Clues to aetiology come from comparing disease rates in groups with differing levels of exposure for example, the incidence of congenital defects before and after a rubella epidemic or the rate of mesothelioma in people with or without exposure to asbestos. Clues will be missed, or false clues created, if comparisons are biased by unequal ascertainment of cases or exposure levels. Of course, if everyone is equally exposed there will not be any clues epidemiology thrives on heterogeneity.
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