{"id":8234,"date":"2019-01-08T04:52:37","date_gmt":"2019-01-08T03:52:37","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=8234"},"modified":"2019-01-08T04:52:37","modified_gmt":"2019-01-08T03:52:37","slug":"no-my-first-name-aint-biostatistician-its-epidemiologist-dr-kerr-if-youre-nasty","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2019\/01\/08\/no-my-first-name-aint-biostatistician-its-epidemiologist-dr-kerr-if-youre-nasty\/","title":{"rendered":"\u201cNo, my first name ain\u2019t \u2018Biostatistician\u2019. It\u2019s \u2018Epidemiologist\u2019 (Dr. Kerr, if you\u2019re nasty)\u201d"},"content":{"rendered":"<h6><em>This was first published as a <a href=\"https:\/\/bjsm.bmj.com\/content\/52\/22\/1457.responses#\u201cno-my-first-name-ain\u2019t-\u2018biostatistician\u2019-it\u2019s-\u2018epidemiologist\u2019-dr-kerr-if-you\u2019re-nasty\u201d\">BJSM special feature on 6 November 2018<\/a>.\u00a0<\/em><\/h6>\n<p>&nbsp;<\/p>\n<p><em><strong>By Zachary Y\u00a0Kerr,\u00a0Sports Injury Epidemiologist,\u00a0University of North Carolina, Department of Exercise and Sport Science<\/strong><\/em><\/p>\n<p>It is with great pleasure that I read the commentary by Casals and Finch on the role of the Sports Biostatistician in injury prevention (1). Thank you to the authors for considering this important area of focus. With that said, I hope my additional comments, despite being a relatively new Sports Injury Epidemiologist in the field (receiving my PhD in 2014), can continue the discussion and dialogue that the authors have generated since this publication.<\/p>\n<p>First, as noted above, I prefer to describe myself as a \u201cSports Injury Epidemiologist\u201d and not the term Casals and Finch use (\u201cSports Biostatistician\u201d). Casals and Finch are forthright in denoting that their term is not well known and includes \u201cthe combination of statistics and epidemiology and public health or medicine and sports science (1, p.1457). Still, I am hesitant to use this term myself as my training was in epidemiology and not in biostatistics (although the expectation is that I have a good working knowledge of the latter as much as the former). I would not feel comfortable using a term that describes a role for which I was not trained. And although I cannot express the opinion of my former advisor and mentor, Dr. Steve Marshall, I would believe that he would agree, particularly as his faculty webpage describes himself as an epidemiologist and not a biostatistician (2).<\/p>\n<p>The term \u201cepidemiology\u201d originates from 3 Latin roots &#8211; (1) epi (Latin for \u2018\u2018on,\u2019\u2019 \u2018\u2018upon,\u2019\u2019 and \u2018\u2018against\u2019\u2019), (2) demos (\u2018\u2018people\u2019\u2019), and (3) logos (\u2018\u2018study of\u2019\u2019) &#8211; and roughly translates to \u2018\u2018the study of that which is against people.\u2019\u2019 Today\u2019s modern definition of epidemiology is the \u201cstudy of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems\u201d (3, p.61). This modern definition captures the extent of thought that epidemiologists must consider alongside their multidisciplinary research team. My role involves the careful deliberation of study design with as many decisions made a priori; it considers the control of confounding via methodological control as much as statistical control; it pushes for both internal and external validity, while minimizing the risk of committing a Type I or Type II error; and most importantly, it weighs what is good science and what is doable science, all the while staying committed to working with the assumption of the null hypothesis being true.<\/p>\n<p>Furthermore, I worry that incorrectly identifying myself as a \u201cbiostatistician\u201d will continue to undermine the true value of a biostatistician. In an ideal setting, all research teams would be inclusive of both epidemiologists, who would help lead study design, and biostatisticians, who would help lead data analysis development and implementation. These roles would complement one another to ensure both study design and data analysis are well-planned and considered concurrently throughout the entire research process. However, too often, a biostatistician\u2019s role is mischaracterized and seen as someone who simply comes in after data collection occurs and is expected to analyze the data; in the worst cases, it is someone who is expected to \u201cmake lemonade out of a lemon\u201d. I am constantly worried my role will be seen as such as well. Neither a biostatistician nor an epidemiologist should be relegated to such a role. I wholeheartedly appreciate Casals and Finch emphasizing that our work \u201cshould start at the beginning of the study design process, well before data have been collected\u201d (1, p.1458).<\/p>\n<p>When I was pursuing my master\u2019s degree in epidemiology at The Ohio State University, a professor I much admired jokingly stated that at parties, he seldom introduced himself as an epidemiologist (but rather a biostatistician) in order to not scare and confuse people at social functions. Throughout my doctoral work, I personally found that the use of either term at parties set me up for an evening on the couch with only the host\u2019s dog to keep me company. However, as I\u2019ve maneuvered through this world of sports injury prevention, I find myself more willing to take this chance of social exile and to proudly proclaim myself as a sports injury epidemiologist. I have also found that I have had to vocally emphasize the value of both sports injury epidemiologists and biostatisticians. Our constant nagging about good study design and study limitations, sometimes much to the chagrin of our colleagues, is not meant to annoy. Rather, it is meant to allow our colleagues as well as our readers the ability to carefully consider the validity and generalizability of research. We are a valuable component of any research team. And to jokingly paraphrase Dr. Evil from the Austin Powers film series, \u201cI didn&#8217;t spend six years in evil [public health] school to be called \u2018mister,\u2019 thank you very much.\u201d<\/p>\n<p>Perhaps, my argument is more about semantics than anything else. However, I believe pooling both parties into one term undermines the true value that each of us brings to the table. Still, I appreciate that Casals and Finch have boldly taken the first step to address this issue. I hope my commentary addresses my concerns, but also encourages continued dialogue regarding the necessity for multi-disciplinary teams inclusive of sports medicine professionals, methodologists, and analysts.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-8229\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/12\/iStock-903141924.jpg\" alt=\"\" width=\"499\" height=\"332\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/12\/iStock-903141924.jpg 724w, https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/12\/iStock-903141924-300x200.jpg 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/12\/iStock-903141924-640x426.jpg 640w\" sizes=\"auto, (max-width: 499px) 100vw, 499px\" \/><\/p>\n<p>***<\/p>\n<p><em><strong>Conflicts of Interest<\/strong><\/em><\/p>\n<p>None declared<\/p>\n<p><em><strong>References<\/strong><\/em><br \/>\n1. Casals M, Finch CF. Sports Biostatistician: a critical member of all sports science and medicine teams for injury prevention. Br J Sports Med 2018;52:1457-1461.<br \/>\n2. University of North Carolina Injury Prevention Research Center. Leadership and faculty.\u00a0<a href=\"https:\/\/iprc.unc.edu\/about-us\/our-people\/leadership-faculty\/\">https:\/\/iprc.unc.edu\/about-us\/our-people\/leadership-faculty\/<\/a>. Accessed November 6, 2018.<br \/>\n3. Last JM. Dictionary of Epidemiology. 4th ed. New York, NY: Oxford University Press; 2001.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This was first published as a BJSM special feature on 6 November 2018.\u00a0 &nbsp; By Zachary Y\u00a0Kerr,\u00a0Sports Injury Epidemiologist,\u00a0University of North Carolina, Department of Exercise and Sport Science It is with great pleasure that I read the commentary by Casals and Finch on the role of the Sports Biostatistician in injury prevention (1). Thank you [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2019\/01\/08\/no-my-first-name-aint-biostatistician-its-epidemiologist-dr-kerr-if-youre-nasty\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":8229,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068,16069],"class_list":["post-8234","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-featured","tag-featured-list"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>\u201cNo, my first name ain\u2019t \u2018Biostatistician\u2019. It\u2019s \u2018Epidemiologist\u2019 (Dr. Kerr, if you\u2019re nasty)\u201d - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2019\/01\/08\/no-my-first-name-aint-biostatistician-its-epidemiologist-dr-kerr-if-youre-nasty\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u201cNo, my first name ain\u2019t \u2018Biostatistician\u2019. It\u2019s \u2018Epidemiologist\u2019 (Dr. Kerr, if you\u2019re nasty)\u201d - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"This was first published as a BJSM special feature on 6 November 2018.\u00a0 &nbsp; By Zachary Y\u00a0Kerr,\u00a0Sports Injury Epidemiologist,\u00a0University of North Carolina, Department of Exercise and Sport Science It is with great pleasure that I read the commentary by Casals and Finch on the role of the Sports Biostatistician in injury prevention (1). 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