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IJE Advance Access originally published online on December 17, 2008
International Journal of Epidemiology 2009 38(2):410-412; doi:10.1093/ije/dyn267
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Commentary: Maziak's essay, seen from another angle

Jan P Vandenbroucke*

Department of Clinical Epidemiology, Leiden University Medical Centre, The Netherlands.

* Corresponding author. E-mail: j.p.vandenbroucke@lumc.nl

Accepted 11 November 2008

The first 150 words of the full text of this article appear below.

The starting point of Maziak's essay is a popular one: the alleged disarray of observational epidemiology in the face of the hormone replacement therapy debacle: the reversal in randomized trials of an apparent protective effect of hormone replacement therapy on coronary heart disease.

Perhaps the story should be put into perspective. There were many diseases for which associations with hormone replacement therapy were studied observationally as well as in randomized trials: breast cancer, colon cancer, pulmonary embolism, fractures, stroke and coronary heart disease. Recently, several reanalyses have been published of observational and randomized trials in conjunction, which might not yet have been available to Maziak at the time of his writing of his essay. A subtle picture emerges. The reasons for slighter or great differences between randomized and observational results might differ according to the topic. For coronary heart disease, randomized and observational evidence can be aligned when adjustments are . . . [Full Text of this Article]


   A priori hypotheses
 

   Small relative risks
 

   Life style epidemiology
 

   Conclusion
 

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