The future of epidemiology: methods or matter?

In our first editorial after taking over responsibility for the content of the IJE in 2001, we illustrated some of the successes and failures of epidemiology, and asked the question whether epidemiology would progress or decay in the 21st century? Embracing new opportunities for aetiological understanding provided by the human genome project was one strand of our strategy for making the IJE relevant – but viewed through the Geoffrey Rose lens that determinants of disease rates in a population and influences on individual susceptibility need not be the same. We were concerned that the ‘big picture’ – health and disease are as much social as biological phenomena – should remain in view. Indeed, the role for genetic discovery seemed to be much more attuned to the discovery of mechanisms of disease and resulting pharmacological advances. We questioned methodological developments in modern epidemiology which seemed to lack appetite for engaging with the wider uses of epidemiology proposed by Jerry Morris in the 1940s and 50s. A formal evaluation of the impact, positive and negative, of the increased methodological refinement of epidemiology, requested in our 2001 editorial, has yet to be submitted to IJE. However, in this the final issue of the journal under our editorship, there are major contributions on causal thinking in epidemiology which illuminate what modern epidemiology can and cannot do. In 2001, what did we want to do? Up to that point, papers published in the IJE had very largely consisted of original manuscripts reporting new data. We noted that the most important paper that the journal had published in its lifetime was one of the few that were not of this type: an invited talk at an International Epidemiology Association meeting (with few references), beautifully and economically summarizing Geoffrey Rose’s big idea alluded to above, with the catchy title ‘Sick individuals and sick populations’. Widespread understanding and application of previous epidemiological research was generally lacking, so in our first issue we published a reprint of a 1943 German case-control study on smoking and lung cancer. With its accompanying commentaries, this was the first of the ‘Reprints and Reflections’ which were to become an important IJE staple over the next 16 years. Later in 2001 it was the turn of the Rose paper from only 16 years previously (and with rather pleasing symmetry we are now the same distance in time from its reprint). Reflecting on the prescience and influence of early contributions to the analysis of genetic influences on human phenotypes by Richard Lewontin or to metabolomic phenotyping by John Moreton, as well as showing how bright minds came to wrong conclusions about the causes of cholera, peptic ulcer and AIDS, can inform future research and act as an immunization against repeating errors. But our innovations were not just about history. From the start we expanded to include editorials, commentaries, point-counterpoint debates, themed issues, theory and methods, and diversions. Over the next 15 years, many other types of article were added: Cohort Profiles, Health and Demographic Surveillance Systems (HDSS) Profiles, Data Resource Profiles, Software Application Profiles, Education Corner, Cochrane Corner, Photoessays, Book Reviews, Special Issues and Supplements, together with blogs, press releases and twitter; all brought into being through the enthusiasm, critical eyes and hard work of what grew from 15 associate editors in 2001 to become a group of 45 editors and three editorial staff in 2016. The question we posed in 2001 was whether a bright young scientist who wanted to make a contribution to