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Stuck in ‘the field’: why applied epidemiology needs to go home
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  • Published on:
    In defence of "the field"
    • Roland L. Salmon, Consultant Epidemiologist (Retired) formerly Director, Communicable Disease Surveillance Centre (Wales))

    Prompted by a BMJ publications email to look at this recent editorial in BMJ Global Health, as someone with a lifelong career as a self styled “Field Epidemiologist”, my interest was instantly piqued by its title (1). It and the supporting Medical Anthropology Quarterly article(2) that it drew heavily upon did not disappoint. It’s a stimulating read that all of us in the field would do well to reflect on.

    Even in a career carried out almost exclusively in the developed country setting of the UK, I encountered “organizational features of hypothesis building”, “structural bias”, that resulted in error. Initial reluctance to acknowledge the zoonotic potential of Bovine Spongiform Encephalopathy (BSE) was prompted in part by the success of the emerging science of molecular genetics in explaining clusters in other countries. In 1995, one acknowledged global expert published a BMJ education and debate piece, implying that a consequence of such suggestions of zoonotic spread, even in the face of emerging evidence, might be, “a class action suit for anxiety brought by the entire British population against its own government” (3) although he did have the grace subsequently to acknowledge his error (4). In the recent international outbreak of hepatitis of unknown cause, viral explanations have predominated (5), even though the epidemiological pattern is more suggestive of a toxin as a cause (6).

    My colleagues and I might be characterised, I suppose, as "elite...

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    Conflict of Interest:
    None declared.