On being first in epidemiology

Abstract

In the past few years it has become the fashion for journal articles to proclaim their finding, however modest, to be first of its kind. Since few if any epidemiological studies are ever replicated down to the last detail, this form of self-advertisement is often less impressive than it appears. What, then, is the importance of establishing primacy for a particular epidemiological result such as the association between cigarette smoking and lung cancer? Should we even care who did it first? Of course we should, for several reasons. As with all scientific disciplines, epidemiology has a history rich with useful and important lessons, but only a complete and accurate history can provide a satisfactory foundation on which to build a sound practice of public health. Careful study of our discipline's history provides a perspective that is otherwise easily overlooked or lost in the day-to-day pursuit of immediate research goals. Furthermore, we learn from mistakes as well as achievements, and there are plenty of both available for study. At first glance, the relationship between cigarette smoking and lung cancer would seem an unlikely candidate for historical challenge. It is so well established that one or another aspect is routinely used as textbook and teaching material (Gordis, 2009). Furthermore, the founders of the field – e.g., Ernst Wynder, Sir Richard Doll, Austin Bradford Hill, and Cuyler Hammond – are so well known and their papers and books so widely reproduced and studied that controversy regarding the early days scarcely seems possible. In this issue of Preventive Medicine Alfredo Morabia (Morabia, 2012) dissects a paper (Muller, 1939) that has been described by later historians and researchers as pathbreaking or seminal