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There was no shortage of epidemiology books when I started writing this book in the summer of 1996, and the intervening years have brought many new and very useful ones. Just as it is uninspiring to do a study that ends up as one more dot on a graph or one more line in a table, it was certainly not my goal to merely add one more book to an overcrowded shelf. But there was a particular need that did not seem to be very well addressed in books or journal articles—to bring together concepts and methods with real research findings in order to make informed judgments about the results. One of the most difficult tasks facing new students and even experienced practitioners of epidemiology is to assess how much confidence one can have in a given set of findings. As I discussed such issues with graduate students and colleagues, and contemplated my own data, it was difficult to find a reasoned, balanced approach. It’s easy but uninformative to simply acknowledge epidemiology’s many pitfalls, and not much more difficult to mount a generic defense of the credibility of one’s findings. What was difficult was to find empirical tools for assessing the study’s susceptibility to specific sources of error in ways that could actually change preconceptions and go beyond intuition. This kind of examination is most fruitful when it can give good or bad news about one’s study that was unexpected.

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