General and clinical epidemiology at square two: A new educational series for the renal physician

Abstract

Epidemiology is the Cinderella of renal research. Many renal physicians still consider it as the science of renal registries. Even enlarging the horizon to the whole spectrum of epidemiologic subspecialties including general and clinical epidemiology of renal diseases, this area of knowledge is perceived as less intriguing than other renal subspecialties within the nephrology community. An epidemiology guru attributes the unattractiveness of this science to the fact that ‘yfor some, epidemiology is too simple to warrant serious attention and for others it is too convoluted to understandy’. Yet, during the last 30 years, epidemiology has had a tremendous growth and the discipline of clinical epidemiology is now the established basic science to clinical medicine. Well-written general and clinical epidemiology books and journal series now abound. However, a problem for the neophyte is that the majority of these provide just basic information; that is, they allow the reader to grasp fundamental concepts but do not help him/her to gain knowledge on important epidemiology themes of greater complexity. Covering the gap between introductory and intermediate level knowledge is important, because this is definitely the critical step that makes the occasional visitor of the subject maturing into an interested reader of epidemiologic studies, thus paving the way for her or him to acquire direct experience with epidemiologic research. The idea of this Epidemiology Series originated within the ERA-EDTA Registry as a part of a larger initiative aimed at increasing interest on epidemiology among nephrologists. The cornerstone of this initiative is an itinerant course in European countries, which is done at an introductoryintermediate level. Over 150 young colleagues completed the course successfully and some of them still maintain contacts with the faculty. Lectures of this course now become a series of 14 articles written in a simple style, avoiding excessive technicalities as well as excessive simplifications. Examples taken from current nephrology literature will be a starting point for addressing epidemiology theory. Epidemiology notions will be presented in a conceptual manner with minimal use of formulas and numbers (Figure 1). Whenever pertinent, we will discuss common errors and give advice on how to avoid these mistakes. For each theme/article, a set of slides will be deposited in the web site of the journal and made freely available to all interested readers for private study. We will cover a variety of important issues including measures of disease occurrence, measures of effect, study design, bias and confounding, survival analysis methods, analysis of interaction, ways to explore causality, and other themes. The new Kidney International poses much attention on education and continuous professional development. I am confident that this series will serve the mission of the journal and meet the expectations of its wide readership.