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International Journal of Epidemiology 2001;30:1243-1244
© International Epidemiological Association 2001

Reformulations

Commentary: When brilliant insights lead astray

Irva Hertz-Picciotto

CB #7435, Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599–7435, USA. E-mail: ihp@unc.edu

Wilcox and colleagues have published numerous papers dissecting the relation of birthweight to neonatal mortality from an entirely new angle.1–6 When I first read these papers in the early 1980s, I found them inspiring. First, they demonstrated that the birthweight distribution consists of a main portion, which has a Gaussian distribution, and an extra residual tail on the left.

Second, they showed how a simple transformation of birthweights to within-population z-scores solved the so-called paradox, whereby certain groups known to have higher neonatal mortality (e.g. Blacks in the US or immigrants in the UK7) were found to have, contrary to expectation, better outcomes at low birthweight than Caucasians/Europeans . . . [Full Text of this Article]

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