From Epidemiologic Knowledge to Improved Health: A Vision for Translational Epidemiology

Abstract

Epidemiology should aim to improve population health; however, no consensus exists regarding the activities and skills that should be prioritized to achieve this goal. We performed a scoping review of articles addressing the translation of epidemiologic knowledge into improved population health outcomes. We identified 5 themes in the translational epidemiology literature: foundations of epidemiologic thinking, evidence-based public health or medicine, epidemiologic education, implementation science, and community-engaged research (including literature on community-based participatory research). We then identified 5 priority areas for advancing translational epidemiology: 1) scientific engagement with public health; 2) public health communication; 3) epidemiologic education; 4) epidemiology and implementation; and 5) community involvement. Using these priority areas as a starting point, we developed a conceptual framework of translational epidemiology that emphasizes interconnectedness and feedback among epidemiology, foundational science, and public health stakeholders. We also identified 2-5 representative principles in each priority area that could serve as the basis for advancing a vision of translational epidemiology. We believe an emphasis on translational epidemiology can help the broader field to increase the efficiency of translating epidemiologic knowledge into improved health outcomes and to achieve its goal of improving population health.

Keywords: education; evidence-based medicine; translational medical research.

Figure 1.

Document flow for a scoping review of papers on translational epidemiology. An initial core set of 43 documents was expanded through forward and backward citation (i.e., “snowballing”). All cited works were then subjected to title, abstract, and full-text review, after which an additional 12 papers were added to the original core to form the final document set.

Figure 2.

A translational view of epidemiology. A) A conceptually linear view of the role of epidemiology in improving population health outcomes. In this admittedly abstracted view, foundational science, epidemiology, and public health stakeholders are independent disciplines, each seeking to identify outputs of the “upstream” disciplines that can be useful but paying relatively little attention to the utility of its outputs for “downstream” disciplines. For example, diamonds might represent statistical methods or philosophical frameworks that prove useful to epidemiologic investigation, and trapezoids might represent epidemiologic findings that are ultimately never used by public health stakeholders. B) A translational view of epidemiology, in which epidemiologists play a more active role in ensuring that knowledge leads to improved health. The distinguishing characteristics of a translational epidemiology are its increased interconnectedness with foundational science and public health stakeholders, feedback at all steps of the process, and increased efficiency of the system in generating improved health outcomes. This goal is achieved by ensuring that the products of each discipline are more useful to other disciplines and more directly delivered to them. A more detailed description of this conceptual framework is provided in the text.