Susser M
Epidemiol Prev. 1997 Jul-Sep;21(3):160-8.
Ways in which frames of reference about causation differ across disciplines are exemplified. The necessity for a multivariate concept of causation is emphasized. On the epidemiological side, divergences of clinical approaches from requirements for meeting preconditions for cause are each illustrated by several examples. Association is discussed in terms of comparability of groups, independent observation of associated variables, sampling and measurement. Securing time order among variables is a matter of sequential positioning by design, and the difficulties that inhere in the clinical situation are again illustrated by example. On the clinical side, strengths in generating hypotheses, in discovery of associations without conventional comparison and in potential precision in measuring outcomes are outlined. On the epidemiological side, the discipline adds to clinical medicine unique dimensions analogous with the basic biomedical sciences. These are essential to capturing environmental causes and the antecedent experience of sick individuals. Convergence between the two perspectives is bound to yield, and has yielded, much profit.
文中举例说明了不同学科之间因果关系参考框架的差异。强调了因果关系多元概念的必要性。在流行病学方面，通过几个例子分别说明了临床方法与满足因果前提条件要求之间的差异。从群体可比性、相关变量的独立观察、抽样和测量等方面讨论了关联性。确定变量之间的时间顺序是通过设计进行顺序定位的问题，文中再次通过例子说明了临床情况中存在的困难。在临床方面，概述了在生成假设、发现无传统对照的关联以及测量结果的潜在精确性方面的优势。在流行病学方面，该学科为临床医学增添了与基础生物医学科学类似的独特维度。这些对于捕捉环境原因和患病个体的既往经历至关重要。两种观点之间的融合必然会产生，而且已经产生了很多成果。
