Evidence, illness, and causation: An epidemiological perspective on the Russo–Williamson Thesis

Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 54:1-9 (2015)
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Abstract

According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions.

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Olaf Dammann
Tufts University

Citations of this work

Establishing Causal Claims in Medicine.Jon Williamson - 2019 - International Studies in the Philosophy of Science 32 (1):33-61.
Treatment Effectiveness and the Russo–Williamson Thesis, EBM+, and Bradford Hill's Viewpoints.Steven Tresker - 2022 - International Studies in the Philosophy of Science 34 (3):131-158.
Causality, mosaics, and the health sciences.Olaf Dammann - 2016 - Theoretical Medicine and Bioethics 37 (2):161-168.

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References found in this work

Inference to the Best Explanation.Peter Lipton - 1991 - London and New York: Routledge/Taylor and Francis Group.
Thinking about mechanisms.Peter Machamer, Lindley Darden & Carl F. Craver - 2000 - Philosophy of Science 67 (1):1-25.
Inference to the Best Explanation.Peter Lipton - 1991 - London and New York: Routledge.
Explanation: a mechanist alternative.William Bechtel & Adele Abrahamsen - 2005 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 36 (2):421-441.

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