Series of papers in Social and Preventive Medicine 2001-2003

Social and Preventive Medicine (An International Journal in Public Health) starts the publication of a collection of papers presented at a Workshop on the history of epidemiology entitled "Measuring our scourges", held in Annecy, France, on July 1-10 1996. This workshop focused on the historical emergence of the corpus of epidemiologic methods used today and their relative importance at different points in time. Three papers (on the history of cohort analysis, case-control studies and cancer registries) were written after the conference but will also be part of this series.

There is currently a need for a text on the history of epidemiology written by both professional historians and epidemiologists. In the absence of such text, this collection of papers can provide useful material for courses dedicated to history in the teaching curriculum of epidemiology scholars.

The aim of the Annecy workshop was to focus on the history of epidemiological methods rather than on specific achievements of epidemiology for the following reason. Students of epidemiology learn successfully how to describe states of health on populations, how to investigate outbreaks and then will learn, with increasing degrees of complexity, to understand and to apply the design of prospective and retrospective studies, and the concepts of bias, confounding, interaction. They are also brought to think in terms of causation, with different levels of sophistication. Thus, epidemiology can be viewed as a set of methods and concepts that one needs to master to become an epidemiologists. Mastering these methods becomes the reasons why someone is considered (and given a position) as an epidemiologist rather than any other kind of scientist.

A historical question is then to determine when were current epidemiologic methods developed ? Methods, just as diseases or scientists, have their own history. It is important to scientists to be aware of the genesis of the methods they use, of the context in which they were developed. This is of cultural interest but can also stimulate a critical appraisal of the methodological tools at hand. The net result should be better science as suggested by Major Greenwood (1880-1947) in the citation at the beginning of this introduction.

Some aspects of the history of epidemiology will not be dealt with specifically in this collection of papers: the history of epidemics, the history of epidemiologists and the evolution of conceptual and philosophical frames. The achievements of epidemiology in the control of plagues such as cholera, tuberculosis, malaria, typhoid fever or lung cancer are fascinating issues. Studying the lives and contributions of specific epidemiologists such as John Snow (1813-1858), William Farr (1807-1883) or Wade Hampton Frost (1880-1938), are fully part of the history of epidemiology. The on-going debate on the "future of epidemiology" and the vigorous reflection on ethics in epidemiology are timely and must be grounded on a historical appraisal of lessons of epidemiology's past. Aspects of these three facets of our history as epidemiologists are exposed in the contributions but are not the main focus of this interrogation on the genesis of epidemiologic methods.

History of cohort analysis and study design

The first set of three papers are about the history of cohort analysis and studies. Comstock (b. 1915) (1) deals with the adaptation by Frost of the life table methods and the refinement of what we currently call "cohort analysis", that is, "the morbidity or mortality rates experienced by a group of persons born in a specified time period, the 'cohort'." In the two subsequent papers, Doll (b. 1912) describes the development of prospective (2) and retrospective (3) cohort studies. The titles of Doll's papers require their own historical explanation. The name " prospective study " was coined by Richard Doll and Austin Bradford Hill (1897-1991) in their 1954 paper on "the mortality of doctors in relation to their smoking habits (4) in which they wrote : "In the last five years a number of studies have been made of the smoking habits of patients with and without lung cancer (...) Further retrospective studies of the same kind would seem to us unlikely to advance our knowledge materially or to throw any new light upon the nature of the association. If, too, there were any undetected flaw in the evidence that such studies have produced, it would be exposed only by some entirely new approach. That approach we considered should be "prospective"". Reference was made after the word "prospective" to a footnote which read:"O.E.D. Characterized by looking forward into the future. (Leigh Hunt: "He was a retrospective rather than a prospective man"). The name " cohort study " instead of "prospective" study was later successfully proposed by Brian MacMahon (b.1923) in 1960.

Alfredo Morabia


(1) Comstock GW. History of epidemiologic methods: Cohort analysis. Soz Praventiv Med 2001;46 (1):7-12.

(2) Doll R. History of epidemiologic methods: Cohort studies. 1. Prospective cohort studies. Soz Praventiv Med 2001;46(2):75-86.

(3) Doll R. History of epidemiologic methods: Cohort studies. 2. Retrospective cohort studies. Soz Praventiv Med 2001;46(3):152-160.

(4) Doll R, Hill AB. The mortality of doctors in relation to their smoking habits: a preliminary report. Br Med J. 1954;1:1451-55.


Comstock GW. Cohort analysis: W.H. Frost's contributions to the epidemiology of tuberculosis and chronic disease. Soz Praventiv Med 2001;46(1):7-12.

Doll R. Cohort studies: history of the method - I. prospective cohort studies. Soz Praventiv Med 2001;46(2):75-86. See Letter to the editor by Gerstman B.

Doll R. Cohort studies: history of the method - II. retrospective cohort studies. Soz Praventiv Med 2001;46(3):152-160.

Eyler JM. The changing assessment of John Snow's and William Farr's cholera studies. Soz Praventiv Med 2001;46(4):225-232.

Vandenbroucke JP. Changing images of John Snow in the history of epidemiology. Soz Praventiv Med 2001;46(5):288-293.

Hardy A. Methods of outbreak investigation in the "Era of Bacteriology" 1880-1920. Soz Praventiv Med 2001;46(6):355-360.

Eyler JM. Constructing vital statistics: Thomas Rowe Edmonds and William Farr, 1835 - 1845. Soz Praventiv Med 2002;47(1):6-13.

Hardy A., Magnello ME. Statistical methods in epidemiology: Karl Pearson, Ronald Ross, Major Greenwood and Austin Bradford Hill, 1900-1945. Soz Praventiv Med 2002;47(2):80-89.

Gerstman B. Letter to the editor. Soz Praventiv Med 2002;47(2):90.

Vineis P. History of bias. Soz Praventiv Med 2002;47(3):156-161.

Vandenbroucke JP. The history of confounding. Soz Praventiv Med 2002;47(4):216-224.

Paneth N., Susser E., Susser M. Origins and early development of the case-control study: part 1, Early evolution. Soz Praventiv Med 2002;47(5):282-288.

Paneth N., Susser E., Susser M. Origins and early development of the case-control study: part 2, The case-control study from Lane-Claypon to 1950. Soz Praventiv Med 2002;47(6):359-365.

Terracini B., Zanetti R. A short history of pathology registries, with emphasis on cancer registries. Soz Praventiv Med 2003;48(1):3-10.

Vineis P. Causality in epidemiology. Soz Praventiv Med 2003;48(2):80-87.

Stellman SD. Issues of causality in the history of occupational epidemiology. Soz Praventiv Med 2003;48(3):151-160.

Farr W. "On Prognosis" by William Farr (British Medical Almanack 1838; Supplement 199-216) Part 1 (pages 199-208). Soz Praventiv Med 2003;48(4):219-224.

Hill GB. Comments on the paper "On prognosis" by William Farr: a forgotten masterpiece. Soz Praventiv Med 2003;48(4):225-226.

Farr W. "On Prognosis" by William Farr (British Medical Almanack 1838; Supplement 199-216) Part 2 (pages 208-216). Soz Praventiv Med 2003;48(5):279-284.

Gerstman BB. Comments regarding "On prognosis" by William Farr (1838), with reconstruction of his longitudinal analysis of smallpox recovery and death rates. Soz Praventiv Med 2003;48(5):285-289.

Eyler JM. Understanding William Farr's 1838 article "On prognosis": comment. Soz Praventiv Med 2003;48(5):290-292.

Zhang FF, Michaels CD, Mathema B, Kauchali S, Chatterjee A, Ferris DC, James TM, Knight J, Dounel M, Tawfik HO, Frohlich JA, Kuang L, Hoskin EK, Veldman FJ, Baldi G, Mlisana KP, Mametja LD, Diaz A, Khan NL, Sternfels P, Sevigny JJ, Shamam A, Morabia A. Evolution of Some Epidemiologic Methods and Concepts in Selected Textbooks of the 20th Century. Soz Praventiv Med 2004; 49(2):97-104.

Rothman KJ. Commentary I: Interaction and evolution of epidemiology. Soz Praventiv Med 2004; 49(2):105-6

Susser MW . Commentary II: Evolution of Some Epidemiologic Methods and Concepts in Selected Textbooks of the 20th Century. Soz Praventiv Med 2004; 49(2):107.

Miettinen, OS . Commentary III: Lack of evolution of epidemiologic "methods and concepts". Soz Praventiv Med 2004; 49(2):108-9


Morabia A. History of epidemiologic methods. Soz Praventiv Med 2001;46(1):3-4.

Morabia A. Snow and Farr: a scientific duet. Soz Praventiv Med 2001;46(4):223-224.

Morabia A. A new look at the relation of epidemiology and bacteriology at the turn of the 20th century. Soz Praventiv Med 2001;46(6):352-353.

Morabia A, Abel T. The making of an epidemiological theory of bias and confounding. Soz Praventiv Med 2002;47(3):146.

Vandenbroucke JP. Continuing controversies over "risk and rates" - more than a century after William Farr's "On Prognosis". Soz Praventiv Med 2003;48(4):216-218.