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Biomedical subjects

C B Eaton

Publications and source records attributed to C B Eaton.

4 recordsLinked to original sources

Teaching epidemiology and biostatistics through interactive problem solving.

Medical education should prepare students for the reasoning and decision making that are required in a physician's clinical work. The disciplines of epidemiology and biostatistics, as combined in clinical epidemiology, lend themselves very well to this purpose. A lecture course in epidemiology and biostatistics was redesigned to emphasize interactive learning through problem-solving workshops in which students worked with actual data from two epidemiologic studies. A third workshop provided experience in the critical appraisal of an epidemiologic study from the current literature. Students respond favorably to these active learning experiences, which deal with relevant contemporary health problems. The concepts of clinical epidemiology should be integrated into clinical teaching in all stages of training.

Biometry

Risk factors for cardiovascular disease in U.S. medical students: the Preventive Cardiology Academic Award Collaborative Data Project.

Risk factors for cardiovascular disease are commonly obtained in freshman medical students for the purpose of increasing interest and awareness in preventive cardiology. What would be a normal range of values for this select group? This paper describes the major cardiovascular risk factors for 3,811 male and female freshman medical students from eight U.S. medical schools that were obtained in a standardized fashion as part of the Preventive Cardiology Academic Award (PCAA) programs at these institutions. The distributions of height, weight, Quetelet index, systolic and diastolic blood pressures, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and calculated low-density lipoprotein cholesterol are presented for male and female medical students stratified by race into white, black, Asian, and Hispanic groups. The sex and race distributions of cardiovascular risk factors such as previously diagnosed hypertension, diabetes mellitus, smoking, lack of regular exercise (three times a week or more), oral contraceptive use in women, and family history of coronary heart disease are presented. The cardiovascular risk of freshman medical students is compared to other epidemiologic studies of young adults. The use and limitations of these race- and sex-specific data on cardiovascular risk, including physiologic measurements, are discussed in the context of educational programs for medical students and house staff in preventive cardiology.

Adult

Relation of physical activity and cardiovascular fitness to coronary heart disease, Part I: A meta-analysis of the independent relation of physical activity and coronary heart disease.

BACKGROUND: This paper is the first of two reports that together review the scientific evidence regarding the inverse relation between physical activity and cardiovascular fitness and coronary heart disease (CHD). METHODS: In Part I, the evidence suggesting a causal link between physical activity and CHD protection independent of other CHD risk factors is reviewed, accounting for bias, confounding, and different study designs. RESULTS: A strong, consistent inverse relation is found. Using meta-analytic techniques, the relative risk of the independent relation of physical inactivity to CHD is 1.37, with a 95 percent confidence interval (1.27-1.48). CONCLUSIONS: A graded biologic response of CHD protection to physical activity is shown, but the intensity, duration, and frequency of activity necessary for CHD benefit remain unclear. Plausible biologic mechanisms for the inverse relation of physical activity to CHD are the risk factor modifications that accrue with physical activity.

Causality

Relation of physical activity and cardiovascular fitness to coronary heart disease, Part II: Cardiovascular fitness and the safety and efficacy of physical activity prescription.

BACKGROUND: This paper is the second of two reports that together review the scientific evidence regarding the inverse relation between physical activity and cardiovascular fitness and coronary heart disease (CHD). METHODS: Using a MEDLINE search with the key words exercise, physical fitness, coronary heart disease, and cardiovascular disease, more than 75 articles were reviewed, evaluating study design, measurement error, bias and confounding, the strength of associations, consistency of results, temporal and dose-response relation, and biologic plausibility. RESULTS: The relative risk in epidemiologic studies comparing the least to the most fit categories ranges from 1.2 to 4.8, which is greater than that for physical inactivity. The differences between cardiovascular fitness (an attribute) and physical activity (a behavior) are highlighted. The range of correlation (r = 0.02 to 0.44) between cardiovascular fitness and physical activity is discussed relative to measurement error and genetic and environmental factors. Studies reporting the safety of regular physical activity suggest an injury rate as high as 35 injuries per 100 persons per year. Efficacy studies limited to secondary prevention trials report a 66 percent compliance rate and 15 percent reduction in total mortality. CONCLUSIONS: The scientific evidence implying a causal relation between cardiovascular fitness and CHD is strongly positive, but the clinical and public health implications are unclear. Further research and clinical guidelines are suggested.

Cardiovascular Diseases