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Society for Epidemiologic Research (SER) Presidential Addresses

1982:Jennifer Kelsey
On Achievements and Challenges, Cincinnati, Ohio

Outgoing SER President Addresses Cincinnati Gathering on Maintaining Quality of Work

Epidemiology as a discipline has gained in stature, but epidemiologists must strive to achieve accuracy and maintain quality in their work if this new stature is to be preserved. This, according to outgoing SER president Jennifer Kelsey, is the main challenge facing epidemiologists today.

As has become traditional, Dr. Kelsey made her remarks on the “State of the Discipline” before some 700 epidemiologists gathered on the opening morning of the 15th annual SER meeting in Cincinnati’s Convention Center. She listed many areas of progress for both the profession and the discipline, but likewise identified a number of problems which she perceives as deserving of increased attention.

The Good News

The first sign of progress noted by Dr. Kelsey is the growing membership of the SER itself, which now has approximately 2000 members. Other signs of vitality are the sound reputation of the American Journal of Epidemiology, the proliferation of private consulting groups in epidemiology, the election of epidemiologists to the National Academy of Sciences, and the growing interest in epidemiology on the part of the news media (Dr. Kelsey expressed some doubt about whether or not to list this latter occurrence as a positive or negative development). Equally encouraging in the mind of the outgoing president was the promulgation of more favorable regulations for the protection of human subjects, and the inclusion of epidemiologists as equal members of interdisciplinary teams.

The Concerns

In additional remarks, Dr. Kelsey focused on the responsibilities which epidemiologists have, and she warned that when people have too much to do, the quality of their work may be sacrificed.

She noted that epidemiology now has a credibility problem, particularly in the area of cancer etiology, stemming from the identification “week after week of cause after cause.” She urged caution in making findings known.
Dr. Kelsey also cautioned against an over dependence on existing data sources rather than the collection of new data. On the use of multivariate statistical techniques, she urged colleagues to fully evaluate biologically, methodologically, and statistically any associations found before assuming causality. Finally, she noted problems with measurement which prohibit the interpretation of findings because some factors cannot be measured satisfactorily or because some confounders cannot be measured at all. She called for work to develop better methods of measurement.

By way of summary, Dr. Kelsey repeated that epidemiologists have gained in stature and are now listened to. However, the main challenge has become to maintain the quality of epidemiologic work and to strive for accuracy in reaching conclusions.

Postscript 2000

Most of the concerns I had then still pertain. We still need to be concerned about the quality of our work and we still have a credibility problem. However, there are many more high-quality existing sources of data available now than there were then, so I would recommend using existing sources of data in combination with the collection of new data. In many instances, better methods of measurement are now available with the emphasis on biological markers, but we do not always know the meaning of what we are measuring. Our field is, of course, now somewhat dominated by the inclusion of genetic markers in our studies, but the public health and clinical importance of many of these markers has yet to become apparent. Only time will tell the extent to which this change in emphasis to genetic epidemiology will affect the health of populations in the United States as well as in other parts of the world where public health needs are greatest.

 

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