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Top Ten Clinical Epidemiology studies

Carl Heneghan
Last edited 3rd April 2011

I’ve created a list of what I think are the top ten the most influential epidemiological studies – I’m looking for feedback to see what folk think.

Therefore, if you believe there should be something different on the list then can you post a comment. Rules are it has to be a clinical study that involves people, which excludes basic sciences. In addition the study has to have subsequently influenced the field significantly.

Doll Richard, Bradford Hilly A (June 26, 1954). "The mortality of doctors in relation to their smoking habits. A preliminary report". British Medical Journal 1 (4877): 1451–55. PMID 13160495

Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients BMJ. 1994 Jan 8;308(6921):81-106. PMID 8298418

Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. N Engl J Med. 1989;321:406-412. PMID 2473403

MRC Streptomycin in Tuberculosis Trials Committee. Streptomycin treatment of pulmonary tuberculosis. BMJ. 1948;ii:769–783. James Lind summary

Thomas Francis, Robert Korn, et al. "An Evaluation of the the 1954 Poliomyelitis Vaccine Trials." American Journal of Public Health 45 (1955), 50 page supplement with a 63 page appendix. The salk vaccine trials

Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study Lancet 1994; 344 1383-1389 PMID 7968073

1998 (now retracted)
The Editors Of The Lancet (February 2010). "Retraction--Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children". Lancet 375 (9713): 445. doi:10.1016/S0140-6736(10)60175-4. PMID 20137807.

Bonadonna G, Brusamolino E, Valagussa P, Veronesi U. Adjuvant study with combination chemotherapy in operable breast cancer. Proc Am Assoc Cancer Res Am Soc Clin Oncol 1975;16:254-and N Engl J Med. 1976 Feb 19;294(8):405-10. PMID 1246307

Thomas R. Dawber, M.D., Gilcin F. Meadors, M.D., M.P.H., and Felix E. Moore, Jr., National Heart Institute, National Institutes of Health, Public Health Service, Federal Security Agensy, Washington, D. C., Epidemiological Approaches to Heart Disease: The Framingham Study Presented at a Joint Session of the Epidemiology, Health Officers, Medical Care, and Statistics Sections of the American Public Health Association, at the Seventy-eighth Annual Meeting in St. Louis, Mo., November 3, 1950.
Framingham Heart Study

On the Mode of Communication of Cholera by John Snow, M.D.
London: John Churchill, New Burlington Street, England, 1855 On the Mode of communication of cholera

Look forward to seeing what you think
you can post it to me on twitter

Cheers Carl

Alternatives for top ten landmark studies

Good list. Here are a few others worth considering. The first group of papers could be considered landmark methodology papers.

  1. A comparison of observational studies and randomized, controlled trials. K. Benson, A. J. Hartz. New England Journal of Medicine 2000: 342(25); 1878-86
  2. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. Ransohoff DF, Feinstein AR. N Engl J Med 1978: 299(17); 926-30
  3. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. Hrobjartsson A, Gotzsche PC. N Engl J Med 2001: 344(21); 1594-602
  4. Issues in Comparisons between Meta-analyses and Large Trials. Ioannidis J, Cappelleri J, Lau J. Jama 2002: 279(14); 1089-93

These articles are landmarks for clinical practice

  1. An evaluation of internal-mammary-artery ligation by a double-blind technic. Cobb LA, Thomas GI, Dillard DH, Merendino KA, Bruce RA. N Engl J Med. 1959 May 28;260(22):1115-8 and/or Comparison of internal mammary artery ligation and sham operation for angina pectoris. Dimond EG, Kittle CF, Crockett JE. Am J Cardiol. 1960 Apr;5:483-6
  2. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. Jacques E. Rossouw, Garnet L. Anderson, Ross L. Prentice, Andrea Z. LaCroix, Charles Kooperberg, Marcia L. Stefanick, Rebecca D. Jackson, Shirley A. A. Beresford, Barbara V. Howard, Karen C. Johnson, Jane Morley Kotchen, Judith Ockene. Jama 2002: 288(3); 321-33
  3. [Prevention of the first occurrence of anencephaly and spina bifida with periconceptional multivitamin supplementation (conclusion)] [Article in Hungarian]. Czeizel E, Dudas I. Orv Hetil. 1994 Oct 16;135(42):2313-7
  4. Thomas Francis, Robert Korn, et al. "An Evaluation of the the 1954 Poliomyelitis Vaccine Trials." American Journal of Public Health 45 (1955), 50 page supplement with a 63 page appendix.

Steve Simon, www.pmean.com

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