Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Eur J Epidemiol. 2010 Oct;25(10):671-5. doi: 10.1007/s10654-010-9486-9. Epub 2010 Jul 11.
Understanding of the logic-dictated essence of the etiologic study, and similarly that of the intervention-study, in the advancement of the knowledge-base of medicine, remains incomplete. Viewing experimental intervention-studies ('clinical trials') as paradigmatic for etiologic studies-necessarily non-experimental-has been wrongheaded. This misunderstanding continues to impede understanding of the essence of what logic dictates to be the etiologic study, adduced decades ago but still commonly confused with the essence of the (seriously malformed) 'case-control' study. Correct understanding of the essence of the etiologic study would pave the way to improved understanding of the intervention study, notably as to how prognostic probability functions could be derived from the data now routinely produced in clinical trials. This paradigm reversal, too, has been previously proposed, but its understanding has remained fogged by wanting understanding of the etiologic study.
对病因研究的逻辑必然性的理解,以及对干预研究的类似理解,在医学知识库的发展中仍然不完整。将实验干预研究(“临床试验”)视为病因研究的典范——必然是非实验性的——是错误的。这种误解继续阻碍人们对逻辑所规定的病因研究的本质的理解,几十年前就已经提出,但仍然经常与(严重畸形的)“病例对照”研究的本质混淆。正确理解病因研究的本质将为更好地理解干预研究铺平道路,特别是如何从现在临床试验中常规产生的数据中推导出预后概率函数。这种范式的转变也以前被提出过,但由于对病因研究的理解不足,其理解仍然模糊不清。