GEOFFREY ROSE was a teacher and a counsellor to numerous physicians and scientists throughout the world. He brought clinical respectability to epidemiology and a healthy scientific scepticism to consultative medicine, and by doing so contributed greatly to the recognition of the value of epidemiological techniques in medical research which came during his lifetime.
Rose will probably be best remembered for his work in the study of chronic cardiovascular diseases, but his influence on epidemiological thought was immense, partly from his lecturing and writing and partly from his international teaching commitments. He trained at Oxford and St Mary's Hospital, Paddington, where, like many others of his generation, he was stimulated by George Pickering to develop a special interest in high blood pressure and its complications. After house jobs at St Mary's, and service in the RAF, in 1959 he started his long association with the department of epidemiology at the London School of Hygiene and Tropical Medicine under Professor Donald Reid.
In 1967 his academic career was threatened by a road accident. I was part of a stunned audience in Chicago at a meeting of the epidemiological section of the American Heart Association when it was announced that, at the start of his journey to that meeting, he had been seriously injured in Buckinghamshire. Rose was already well- known in American epidemiological circles. He had spent a year at John Hopkins Medical School in Baltimore, as a lecturer, and had initiated a series of studies which led on to internationally accepted standardised methods for the diagnosis and measurement of coronary heart disease in population studies. Though that accident resulted in acute renal failure which almost cost Rose his life and also caused, among other injuries, permanent blindness in one eye, it did not appear seriously to restrict his physical activities and certainly had no detectable effect on his intellectual ones. It led him to believe that he was living on borrowed time and his inner strength made sure that the borrowed time was not wasted.
Geoff Rose managed to keep both sides of his career running in parallel. Throughout he retained his clinical expertise and became a consultant physician at St Mary's while progressing up the academic ladder at the London School of Hygiene. He was thus able to ensure that his epidemiological interests were always clinically relevant. In 1970 he was appointed to the chair of Clinical Epidemiology at St Mary's, and in 1977, following Reid's death, he became Professor of Epidemiology at the London School of Hygiene. His early work concentrated on the need for reproducibility in medical measurements; he developed what became known as the Rose questionnaire for eliciting symptoms of cardiovascular disease, he helped to design the London School of Hygiene sphygmomanometer to avoid observer bias in blood-pressure measurement, and with Henry Blackburn he developed the Minnesota Code for quantifying electrocardiographic abnormalities in population studies which allowed comparability between the findings of cardiovascular surveys world-wide.
He and his team carried out a series of prospective surveys of coronary heart disease incidence among London civil servants - the so- called Whitehall studies - and he later became the leader of two international collaborative trials of intervention measures: the European multifactorial trial in the prevention of coronary disease, and the Intersalt study of the relationship between electrolyte excretion and blood pressure, involving 50 population studies from 32 countries.
Perhaps his influence will find its greatest expression among the 700 epidemiologists, from 70 countries, who participated in one of the 10- day teaching seminars carried out under the auspices of the International Society and Federation of Cardiology. For 20 years, from its outset in 1968, Rose was chairman of the planning committee for those seminars. His advice was much in demand from the World Health Organisation and the promotion by WHO of a population approach to heart-disease prevention started during his chairmanship in 1982 of its Expert Committee on the prevention of coronary disease. He served on Medical Research Council committees and working parties and on retirement, in 1991, acted as Research Adviser to the Royal College of General Practitioners.
Geoffrey Rose's attitude to his own impending death was characteristic. He wrote to his friends, apologising for sending them news that might sadden them - the discovery of cancer cells in his liver. His overwhelming feeling was one of gratitude for a good life and thankfulness for the tranquillity which came from his religious conviction. Death held no fears for him. His concern was for his wife, Ceridwen, and their family.
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