One theory is that physicians gave too much credence to hypothesised mechanisms for which there was little or no evidence. If so, the problem was one of method: too little time spent obtaining solid evidence of mechanisms and too little inclination to properly evaluate the evidence that was available.
The next issue of Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences is currently in progress, but some articles from the forthcoming issue have recently been made available online first. One article is by Alexander R. Fiorentino (Public Health and Community Medicine, Tufts) and Olaf Dammann (Public Health and Community Medicine, Tufts & Gynecology and Obstetrics, Hannover Medical School) and is on the topic of the Russo-Williamson thesis.
Enormous effort, by many people, has helped us understand how important good evidence of correlations is in choosing medical treatments, and has characterised how to go about carefully and responsibly performing randomised controlled trials (RCTs) and observational studies on various populations of people. We are trying to do a similar job for understanding – and also explicitly characterising – how evidence of mechanisms helps choose medical treatments.
Last month saw the 25th First Annual Ig Nobel Prize ceremony. The Ig Nobel prizes aim to honour achievements that ﬁrst make people laugh and then make people think. Here is a quote from their website: “The prizes are intended to celebrate the unusual, honor the imaginative—and spur people’s interest in science, medicine, and technology.”The award ceremony takes place every September. This year’s ceremony can be viewed on the Improbable Research website. And past ceremonies can be viewed at the Improbable Research YouTube channel.
We all know that correlation is not causation. A correlation can be due to factors other than causation, such as bias, confounding, chance, time-series trends (e.g., the correlation between British bread prices and the sea level in Venice), or semantic, logical, physical or mathematical connections. In order to rule out these alternative explanations of a correlation – and establish causation – we need to seek evidence of a mechanism. One needs to account for the correlation via some mechanism by which the putative cause brings about the putative effect.