As more attention and resources have been focused on the health of populations over the last 2 centuries, epidemiology has emerged as an essential tool for gaining knowledge about disease and reducing the associated burden. Driven by the discovery of biomarkers, the advent of DNA analysis, and high-powered statistical software, as well as numerous other technological advances, epidemiology has evolved to a point at which massive cohorts with hundreds of thousands of participants are needed. Each step in this evolution can be defined by an enabling technology that aided in a better understanding of exposure-disease relationships, and in many cases, to transformative changes in public health efforts related to health care delivery. This commentary describes this evolution, from early descriptive studies to the new mega cohorts of today.
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