Feinstein and study design

Abstract

Dr. Alvan Feinstein saw himself as the father of "clinical epidemiology" in the modern meaning of this term, of this "new intellectual domain of modern medical science." In this role, he saw himself as drawing from his "clinical sophistication" and from "the rigorous scientific demands" to which "clinicians are accustomed," while "public health" epidemiologists "often use a more arbitrary set of standards." His conception of the scope of clinical epidemiology was remarkably Catholic and the same was the case in respect to cause-effect research in it. In the latter, he was firmly committed to the randomized-trial paradigm, including in his teachings on study design in etiologic research. Characteristically original, many of Dr. Feinstein's study-design ideas remain controversial.