Table 1.

Broad recommendations and proposed actions to transform epidemiology for 21st century medicine and public health

RecommendationProposed actions
  • Extend the reach of epidemiology

  • Balance the epidemiology research portfolio beyond traditional emphasis on discovery and etiologic research to encompass development and evaluation of clinical and population interventions, implementation, dissemination, and outcomes research

  • Create incentives to balance discovery and translational research

  • Foster integration of observational epidemiologic studies with intervention trials

  • Encourage academic and research institutions to promote career advancement that rewards collaborative, interdisciplinary, and translational research

  • Transform the practice of epidemiology

  • Move toward greater access to data, metadata, and specimens to foster collaboration, to ensure reproducibility, replication, and to accelerate translation into population health impact

  • Support the harmonization of existing epidemiologic data (including cohorts and consortia) and the creation of study repositories

  • Support processes for registration of new studies, data access and sharing, and collaborative analyses

  • Work with scientific journals and academic institutions to create more incentives for data sharing, reproducibility, and replication

  • Expand cohort studies across the lifespan including multiple health outcomes

  • Maximize the output and productivity from existing cohorts and assess the need for new cohorts of etiology and outcomes including multiple health-related outcomes and intermediate biomarkers

  • Map and register existing cohort studies worldwide

  • Expand current studies to include multiple outcomes and to incorporate early life events and pre and postdiagnostic information

  • Engage with stakeholders and field leaders to discuss the concept of a national (centralized or synthetic) cohort for multiple health-related outcomes

  • Develop, evaluate, and use novel technologies appropriately

  • Develop and validate reliable methods and technologies to quantify exposures and outcomes in massive scale and to assess concomitantly multiple factors in complex diseases

  • Support pilot studies that leverage existing resources to validate new and emerging technologies for epidemiologic studies

  • Support methodologic work for measuring and modeling concomitantly multiple risk factors and outcomes

  • Integrate “big data” science into the practice of epidemiology

  • Develop systematic approaches to manage, analyze, display and interpret large complex datasets

  • Support the development and maintenance of scalable and sustainable bioinformatics and data storing infrastructures that can handle large, complex, and diverse data sets

  • Promote cross-study best practices for managing complex datasets and develop novel analytic strategies

  • Expand knowledge integration to drive research, policy, and practice

  • Support knowledge integration and meta research (systematic reviews, modeling, decision analysis, etc.) to identify gaps, inform funding, and to integrate epidemiologic knowledge into decision making

  • Develop and apply new methods for knowledge integration across basic, clinical, and population sciences

  • Make knowledge integration activities integral to decision making by various sectors of society (e.g., medicine, public health, law, urban development etc.)

  • Develop metrics of evaluation of success and impact of epidemiologic research

  • Transform training of 21st century epidemiologists

  • Train 21st century epidemiologists with an increasing emphasis on collaboration, multilevel analyses, knowledge integration and translation

  • Modify training curricula to adapt a interdisciplinary approach to education by equipping future epidemiologists with practical skills to meet the needs of modern epidemiologic research (collaboration, translation, and multilevel)

  • Foster collaborations and shared knowledge between Schools of Public Health and Schools of Medicine

  • Train more epidemiologists in implementation and dissemination research

  • Optimize the use of resources for epidemiologic studies

  • Develop and design rational cost-effective epidemiologic studies and resources to optimize funding, accelerate translation, and maximize health impact

  • Encourage the leveraging of existing resources instead of the creation of new ones

  • Integrate information from different settings (e.g., RCTs, HMOs, and cancer registries) to spur new research and validate findings

  • Develop initiation and sunsetting criteria for research studies to maximize return on investment

  • Establish novel funding mechanisms that encourage multidisciplinary collaboration and translational research

  • Leverage disease-specific funding resources across funding agencies to build basic cross-cutting epidemiologic capacity

Abbreviations: RCTs, randomized controlled trials; HMO, health maintenance organizations.