Epidemiology, Public Health, and the Rhetoric of False Positives

BACKGROUND: As an observational science, epidemiology is regarded by some researchers as inherently flawed and open to false results. In a recent paper, Boffetta et al. [Boffetta P, McLaughlin JK, LaVecchia C, Tarone RE, Lipworth L, Blot WJ. False-positive results in cancer epidemiology: a plea for epistemological modesty. J Natl Cancer Inst 100:988-995 (2008)] argued that "epidemiology is particularly prone to the generation of false-positive results." They also said "the tendency to emphasize and over-interpret what appear to be new findings is commonplace, perhaps in part because of a belief that the findings provide information that may ultimately improve public health" and that "this tendency to hype new findings increases the likelihood of downplaying inconsistencies within the data or any lack of concordance with other sources of evidence." The authors supported these serious charges against epidemiology and epidemiologists with few examples. Although we acknowledge that false positives do occur, we view the position of Boffetta and colleagues on false positives as unbalanced and potentially harmful to public health. OBJECTIVE: We aim to provide a more balanced evaluation of epidemiology and its contribution to public health discourse. DISCUSSION: Boffetta and colleagues ignore the fact that false negatives may arise from the very processes that they tout as generating false-positive results. We further disagree with their proposition that false-positive results from a single study will lead to faulty decision making in matters of public health importance. In practice, such public health evaluations are based on all the data available from all relevant disciplines and never to our knowledge on a single study. CONCLUSIONS: The lack of balance by Boffetta and colleagues in their evaluation of the impact of false-positive findings on epidemiology, the charge that "methodological vigilance is often absent" in epidemiologists' interpretation of their own results, and the false characterization of how epidemiologic findings are used in societal decision making all undermine a major source of information regarding disease risks. We reaffirm the importance of epidemiologic evidence as a critical component of the foundation of public health protection

Prato: The Social Construction of an Industrial City Facing Processes of Cultural Hybridization

This chapter deals with a widely studied case, that is, Prato, a middle-sized city with rooted industrial traditions, in the Centre of Italy. Prato is a textile industrial district embedded in the so-called Third Italy—an area characterized by the presence of small firms spread throughout the territory, linked together in supply and subcontracting relationships—which, in the last twenty years, has undergone a profound transformation as a consequence of the crisis of textile and immigration, leading to the formation of a large Chinese community. The related changes brought with them problems of social cohesion and sustainable development. The authors address these issues by analyzing both academic and public discourses on Prato. Their basic idea is that common stereotypes act as drivers of a public discourse that prevents the city to re-negotiate its identity. The analysis concludes that different forms of hybridization—particularly cultural hybridization—are occurring, which would need further investigations