as a determinant of mean population C-reactive protein values: implications for cardiovascular risk prediction.
Tina Shah,Paul J. Newcombe,Liam Smeeth,Juliet Addo,Juan P. Casas,John C. Whittaker,Michelle A. Miller,Lorna Tinworth,Steve Jeffery,Pasquale Strazzullo,Francesco P. Cappuccio,Aroon D. Hingorani +11 more
TL;DR: This paper evaluated the influence of ancestry on population C-reactive protein (CRP) concentration to assess the implications for statin targeting in non-Europeans and found that differences in CRP concentration in populations of diverse ancestry are sufficient to affect statin eligibility, based on a single CRP threshold of 2 mg/L, and only partially influenced by differences in variables related to cardiovascular risk.
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Is alcohol dependence best viewed as a chronic relapsing disorder
TL;DR: It is suggested that caution is therefore needed in using the chronic relapsing disorder label, as this formulation privileges biological aspects of dependence to the detriment of psychological and social contributions, it inhibits much-needed developments in understanding alcohol dependence and leads to inefficient distributions of public health and clinical care resources for alcohol dependence.
References
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Journal ArticleDOI
Strategy of prevention: lessons from cardiovascular disease.
TL;DR: In this article, two types of preventive measures are proposed; the first consists in the removal of an unnatural factor and the restoration of biological normality as the reduction of intake of saturated fats would be in the case of heart disease; the second does not consist of removing a supposed cause of disease but in adding some other factors in the hope of conferring protection as a high intake of polyunsaturated fat and of long-term medication would be for heart disease.
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A Co-operative trial in the primary prevention of ischaemic heart disease using clofibrate: Report1 from the Committee of Principal Investigators
M.F. Oliver,J. A. Heady,J.N. Morris,J. Cooper,H. Geizerova,I. Gyarfas,Green K,T. Strasser,W. G. Macfie,E. Scott,M. Czukas,J. Duba,E. Ostor,D. Grafnetter,Z. Hejil,Z. Pisa,K. Uemura,G. Lamm,J. M. Thorp +18 more
TL;DR: A double-blind intervention trial to test the hypothesis that the incidence of ischaemic heart disease in middle-aged men can be reduced by lowering raised serum cholesterol levels found men with a substantial reduction of cholesterol concentration, who smoked, and also had above average blood pressure levels showed the most benefit.
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Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention.
TL;DR: In this paper, a screening survey for cardiorespiratory disease and diabetes among 18,403 male Civil Servants aged 40-64 years, representing a 77% response of those eligible.
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How well can we predict coronary heart disease? Findings in the United Kingdom Heart Disease Prevention Project.
TL;DR: Although a group of subjects at high risk can be identified, among whom will be a high proportion of potential victims of heart attack, many subjects will be wrongly classified and highlight the need for research to improve the prediction of the development of coronary heart disease.
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British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality.
TL;DR: A negative relation existed between water hardness and cardiovascular mortality, although climate and socioeconomic conditions also appeared to be important influences.
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European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)
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