ROOTS AND TRIBUTES

ROOTS AND TRIBUTES

According to Spitzer, writing in this issue, Alvan R Feinstein “influenced the very meaning of clinical research. He eschewed the concept of the patient as merely the ultimate beneficiary of clinical research and closed the loop by demonstrating that the best clinical data were provided by the patient”. Full circle, then, from clinical epidemiology to “the doctor, the patient and the illness”.

Diagnostic research needs to find new ways of producing knowledge relevant to diagnostic decision making so that evidence based diagnosis can become more of a reality. Research on diagnosis has yet to achieve the standards of quality of that in therapeutics. Moreover, the results of diagnostic research are rarely well integrated into evidence based recommendations or clinical guidelines.

In this issue, the Journal of Epidemiology and Community Health publishes an exchange of opinions on the future development of diagnostic research. A paper by Dr Feinstein is the starting point for this debate, sadly the father of clinical epidemiology died while this issue was being prepared. We have supplemented Dr …