Kraemer H C, Kazdin A E, Offord D R, Kessler R C, Jensen P S, Kupfer D J
Department of Psychiatry and Behavioral Sciences, Stanford University, Calif, USA.
Arch Gen Psychiatry. 1997 Apr;54(4):337-43. doi: 10.1001/archpsyc.1997.01830160065009.
Terms such as risk, risk factors, and especially the term cause are inconsistently and imprecisely used, fostering scientific miscommunication and misleading research and policy. Clarifying such terms is the essential first step. We define risk and a risk factor (protective factor) and their potency, set out the conceptual basis of the methods by which risk factors are identified and potency demonstrated, and propose criteria for establishing the status of a risk factor as a fixed or variable marker or a causal risk factor. All definitions are based on the state of scientific knowledge (empirical documentation), rather than on hypotheses, speculations, or beliefs. We discuss common approaches and pitfalls and give a psychiatric research example. Imprecise reports can impede the search for understanding the cause and course of any disease and also may be a basis of inadequate clinical or policy decision-making. The issues in risk research are much too important to tolerate less than precise terminology or the less than rigorous research reporting that results from imprecise and inconsistent terminology.
诸如风险、风险因素，尤其是“病因”一词，其使用既不一致又不精确，从而导致科学交流不畅，并误导研究和政策制定。明确此类术语是至关重要的第一步。我们定义了风险和风险因素（保护因素）及其效力，阐述了识别风险因素和证明其效力的方法的概念基础，并提出了将风险因素确定为固定或可变标志物或因果风险因素的标准。所有定义均基于科学知识状态（实证记录），而非基于假设、推测或信念。我们讨论了常见方法和陷阱，并给出了一个精神病学研究实例。不精确的报告可能会妨碍对任何疾病的病因和病程的理解，也可能成为临床或政策决策不足的依据。风险研究中的问题非常重要，不能容忍术语不精确或因术语不精确和不一致而导致的研究报告不够严谨的情况。
