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of aspirin prevent coronary heart disease? Does psychiatric support prevent
suicide in patient with suicide ideations?
Hence, causal relationships apply both of the following:
Noxious causes disease occurrence and/or course
Beneficial factors (drug, vaccine, surgery, psychiatric care) prevention
of disease and/or improvement of its severity, course, and outcomes
Ultimately, does a morphological and/or physiological anomaly produce
a positive result for a diagnostic test, method, or technique? (N.B. Their
evaluation occurs through other methods and criteria to answer practical
and operational questions beyond causality as we will see when discussing
diagnosis as a step in clinical care.)
Causal reasoning serves as a confirmation or a refutation of our impres-
sion that one phenomenon produces another.
2.2.1 Causal Reasoning in a Quantitative and Qualitative Way
Causal reasoning is a mental process whose objective is to establish on
the basis of available data and information whether some phenomenon
(a) under study causes leads to or produces another phenomenon (b) as
a consequence of the former. In medicine, as already mentioned above, a
causal relationship may be between a noxious factor and the deterioration
of health (smoking causes cancer) or a beneficial factor and the improve-
ment of health (drug treatment cures an infection, surgery alleviates coro-
nary heart disease, psychotherapy improves an affective disorder).
For pragmatic reasons, we can make a distinction between risk factors ,
that is, causally related characteristics that can be modified (such as changing
unhealthy dietary habits to control overweight) and risk markers that cannot
be modified in their possible causal relationship such as age or gender. (N.B.
Similar distinctions may be made between prognostic factors and prog-
nostic markers as possible causes of disease and treatment outcomes.)
The process of causal reasoning is triggered by some hypothesis about a
cause-effect relationship : A proposal to be accepted or rejected by ad hoc
research. Three types of research are also related to hypothesis generation
and testing:
More traditionally, medical research is a quantitative research : A study of
multiple cases brought together provides an idea about a common problem
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