A Framework for Thinking About the Potential Public Health Impact of Epidemiologic Research

An impactful epidemiologic question is one that, if answered, could inform meaningful action to reduce the burden of disease in the population it concerns. We propose a set of factors that could be used for discussing, evaluating, and communicating the public health impact of epidemiologic studies. These factors pertain to the burden and distribution of disease, the potential for an intervention to alter the disease burden, and the context in which the study is conducted. The disease burden is characterized by the number of cases, severity or cost of disease, and distribution of disease across the population. The potential for intervention is characterized by the mutability of the exposure itself, the prevalence and distribution of other causes of the disease in the population, the prevalence of the exposure and risk of the outcome under the natural course (before any intervention), and the feasibility of intervening. An epidemiologic question need not be impactful along all these factors to make answering it worthwhile. However, answering epidemiologic questions with more of these factors present will likely have a greater public health impact than answering questions for which these factors are absent. We hope that collecting these factors into a single framework may aid students and senior epidemiologists alike when organizing arguments for the value of their own work or attempting to evaluate the impact of others' work.