20th Anniversary Edition

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University of North Carolina at Chapel Hill
School of Public Health, Department of Epidemiology
Fundamentals of epidemiology (EPID 168)

Information resources for epidemiologists - textbooks and other books

There is a large - and growing - number of very good introductory and intermediate epidemiology textbooks. For a recent comparative review, see Bhopal RS. Which book? A comparative review of 25 introductory epidemiology textbooks. J Epidemiology Community Health 1997;51:612-622.

This course will use a web-published text: Understanding the fundamentals of epidemiology: an evolving text, which has been written specifically for EPID168.

Students who are new to epidemiology and wish to purchase a commercially published text should consider the text by Charles Hennekens and Julie Buring and the text by Leon Gordis, both of which cover many of the topics in EPID 168 from a fairly similar perspective. Epidemiology majors and other students taking EPID 268 will need to obtain Rothman and Greenland's Modern Epidemiology for that course. By puchasing it now they will be able to refer to it conveniently during EPID 168.

Students lacking previous coursework about human disease should find the textbook A Survey of Human Diseases, by David T. Purtilo and Ruth B. Purtilo (Second edition, Boston: Little, Brown, and Co., 1989) useful for background information.

  • Rothman, Kenneth J. and Sander Greenland. Modern Epidemiology. 2nd ed. Hagerstown MD, Lippincott-Raven, 1998 copies ordered).

    A revised, expanded edition of the highly-regarded Rothman KJ. Modern Epidemiology (Boston, Little Brown, 1986), this text provides one of the best expositions of the contemporary formulation of epidemiologic concepts, many of which the authors have helped to refine. This book is not recommended as an introductory textbook, but those of you who already have another text and/or have taken an introductory epidemiology course will find this book the most useful. Since this book is one of the required texts for EPID 268 (Advanced Methods in Epidemiology), those of you planning to take that course can purchase it early and have the use of it for EPID 168 as well. Rothman and Greenland are two of the leading exponents of "modern" epidemiologic concepts and methods. (Rothman also maintains the list of errata on the web.)

  • Gordis, Leon. Epidemiology. 2nd ed. Philadelphia: Saunders, 2000, paperback (ISBN 0-7216-8338-X)

    A very well-illustrated and clearly presented book by a master teacher who for many years has taught epidemiology at Johns Hopkins and edited the American Journal of Epidemiology.

  • Szklo, Moyses and F. Javier Nieto. Epidemiology: beyond the basics. Gaithersburg MD, Aspen, 2000 (ISBN: 0-8342-0618-8, 320 pages)

    According to the review by Robert KcKeown in the Epidemiology Monitor (January 2000;21:10,13), this intermediate level text is an "ideal" complement to the preceding text, by Gordis. Strong points, according to McKeown, are the clarity of treatment of age-period-cohort analysis, sampling strategies for case-control studies, and matching; the discussions of estimation of measures of disease occurrence, meaning and context of measures of association, the kappa statistic, and the distinction between confounding and effect modification; and the inclusion of many, relevant real-life examples.

  • Hennekens, Charles H. and Julie E. Buring. Edited by Sherry L. Mayrent. Epidemiology in Medicine. Boston, Little Brown, 1987. 1st ed. (copies ordered at the bookstore)

    A very well-organized, clear and readable treatment of current epidemiologic concepts and terminology. The book covers most of the material in EPID 168. The book is not coextensive with the course, however, omitting several topics and many nuances.

  • Friss, Robert H. and Thomas A. Sellers. Epidemiology for public health practice. Maryland, Aspen, 1996.

    A book that combines modern terminology and methods with ample coverage of descriptive epidemiology and applied epidemiology. A very good introduction to the field for those without previous exposure or who want to increase their knowledge of descriptive epidemiology and sources of data.

  • Timmreck T. An introduction to epidemiology. 2 ed, Boston, Jones and Barlett, 1998

    Written as an introductory text for an undergraduate course.

  • Kelsey, Jennifer L., W. Douglas Thompson, and Alfred S. Evans. Methods in observational epidemiology. NY, Oxford, 1986. WA 950 K29M 1986.

    Covers the general range of epidemiologic concepts. Includes chapters on sources of routinely collected data on disease, epidemic investigation, sampling and sample size estimation, and questionnaire design.

  • Kleinbaum, David G., Lawrence L. Kupper, and Hal Morgenstern. Epidemiologic research: principles and quantitative methods. Lifetime Learning Publications, Belmont, California, 1982. WA950 K64e 1982. (on reserve)

    Developed as a textbook for EPID 268, Advanced Epidemiologic Methods. Though advanced, certain chapters ("Fundamentals of epidemiologic research", "Types of epidemiologic research", and others listed in the lecture notes are useful to students in EPID 168.

  • Mausner, Judith S. and Shira Kramer. Mausner & Bahn Epidemiology: an introductory text. W.B. Saunders, Philadelphia, 1985. WA100 M459? 1985.

    Provides a systematic coverage of basic concepts and is particularly helpful for understanding semi-quantitative ones such as measures of disease and evaluation of screening tests. It is somewhat easier to understand than MacMahon and Pugh, and has problems and answers following each chapter. A survey of 22 introductory epidemiology courses (published in the Epidemiology Monitor) several years ago reported that Mausner and Kramer was the text in 15.

  • Morton, Richard F.; J. Richard Hebel, Robert J. McCarter. A study guide to epidemiology and biostatistics. 4 ed. Aspen, Fredrick MD, 1996.

    Includes a chapter on how to systematically examine a journal article.

  • Stolley, Paul D., Tamar Lasky. Investigating disease patterns: the science of epidemiology. NY: Scientific American Library (WH Freeman), 1995.

    Has a very good overview of the history and development of the field, ample background on the biology of the disease, and excellent illustrations. A beautifully-done book.

  • Lilienfeld, David E. and Paul D. Stolley. Foundations of epidemiology. 3rd ed. Oxford, New York, 1994.

    This is a new edition of a classic textbook by Abraham M. Lilienfeld and his son David. Abe Lilienfeld, who passed away during the 1980's, is regarded as one of the great American epidemiologists.

  • MacMahon, Brian and Dimitrios Trichopolous. Epidemiology: Principles & Methods. 2nd ed. Boston, Little, Brown, 1996, ISBN 0-316-54222-9)

    This is the second edition of a classic textbook by MacMahon and Thomas F. Pugh. A particular strength of this book and its predecessor are the extensive presentation of descriptive epidemiologic studies over the years.

  • Norell, Staffan E. A short course in epidemiology. NY, Raven Press, 1992. 208pp, $37.50, ISBN 0-88167-842-2

    According to the review in the January 1993 Epidemiology Monitor, this book gives an excellent treatment of case-control studies as well as covering cohort studies and general concepts in epidemiology and is well suited for a second level text. Two chapters are devoted to practice exercises.

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Other general textbooks of interest are:

  • MacMahon, Brian. Epidemiology: principles and methods. 2nd ed. Hagerstown MD, Lippincott-Raven, 1997.

    This book is a revised edition of the classic text of the same name, by Brian MacMahon and Thomas F. Pugh (Boston, Little Brown, 1970. WA100 M167e 1970). The first edition provided a rich coverage of past epidemiologic studies, as well as a more conceptual bent than those texts which emphasize "methods". Since many of the concepts and practices in epidemiology have developed primarily from the experience of working epidemiologists, rather than through systematic theoretical development supported by experimentation, familiarity with the range of work in the field is invaluable. The first edition was dated in respect to its presentation of concepts, but the descriptive epidemiology is excellent.

  • Walker, Alexander M. Observation and inference: an introduction to the methods of epidemiology. Newton Lower Falls, MA, Epidemiology Resources Inc., 1991.
  • Ahlbom, Anders and Staffan Norell. Introduction to modern epidemiology. 2nd ed. Newton Lower Falls, MA, Epidemiology Resources Inc., 1990.

    This text is very succinct and has a quantitative orientation. It's main strength is in providing a fairly basic, quick overview of the modern formulation of epidemiologic concepts.

  • Woodward, Mark Epidemiology: study design and data analysis. Boca Raton, FL: Chapman & Hall/CRC Press, 1999, ISBN:1584880090. 700 pp.

    According to the review by J. Mac Crawford in the Epidemiology Monitor (January 2000;21:11), this book targets epidemiologists "who desire a grounding in the statistical analysis of epidemiologic data" and statisticians "who need an understanding of how their discipline may be utilized". Crawford says that the author presents each topic (the standard set of epidemiologic concepts plus ways of summarizing, presenting, and computing inferential statistics for data) and includes computer analyses of examples (with the SAS programming in the appendix). The reviewer judges this book more accessible to epidemiologists lacking a background in mathematical statistics than Steve Selvin's Statistical analysis of epidemiologic data (1996), which is designed for the same audience.

  • Kahn, Harold A. Statistical methods in epidemiology. New York, Oxford, 1989.
  • Miettinen, Olli S. Theoretical epidemiology. NY, Wiley, 1985.

    This long-awaited textbook by a principal contributor to the development and systematization of epidemiologic theory concerning measures, confounding, and other quantitative topics was reviewed by Sander Greenland (Epidemiology Monitor 7(3), March 1986). His review concludes:

    "Given the book's unyielding and sometimes dogmatic style, its idiosyncratic terminology, and its lack of exercises or detailed case studies, I cannot recommend it as a course text for anything but an advanced seminar. Nevertheless, I would recommend the first nine chapters and appendices 1-6 to all research-oriented students, with the warning that the text should be read as a stimulus to thought rather than the revealed word."

  • Morris, J.N. The uses of epidemiology. Third edition. Churchill Livingstone, New York, 1975. WA100 M876 1975. Paperbound edition available.

    This is a classic and very useful reference book providing a wide series of provocative illustrations of the uses to which epidemiological principles and methods can be put. The book is not a "text" in itself but provides insights into a number of problems and a very full set of references as a guide to further reading. It does not deal extensively with epidemiological methods.

  • Last, John M. (ed), James Chin, Jonathan Fielding, Arthur Frank, Joyce Lashof (associate eds). Public health and preventive medicine. 12 ed. Norwalk, CT, Appleton-Century-Crofts
  • B. Burt Gerstman. Epidemiology kept simple. NY, Wiley, 1998.

    According to a review by Dimitrios Trichopoulos (Ann Epidemiol 1999;9:206), this book has many carefully worked out examples and illustrations and a number of topics not covered in most other texts infectious disease epidemiology, disease outbreak investigations, and computing and epidemiology but very little on chronic disease epidemiology. According to a review by Robert McKeown and Samuel Harper (Epidemiology Monitor, June 1999), the exercises do not "engage the student at higheer levels of learning: analysis, synthesis, evaluation, or application" with the important exception of four case studies (three from CDC training materials, the fourth from the late Joyce Piper) which are "wonderful".

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Specialty texts:

  • Rockett, Ian R. H. "Population and health: an introduction to epidemiology", Population Bulletin 1994;49(3) (Population Reference Bureau, Inc., Washington, DC).

    A marvelously clear, well-organized, readable, accurate, and well-illustrated overview of the field - an excellent resource to help your friends and family know what your are learning or for students taking a short course. Read this now if you've not had much previous exposure to epidemiology.

  • American Health Foundation. Workshop on Guidelines to the Epidemiology of Weak Associations. Preventive Medicine 1987; 16:139-212.

    These workshop papers provide an excellent treatment of a broad range of epidemiologic concepts. A set of reprints is on reserve in the library.

  • D. Coggon, Geoffrey Rose, D.J.P. Barker. Epidemiology for the uninitiated
  • . A very basic introduction that you can read at the British Medical Journal web site.

  • Petitti, Diana B. Meta-analysis, decision analysis, & cost-effectiveness analysis: methods for quantitative synthesis, 2nd ed. Oxford University Press, 2000. ISBN: 0195133641

    According to the review by Steven Teutsch in the March 2000 Epidemiology Monitor, this book addresses the various aspects of a quantitative syntheses of the literature, such as articulating the question, judging study quality, combining studies, measuring effect size, and interpreting results. The text is clear, logical, thoughtful, and contains many examples.

  • Principles of Epidemiology: an introduction to applied epidemiology and biostatistics. 2nd edition (field test version 4/92). Self-study course 3030-G. Epidemiology Program Office and Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, GA 30333.

    This book provides a clear and easily read introduction and overview of basic concepts in epidemiology and biostatistics, particularly those related to the practice of epidemiology in health departments. Examples, exercises, and self-graded quizzes. In addition to basics of epidemiologic measures, descriptive statistics, and methods of data presentation, the book includes sections on public health surveillance and investigating a disease outbreak.

  • Susser, Mervyn. Causal thinking in the health sciences. Oxford University Press, 1973. WA100 S964 1973.

    Another classic and an excellent introductory text whose forte is the presentation of the historical and philosophical dimensions of epidemiologic thinking about disease etiology. The book is one of the most intellectually stimulating texts, but has less systematic coverage of basic concepts than, for example, Mausner and Bahn. Unfortunately, it is out of print, but is in the library.

  • Armenian, Haroutune K. Applications of the case-control method. Epidemiologic Reviews 1994;16(1):1-64. $20.

    A series of review articles addressing historical and future perspectives, selection of cases and controls, statistical analysis, and application of this mainstay of epidemiologic investigation in selected areas of epidemiology.

  • Schlesselman, James J. (with contributions by Paul D. Stolley). Case-control studies. Oxford University Press, New York, 1982. WA950 S342x.

    Presents a systematic coverage of the concepts, methods, and analysis of case-control studies, in a comparable fashion to the coverage of clinical trials in the Friedman, Furberg, and DeMets book (see below). Schlesselman includes coverage of related topics, such as measures of risk, comparison of the case-control, cohort, and experimental approaches, and provides extenisve discussion of questions, the matching, sample size, and statistical analysis. The level and treatment are more advanced than EPID 168, but much of the material is very readable and relevant, particularly the earlier chapters. The chapters on "Planning and conducting a study" and "Sample size" are excellent, and provide a resource absent from most epidemology texts.

  • Ibrahim, Michel A. (Ed.), Walter O. Spitzer (Coordinating Associate Editor). The case-control study: consensus and controversy. Pergamon, New York, 1979.

    This book presents the papers and discussion from a conference convened by the Journal of Chronic Diseases (now the Journal of Clinical Epidemiology) to review concepts, methods, pitfalls, and policies for case-control studies. The book is valuble for gaining an appreciation of the mechanisms of bias in epidemiologic research, problems of study design, execution and interpretation, the application of statistics in epidemiologic research, the development of policy regarding the conduct of research, and the development of this essential research strategy.

  • Breslow, Norman E. and N.E. Day. Statistical methods in cancer research. Volume I: The analysis of case-control studies. International Agency for Research on Cancer (IARC), Lyon, 1980. QZ206 S797.

    This book is Breslow and Day's textbook from the University of Washington. It is intended for a more advanced course than EPID 168. The first three chapters may be of most interest to EPID 168 students.

  • Breslow, Norman E. and N.E. Day. Statistical methods in cancer research. Volume II: The design and analysis of cohort studies. (IARC Scientific Publications 82). NY, Oxford, 1988.

    This book is a companion volume to the preceding text.

  • Friedman, Lawrence M., Curt D. Furberg, David L. DeMets. Fundamentals of clinical trials. John Wright/PSG, Boston, 1980. W20.5 F911f 1981.

    This text is an excellent introduction to understanding and designing clnical trials. It is very clearly written and systematic, and is a good resource for understanding other aspects of analytic studies, particularly issues in the interpretation of statistical questions.

  • Meinert, Curtis L. Clinical trials: design, conduct, and analysis. NY, Oxford, 1986.

    A valuable reference work on clinical trials (and field research in general) including practical, applied issues.

  • Silva, Isabel dos Santos. Cancer epidemiology: principles and methods. Lyon, France, International Agency for Research on Cancer (IARC), 1999 (ISBN 92 832 0405 0, 442 pages). Other books from IARC include Epidemiology of childhood cancer, International incidence of childhood cancer, and Cancer survival in developing countries. In addition IARC produces a CD-ROM with data and software (GLOBOCAN) to access incidence and mortality of 25 major cancers for all areas of the world.
  • Checkoway, Harvey, Neil Pearce, and Douglas J. Crawford-Brown. Research methods in occupational epidemiology. NY, Oxford, 1989.

    Written while the three authors were at the UNC School of Public Health.

  • Monson, Richard R. Occupational epidemiology. 2nd ed. CRC Press, 1980. WA950 M7550 1990.

    Chapters 1-5 cover general epidemiologic concepts in a very succinct fashion.

  • Halperin W, Baker EL, Jr., Monson RR. Public health surveillance. NY, Van Nostrand Reinhold, 1992
  • Sechrest L, Perrin E, Bunker J. Research methodology: strengthening causal interpretations of nonexperimental data. USDHHS, AHCPR, May 1990.

    From a conference sponsored by the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality).

  • Fletcher, Robert H., Suzanne W. Fletcher, Edward H. Wagner. Clinical epidemiology -- the essentials. Williams & Wilkins, Baltimore, 1982. WA105 F614c 1982. Paperbound edition available.

    This textbook is written with a clinical orientation, but contains particularly clear and well-illustrated coverage of many topics of universal concern for epidemiologists. Moreover, since the authors were affiliated with this Department, the terminology and treatment of topics are more similar to those used by the instructors than for many of the other texts. Coverage is systematic and succinct, rather than philosophical and rich in examples.

  • Sackett, David L., R. Brian Haynes, and Peter Tugwell. Clinical epidemiology: a basic science for clinical medicine. NY, Little, Brown, 1985.

    This book emphasizes the "clinical" rather than the "epidemiology". The principal audience is practicing physicians wishing to apply others' research rather than wanting to do research.

  • Weiss, Noel S. Clinical epidemiology: the study of the outcome of illness. NY, Oxford, 1986.
  • Kramer, Barnett S., John K. Gohagan, Philip C. Prorok. Cancer screening: theory and practice. NY, Marcel Dekker, 1999 (ISBN 0-8247-0200-X, 650 pp, $195)
  • Feinstein, Alvan R. Clinical biostatistics. The C.V. Mosby Company, St. Louis, 1977. HA29 F299c 1977. (Out of print but in the library)

    This book contains a series of essays that appeared in Clinical Pharmacology and Therapeutics, during 1970-1975. Coverage is at a more advanced level and reflects Dr. Feinstein's strong views and trenchant expression. This book is a very intellectually stimulating collection on epidemiologic concepts and methods, but is more advanced than the level of this course. It is also out of print. Dr. Feinstein has published a new text (below).

Other books of interest

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Victor_Schoenbach@unc.edu, 8/4/2000, 9/27/2000, 1/5/2001