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A response to the crisis of epidemiology | John Dunn, MD
Article Published: 2009/03/06

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Type: Articles and Dissertations
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In reference to the following articles:

I respond to the essay "The triumph of the null hypothesis: epidemiology in an age of change" by Wasim Maziak published December 17, 2008.

Maziak outlines the crisis in epidemiology that has been brewing for many years and was documented very forcefully in 1995 by Taubes. (1) Taubes then focused mostly on the scandal of small effects research that is falsely asserted as proof of causation, quoting Marcia Angell of the New England Journal of Medicine, Dimitrous Trichopoulos, chairman of Epidemiology at Harvard, Sir Richard Peto, Ken Rothman, and others.

Taubes exposed at the time the original sin of epidemiology, the reliance on small effects, less than a Relative Risk of 2, as proof of causation.

Then, in 2007 Taubes revisited the problem of unreliable epidemiology, and hit the epidemiologists and their professional activities out of the park (2) exposing the failures of epidemiology and the repeated episodes of scandalously unreliable claims, exposing the problem of bad studies in hormone replacement therapy, nutrition studies, quoting the great epidemiologist Sir Richard Peto, "an incredible amount of rubbish is published"

What possibly can Maziak do to respond to such a travesty of science--could he have the nerve to propose evolutionary perspectives as an escape?  I protest.

In many areas of important public health toxicology, but even in the less important studies of toxicology, epidemiologists seem to be addicted to small effects--but it is not really an addiction, it is about survival, for the reasons Maziak admits--there are no big effects left to study.

Maziak offers a new field to plow and cultivate, genomics and evolution, which I assert is a distraction and a deceptively complex and attractive area for new junk science projects. 

When observational epidemiology is adrift, the redemption is not another trans-science political forest or swamp--something as unscientific and political as evolutionary studies. A new area of study will merely compound the problem for epidemiologists and force even more methodological and statistical machinations and deceptions.

Epidemiology is uncertain, the rate of irreproducible studies is unacceptable as admitted by Maziak and demonstrated by Ioannidis (3), and Maziak expands the data dredge to evolutionary and genetic studies?  What is an evolutional perspective?  Talking about hunter gatherer genes, and adaptation to cities and apartment living? 

I assert such talk and writing doesn't represent a serious or even relevant take off point for the new generation of epidemiological studies.  Evolutionary theory is trans-science because even the strongest advocates of evolution admit it can't be studied; it is a phenomenon that takes eons. Dr. Maniac’s studies would have to be followed by a 4th or 5th generation of descendants?  Maybe the 10th or the 50th.  50th would be about right, 1000 years. 

What does Maziak mean when he says we are genetically hardwired?  Is that a scientific concept that can be studied by epidemiologists? Or is he maybe looking for something that can be discussed vaguely and generally for the evening news?

Maziak's essay is not a new area of inquiry as much as a desperate reach into a black box with the hope that creating a new language and area of inquiry for epidemiology will avert the discovery that epidemiology has evolved into data dredging and cherry picking for publishable papers and pronouncements, a pathetic substitute for those big effects found in the early days.  Sometimes it's just best to quit.  Maybe epidemiology should consider a short rest for reevaluation rather than a plunge into genetic and evolutionary studies.

John Dale Dunn MD JD
Civilian Emergency Medicine Faculty
Carl R. Darnall Army Medical Center
Fort Hood, Texas

  1. Taubes G, "Epidemiology Faces Its Limits." Science  July 14 1995 P164-169.
  2. Taubes "Do we really know what makes us healthy?  New York Times September 16, 2007.
  3. Ioannidis JPA (2005) Contradicted and initially stronger effects in highly cited clinical research. JAMA 294: 218–228.

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