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November 1987

Clinical Neuroepidemiology: II. Outcomes

Author Affiliations

From the Neuroepidemiology Group, Division of Neurology (Dr Longstreth), Department of Medicine, School of Medicine and Departments of Epidemiology and Health Services (Dr Koepsell) and Biostatistics (Dr van Belle), School of Public Health and Community Medicine, University of Washington, Seattle.

Arch Neurol. 1987;44(11):1196-1202. doi:10.1001/archneur.1987.00520230076022

The previous article in this series dealt with diagnosis. Now, we consider outcomes from neurologic conditions, namely the clinical course and how it can be altered with treatment. Weiss1 has proposed that as cause is the subject of classical epidemiology, outcome is the subject of clinical epidemiology. Prognosis consists of the set of outcomes and their associated probabilities following a symptom (such as amaurosis fugax), sign (such as asymptomatic carotid bruit), or disease (such as stroke). Ideally, we want to know the natural history, from the biologic start of the condition to its end. Realistically, what we learn is the clinical course—the events that follow once a diagnosis is made and that may be influenced by our interventions, effective or not. Information on prognosis shapes how we manage patients, how we formulate questions about management, and how we answer these questions.

Primary prevention, a topic of classical epidemiology

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