Kerry Roger, Eriksen Thor E, Noer Lie Svein A, Mumford Stephen, Anjum Rani L
Division of Physiotherapy Education, University of Nottingham, Nottingham, UK.
J Eval Clin Pract. 2014 Dec;20(6):985-7. doi: 10.1111/jep.12189. Epub 2014 Jun 27.
Strand and Parkkinen criticize our dispositional account of causation in evidence-based medicine for failing to provide a proper epistemology of causal knowledge. In particular, they claim that we do not explain how causal inferences should be drawn. In response, we point out that dispositionalism does indeed have an account of the epistemology of causation, including counterfactual dependence, intervention, prediction and clinical decision. Furthermore, we argue that this is an epistemology that fits better with the known fallibility of even our best-informed predictions. Predictions are made on the basis that causes dispose or tend towards their effects, rather than guarantee them. The ontology of causation remains a valuable study for, among other reasons, it tells us that powers do not always combine additively. This counts against the monocausality that is tested by randomized controlled trials.
斯特兰德和帕尔基宁批评我们在循证医学中对因果关系的倾向性解释未能提供恰当的因果知识认识论。他们特别指出，我们没有解释应该如何进行因果推断。对此，我们指出，倾向性理论确实有关于因果关系认识论的解释，包括反事实依赖、干预、预测和临床决策。此外，我们认为这种认识论更符合即使是我们最充分了解的预测也存在的已知易谬性。预测是基于原因倾向于产生其结果而非保证其结果这一基础做出的。因果关系的本体论仍然是一项有价值的研究，原因之一在于它告诉我们，力量并不总是以相加的方式结合。这与随机对照试验所检验的单因果关系相悖。
