Causality in complex interventions.
In this paper I look at causality in the context of intervention research, and discuss some problems faced in the evaluation of causal hypotheses via interventions. I draw attention to a simple problem for evaluations that employ randomized controlled trials. The common alternative to randomized trials, the observational study, is shown to face problems of a similar nature. I then argue that these problems become especially acute in cases where the intervention is complex (i.e. that involves intervening in a complex system). Finally, I consider and reject a possible resolution of the problem involving the simulation of complex interventions. The conclusion I draw from this is that we need to radically reframe the way we think about causal inference in complex intervention research.
Rickles
Dean
D
Unit for History & Philosophy of Science, University of Sydney, Sydney, NSW, 2006, Australia. d.rickles@usyd.edu.au
D015982:Bias; D015984:Causality; D015986:Confounding Factors, Epidemiologic; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D009626:Terminology as Topic