THE ROLE OF CONCEPTUAL FRAMEWORKS IN EPIDEMIOLOGIC ANALYSIS - A HIERARCHICAL APPROACH

Background. This paper discusses appropriate strategies for multivaria te data analysis in epidemiological studies. Methods. In studies where determinants of disease are sought, it is suggested that the complex hierarchical inter-relationships between these determinants are best m anaged through the use of conceptual frameworks. Failure to take these aspects into consideration is common in the epidemiological literatur e and leads to underestimation of the effects of distal determinants. Results. An example of this analytical approach, which is not based pu rely on statistical associations, is given for assessing determinants of mortality due to diarrhoea in children. Conclusions. Conceptual fra meworks provide guidance for the use of multivariate techniques and ai d the interpretation of their results in the light of social and biolo gical knowledge.