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April 15, 2002

Medical decision making to be focus of next Great Teachers lecture

By Tia Webster

 

A four-time Teacher of the Year, according to Emory’s medical students, and one of the most popular professors in the Rollins School of Public Health will give the next Great Teachers Lecture on Thursday, April 18, at 7:30 p.m. in the Miller-Ward Alumni House.

John Boring, professor and chair of the Department of Epidemiology, will speak on “Thinking About Thinking: The Predictive Value of Epidemiolog-ical Thinking.”

As a longtime professor in public health (as well as the School of Medicine) and one of the “midwives” of the 12-year-old Rollins school, Boring has taught generations of students the value of the analytic method of thinking adopted by epidemiologists. His Great Teachers Lecture will focus on how that kind of thinking can be applied to problem solving in many fields—and why it is especially valuable when it comes to problem solving in medicine.

He should know. His course in analytic medicine (medical decision making) remains a required course for all medical students at Emory.

Epidemiology is the study of diseases among populations. It examines risk factors that cause diseases and the impact of interventions for prevention and treatment. Boring will talk mostly about a way of looking at information called the “Denominator Science” approach to thinking. This approach also can be called evidence-based medicine: The more people in the denominator, the more reliable the conclusion.

Epidemiologists often can figure out what causes a disease—or how to stop it—simply by looking at the numbers. John Snow, known as the father of epidemiology, studied the geographic distribution of cholera cases in an 1859 London epidemic and concluded the cause was a certain sewage-tainted well. The well was closed and the epidemic ended. Boring will explain how the epidemiologic method continues to unravel some of the trickiest medical puzzles in the history of medicine.

“Medical decision making often is fraught with serious difficulties,” Boring said. “Medical practitioners are problem solvers who must diagnose and treat problems suffered by patients. Very often the evidence needed to solve these problems is uncertain, at best. Analytic methods have an important contribution here. Probabilities for diagnostic tests and therapies may be developed in population studies and become the guidelines for diagnosis and therapy. Thus, predictive value theory and clinical trials are based on ideas of Denominator Science.”

Boring has been an Emory faculty member for 36 years. After working for the Epidemic Intelligence Service and as a senior scientist at the Centers for Disease Control and Prevention, he joined the School of Medicine in 1966.

He was director of epidemiology in the medical school’s Department of Biostatistics and Epidemiology until the Rollins school was established. Epidemiology became part of that school, and Boring continued as director, then chair of the department. His research interests include infectious disease epidemiology. Among his many honors, Boring has received the Thomas Jefferson award, Emory’s highest award for lifetime contributions to the University.