The next stage: molecular epidemiology

J Clin Epidemiol. 1997 Jun;50(6):633-8. doi: 10.1016/s0895-4356(97)00052-8.


The traditional approach in epidemiology of relating exposure to an environmental agent such as a drug or infective agent has been to measure an overall risk (i.e., average and then "adjust risk for demographic variables and other confounders"). An attempt is sometimes made to define a "susceptible" subgroup. The analyses are usually based on good statistical methodology rather than an understanding of the interaction of body of host and agent. A twofold risk for 1000 exposed versus nonexposed people could be an average twofold risk for all 1000 exposed or a 20-fold risk for 100 exposed individuals (i.e., a drug-host interaction). Clearly, finding the 100 individuals with a 20-fold risk has much greater clinical importance than a twofold risk for 1000 people. The world of epidemiology may be changing-we may soon be able to define risk based on genetic susceptibility, at least sometimes.

MeSH terms

  • Apolipoproteins E / genetics
  • Arteriosclerosis / epidemiology
  • Arteriosclerosis / genetics
  • Carcinogens / adverse effects
  • Chronic Disease
  • Contraceptives, Oral / adverse effects
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / genetics
  • Epidemiologic Methods*
  • Estrogen Replacement Therapy / adverse effects
  • Genetic Predisposition to Disease*
  • Genotype
  • Humans
  • Primary Prevention / methods
  • Risk
  • Thromboembolism / epidemiology
  • Thromboembolism / genetics


  • Apolipoproteins E
  • Carcinogens
  • Contraceptives, Oral