Rickles Dean
Unit for History & Philosophy of Science, University of Sydney, Sydney, NSW, 2006, Australia.
Med Health Care Philos. 2009 Mar;12(1):77-90. doi: 10.1007/s11019-008-9140-4. Epub 2008 May 9.
In this paper I look at causality in the context of intervention research, and discuss some problems faced in the evaluation of causal hypotheses via interventions. I draw attention to a simple problem for evaluations that employ randomized controlled trials. The common alternative to randomized trials, the observational study, is shown to face problems of a similar nature. I then argue that these problems become especially acute in cases where the intervention is complex (i.e. that involves intervening in a complex system). Finally, I consider and reject a possible resolution of the problem involving the simulation of complex interventions. The conclusion I draw from this is that we need to radically reframe the way we think about causal inference in complex intervention research.
在本文中,我探讨了干预研究背景下的因果关系,并讨论了通过干预评估因果假设时面临的一些问题。我提请注意在采用随机对照试验的评估中存在的一个简单问题。随机试验的常见替代方法——观察性研究,也被证明面临类似性质的问题。然后我认为,在干预复杂(即涉及对复杂系统进行干预)的情况下,这些问题会变得尤为严重。最后,我考虑并否定了一种涉及模拟复杂干预的问题解决方案。由此得出的结论是,我们需要从根本上重新构建我们对复杂干预研究中因果推断的思考方式。