Current Concepts Review - Principles of Epidemiology for the Orthopaedic Surgeon*

It has been stated that “`the object of any science is the accumulation of systematized verifiable knowledge,' and that this is to be achieved through `observation, experiment and thought.'”12 Orthopaedists are concerned primarily with individual patients; epidemiologists study the occurrence of disease or other health-related conditions or events in defined populations26. Epidemiological research is based on the systematic collection of observations related to the phenomenon of interest in a defined population. These data then are subjected to quantification, which includes the measurement of random variables, the estimation of population parameters, and the statistical testing of hypotheses22.

The changing profile of health-care-delivery systems requires orthopaedists to go beyond the individual and to consider their practices in terms of their effects on the lives entrusted to them. Epidemiology is the biomedical discipline focused on the distribution and determinants of disease in groups of individuals who happen to have some characteristics, exposures, or diseases in common. Viewed as the study of the distribution and societal determinants of the health status of populations, epidemiology is the basic-science foundation of public health38. The American Academy of Orthopaedic Surgeons has launched a national public-education effort, the Play It Safe program, for the prevention of injuries in children. This program calls attention to the problem and offers safety guidelines for the maintenance and layout of playgrounds. It is one of several new campaigns sponsored by The American Academy of Orthopaedic Surgeons in which orthopaedists clearly assume an expanded role compared with their role in the past. Other programs of The American Academy of Orthopaedic Surgeons address areas such as safety in sports and the prevention of domestic violence. These programs demonstrate that The American Academy of Orthopaedic Surgeons recognizes the increasing responsibility of its members in the field of population …

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