Sound scientific evidence is a prerequisite for any modern health service to provide safe, high quality patient care

Sound scientific evidence is a prerequisite for any modern health service to provide safe, high quality patient care, while incorporating modern developments in diagnosis, treatment, rehabilitation and prevention. This evidence is best derived from continually updated answers to four key generic clinical questions:

1. What is the expected course of a disease, e.g., spontaneous cure or progression without clinical intervention?
2. Which tests/examinations should be used to diagnose a disease and predict its course, minimizing false positive and false negative results?
3. What is the likelihood that a clinical intervention will be beneficial: curing or preventing a disease, slowing its progression, or reducing its symptom burden?
4. What are the risks -- side effects or complications -- from selected treatments and interventions?

Answering these questions in the current clinical context requires overcoming rapidly evolving challenges.  The population in many countries is aging, resulting in an increasing burden of morbidity and polypharmacy.  A substantial portion of patients does not receive recommended therapies, and preventable iatrogenic harms are common.  Modern research brings the possibility of new treatments that may be effective, but with unknown long-term side effects.  Increasing health care costs are unsustainable.   The quality of clinical care and the efficiency of health care delivery must improve to overcome problems brought on by demographic changes, rapidly evolving and complex technology, and increasingly limited economic resources. 

Information technology is transforming the way medical care is carried out and managed, and improved diagnostics and new treatments also may help address the challenges of contemporary medicine.  However, these advances alone will not solve the problems and, in any case, impose their own challenges.  There is a clear need to integrate research on innovative diagnostics, treatments, and information technology with traditional epidemiological and clinical data, in order to provide the knowledge necessary to ensure better clinical outcomes at an affordable level of health care spending. Clinical Epidemiology would like to invite scientists to submit papers covering these important challenges.

Dr. Henrik Toft Sorensen
Editor-in-Chief, Clinical Epidemiology