Amalgamating Evidence About Causes: Medicine, the Medical Sciences, and Beyond

在许多科学领域，人们可以依靠来自不同方法、专家和学科的各种证据来得出因果陈述。因此，充分合并证据以产生因果知识，对科学家和那些在决策中依靠科学因果主张的人来说是一个普遍的挑战。在生物医学科学和医疗实践中尤其如此。在这里，至少有四个特定的领域，从业者必须综合因果知识：（i）在常规临床实践中治疗一系列患者，（ii）从多个医学试验中测量个体效应量并将其合并为整体效应量，（iii）根据广泛不同的证据得出干预效果的结论，以及（iv）综合一组专家的判断。在每一个地区，推定因果关系的证据有不同的形式和性质，以及不同程度的可靠性，而这种不同证据的综合方式也因地区而异。事实证明，在每个领域都有许多有争议和未解决的争论。人们可能会认为这些都是纯科学问题，可以通过医学或统计学的技术发展来解决。然而，事实上，这些悬而未决的辩论的存在表明了更深层次的哲学挑战。因此，本项目的目标是系统地探讨如何采取步骤，利用科学哲学的工具，更好地了解在上述四个领域中合并原因证据的各种可能性。特别是，我们的目标是制定正式的约束、规定性原则和方法论启发式，以指导医学从业者，并在这种实际的、政策导向的背景下用作评估规范。要做到这一点，我们使用案例研究调查，正式的工作，和计算机模拟。

In many areas of science, one can rely on a variety of evidence from different methods, experts, and disciplines to derive causal statements. Accordingly, the adequate amalgamation of evidence to produce causal knowledge is a widespread challenge for scientists and those aiming to rely on scientific causal claims in decision-making. This is particularly true in the biomedical sciences and medical practice. Here, there are at least four particular areas in which practitioners must synthesize causal knowledge: (i) treating a series of patients in routine clinical practice, (ii) measuring individual effect sizes from multiple medical trials and combining them into an overall effect size, (iii) drawing conclusions about intervention effects based on widely varying evidence, and (iv) synthesizing the judgments of a group of experts. In each area, the evidence for presumed causal relationships has different forms and properties, as well as different levels of reliability, and the way in which this different evidence can be synthesized varies from area to area. It turns out that there are numerous controversial and unresolved debates in each of these areas. One might be tempted to think that these are purely scientific issues that could be resolved by technical developments in medicine or statistics. In fact, however, the existence of these unresolved debates is indicative of deeper philosophical challenges. Accordingly, the goal of this project is to systematically explore steps toward a better understanding of the range of possibilities for amalgamating evidence of causes in each of the four areas described above, using the tools of philosophy of science. In particular, we aim to formulate formal constraints, prescriptive principles, and methodological heuristics that could guide practitioners in medicine and be used as evaluative norms in this practical, policy-oriented context. To do this, we use case study investigation, formal work, and computer simulations.