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Jane E Ferrie, Data resources from Case No. 28 to datasets of millions, International Journal of Epidemiology, Volume 41, Issue 6, December 2012, Pages 1495–1500, https://doi.org/10.1093/ije/dys224
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Extract
Our Reprints and Reflections section in this issue of the IJE presents a paper by Sir James Mackenzie, first published in the BMJ in 1921. In it Mackenzie expounds the benefits for medical progress of meticulous observation and record keeping by the general practitioner. This treatise on the importance of tracking early signs and symptoms initially in the relatively healthy and studying their development over time is acknowledged to have laid the foundations of academic research in general practice. It also clearly establishes the primacy of general practice in establishing disease aetiology and prevalence, particularly in populations with high levels of co-morbidity.1 Our commentators on Mackenzie’s paper all highlight the folly of his diatribes against specialists, technology and laboratory based methods, whose judicious espousal might have aided his cause.2-4 However, in different ways they also emphasize the importance of his work and its influence and relevance today.
Based in the Mackenzie Building at the University of Dundee, Blair Smith and colleagues remind us that Mackenzie’s belief that disease prevention is the most important focus of research was key to the establishment of this principle at the heart of public health and epidemiology.2 Richard Baker points out that much remains to be gained from the application of Mackenzie’s methods to the early diagnosis of cancer, in which progress has been poor, and to the management of co-morbidity as the proportion of elderly in the population increases.3 Baker also pays tribute to Julian Tudor Hart, our third commentator, whose work in primary care in a deprived community led to the formulation of his famous ‘inverse care law’ (Box 1). Hart returns to this theme in his commentary, using Mackenzie’s achievements eloquently to back up his call to resist and roll back the marketization of healthcare so that a rational integration of primary and secondary care can be re-achieved.4
