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Sick individuals and sick populations

Geoffrey Rose
- 01 Mar 1985 - 
- Vol. 30, Iss: 3, pp 427-432
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TLDR
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.

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Understanding attention deficit hyperactivity disorder as a continuum

TL;DR: Research findings that consider whether attention deficit hyperactivity disorder (ADHD) is a discrete entity or whether it is more consistent with an extreme end-of-trait distribution in the population are reviewed to grapple with the potential clinical implications.
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Evaluating Competing Models of Alcohol‐Related Harm

TL;DR: This paper summarizes “Evaluating Competing Models of Alcohol-Related Harm” of the International Workshop on Consumption Measures and Models for Use in Policy Development and Evaluation, May 12-14, 1997, Bethesda, MD.
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Overview of Screening: Where We Are and Where We May Be Headed

TL;DR: This volume of Epidemiologic Reviews continues a discussion about screening within the evidence community that has been going on for many years; from various perspectives, the authors of these reviews consider the benefits and harms of screening for multiple conditions.
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Beyond low-density lipoprotein cholesterol. A perspective on low high-density lipoprotein disorders and Lp(a) lipoprotein excess.

TL;DR: Until clinical trials determine whether specific therapeutic interventions can prevent the occurrence and recurrence of coronary heart disease in patients with these dyslipidemias, the implementation of cholesterol-lowering guidelines can provide a reasonable way to manage low high-density lipoprotein disorders and to identify specific categories of patients who may be at particularly high risk for premature coronaryHeart disease.
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Tuberculosis in intra-urban settings: a Bayesian approach.

TL;DR: To model the effect of socio‐economic deprivation and a few transmission‐related indicators of the tuberculosis incidence at small area level, to discuss the potential of each indicator in targeting places for developing preventive action.
References
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Journal ArticleDOI

Strategy of prevention: lessons from cardiovascular disease.

Geoffrey Rose
- 06 Jun 1981 - 
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

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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