Drawing from an inexhaustible source of clinical expertise, clinical research, and intellectual creativity, Alvan R Feinstein (1925–2001) became the founding father of clinical epidemiology. He was professor of Medicine and Epidemiology at Yale University School of Medicine from 1969, Editor of the Journal of Chronic Diseases (1982–1988) and founder and Editor of the Journal of Clinical Epidemiology (1988–2001). He was author of about 800 scientific publications. Most of these were full papers in peer reviewed journals, of which Feinstein was first author in most cases. Feinstein published six authoritative books. Clinical Judgment (1967), Clinical epidemiology: the architecture of clinical research (1985), and Clinimetrics (1987) were breakthroughs in clinical science, and still a breeding ground for innovation. (Photograph reprinted from Journal of Clinical Epidemiology, with permission from Elsevier Science).
Alvan Feinstein, MD
1926 — 2001
Dr. Feinstein was perhaps the most outspoken of highly placed critics of CVD prevention research design and conduct. He was born in Philadelphia and received a bachelor’s degree, a master’s degree in mathematics, and a doctor of medicine degree all from the University of Chicago. Upon completing residency training in internal medicine at Yale and research training at the Rockefeller Institute, he became medical director at Irvington House, near New York City, an institute for the study and care of rheumatic diseases.
In 1962, Feinstein joined the Yale faculty and in 1974 became the founding director of Yale’s Robert Wood Johnson Clinical Scholars Program, which became a leading site for training in clinical research. His research and scholarship covered rheumatic fever patterns and treatment; cancer prognosis and therapy; the appropriate use of diagnostic tests; and methods of study design and statistical analysis in clinical investigation. His methods were detailed in books: Clinical Judgment, Clinical Epidemiology, and Clinimetrics, which widely influenced research and practice methods. In 1991, he was named Sterling Professor of Medicine and Epidemiology at Yale. By his peers he was thought to blend clinical care with an unrelenting reliance on rigorous clinical research.
He was best known in CVD epidemiology circles as an active and severe critic, while acting as drug industry consultant, of the investigators and the design and operation of the University Group Diabetes Program, the early trial of oral hypoglycemic drugs. Later, he vigorously attacked the concepts and design of the multifactor risk reduction strategies of the 70-80s multicenter preventive trials in CVD. Some of his criticism was justified. (HB)