Causality and causal inference in epidemiology: the need for a pluralistic approach.
Causality and causal inference in epidemiology: the need for a pluralistic approach.
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DOI：
10.1093/ije/dyv341
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发表时间：
2016-12-01
影响因子：
7.7
通讯作者：
Pearce N
中科院分区：
文献类型：
--
作者：
Vandenbroucke JP;Broadbent A;Pearce N
基于潜在结果方法推理的限制性版本的因果推理在流行病学的教学和实践中占据越来越突出的地位。所提出的概念和方法对特定问题是有用的，但如果整个流行病学领域的理论和实践都局限于这种因果推理的单一方法，那将是令人担忧的。我们担心的是，这一理论限制了流行病学家可能提出的问题和他们可能考虑的研究设计。它还限制了可能被认为可用于评估因果关系的证据，从而限制了可能被认为可用于科学和公共卫生决策的证据。这些限制基于思考因果关系的特定概念框架。在第1节中，我们描述了限制性潜在结果方法（RPOA）的特点，并表明有一个方法学运动，提倡这些原则，不仅是为了解决特定的问题，但作为理想的流行病学作为一个整体应该努力。在第2节中，我们试图表明流行病学局限于因果关系性质的一种特定观点是有问题的。在第3节中，我们认为RPOA在因果关系评估方面也存在问题。我们认为，它有可能限制研究设计的选择，错误地怀疑过去非常有用的观察性研究的结果，并损害流行病学推理的教学。最后，在第四节中，我们提出了一个我们认为更合理的关于因果关系的性质及其评估的“工作假设”：语用多元化。
Causal inference based on a restricted version of the potential outcomes approach reasoning is assuming an increasingly prominent place in the teaching and practice of epidemiology. The proposed concepts and methods are useful for particular problems, but it would be of concern if the theory and practice of the complete field of epidemiology were to become restricted to this single approach to causal inference. Our concerns are that this theory restricts the questions that epidemiologists may ask and the study designs that they may consider. It also restricts the evidence that may be considered acceptable to assess causality, and thereby the evidence that may be considered acceptable for scientific and public health decision making. These restrictions are based on a particular conceptual framework for thinking about causality. In Section 1, we describe the characteristics of the restricted potential outcomes approach (RPOA) and show that there is a methodological movement which advocates these principles, not just for solving particular problems, but as ideals for which epidemiology as a whole should strive. In Section 2, we seek to show that the limitation of epidemiology to one particular view of the nature of causality is problematic. In Section 3, we argue that the RPOA is also problematic with regard to the assessment of causality. We argue that it threatens to restrict study design choice, to wrongly discredit the results of types of observational studies that have been very useful in the past and to damage the teaching of epidemiological reasoning. Finally, in Section 4 we set out what we regard as a more reasonable ‘working hypothesis’ as to the nature of causality and its assessment: pragmatic pluralism.
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影响因子：
3.4
作者：
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