WHAT IS A CAUSE AND HOW DO WE KNOW ONE - A GRAMMAR FOR PRAGMATIC EPIDEMIOLOGY

被引:344
作者
SUSSER, M
机构
[1] Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032
关键词
ASSOCIATION; CAUSAL CRITERIA; CAUSALITY; EPIDEMIOLOGIC METHODS; EPIDEMIOLOGY; LOGIC; PHILOSOPHY; RESEARCH DESIGN;
D O I
10.1093/oxfordjournals.aje.a115939
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In this paper, criteria used by many epidemiologists as aids in causal inference are reviewed and revised. The revised scheme emphasizes the distinction between essential properties of a cause and criteria useful for deciding on the presence of these properties in a given case. A systematic procedure for causal inference tests each essential causal property in turn against appropriate criteria. For a pragmatic epidemiology in which all determinants serve as causes, their essential properties are held to be association, time order, and direction, in an ascending hierarchy. Criteria for association are probabilistic and can be enhanced by strength and consistency. Givn association, criteria for time order of the relevant variables follow from access to observation, which is dependent on design. Given association and time order, causal direction (or consequential change) calls on an array of criteria, namely, consistency and survivability, strength, specificity in cause and in effect, predictive performance, and coherence in all its forms (e.g., theoretical, factual, biologic, and statistical). The evolution of such criteria is traced through the epidemiologic literature in the light of historical context. Although Popper's philosophy cannot directly serve an inherently inductive judgmental process, his notion of survivability has here been added, alongside replicability, as a subclass of consistency. This criterion is proposed to bridge the gap between the particularity of designs and the generality required of causal relations. Designs are ordered and described in the framework of testing survivability. Finally, definitions are offered for the list of criteria deployed.
引用
收藏
页码:635 / 648
页数:14
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