TY - JOUR
T1 - Defining metabolic syndrome
T2 - Which kind of causality, if any, is required?
AU - Benzi, Margherita
N1 - Publisher Copyright:
© 2017 Benzi. Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.
PY - 2017/12
Y1 - 2017/12
N2 - The definition of metabolic syndrome (MetS) has been, and still is, extremely controversial. My purpose is not to give a solution to the associated debate but to argue that the controversy is at least partially due to the different 'causal content' of the various definitions: their theoretical validity and practical utility can be evaluated by reconstructing or making explicit the underlying causal structure. I will therefore propose to distinguish the alternative definitions according to the kinds of causal content they carry: (1) definitions grounded on associations, (2) definitions presupposing a causal model built upon statistical associations, and (3) definitions grounded on underlying mechanisms. I suggest that analysing definitions according to their causal content can be helpful in evaluating alternative definitions of some diseases. I want to show how the controversy over MetS suggests a distinction among three kinds of definitions based on how explicitly they characterise the syndrome in causal terms, and on the type of causality involved. I will call 'type 1 definitions' those definitions that are purely associative; 'type 2 definitions' the definitions based on statistical associations, plus generic medical and causal knowledge; and 'type 3 definitions' the definitions based on (hypotheses about) mechanisms. These kinds of definitions, although different, can be related to each other. A definition with more specific causal content may be useful in the evaluation of definitions characterised by a lower degree of causal specificity. Moreover, the identification of the type of causality involved is of help to constitute a good criterion for choosing among different definitions of a pathological entity. In section (1) I introduce the controversy about MetS, in section (2) I propose some remarks about medical definitions and their 'causal import', and in section (3) I suggest that the different attitudes towards the definition of MetS are relevant to evaluate their explicative power.
AB - The definition of metabolic syndrome (MetS) has been, and still is, extremely controversial. My purpose is not to give a solution to the associated debate but to argue that the controversy is at least partially due to the different 'causal content' of the various definitions: their theoretical validity and practical utility can be evaluated by reconstructing or making explicit the underlying causal structure. I will therefore propose to distinguish the alternative definitions according to the kinds of causal content they carry: (1) definitions grounded on associations, (2) definitions presupposing a causal model built upon statistical associations, and (3) definitions grounded on underlying mechanisms. I suggest that analysing definitions according to their causal content can be helpful in evaluating alternative definitions of some diseases. I want to show how the controversy over MetS suggests a distinction among three kinds of definitions based on how explicitly they characterise the syndrome in causal terms, and on the type of causality involved. I will call 'type 1 definitions' those definitions that are purely associative; 'type 2 definitions' the definitions based on statistical associations, plus generic medical and causal knowledge; and 'type 3 definitions' the definitions based on (hypotheses about) mechanisms. These kinds of definitions, although different, can be related to each other. A definition with more specific causal content may be useful in the evaluation of definitions characterised by a lower degree of causal specificity. Moreover, the identification of the type of causality involved is of help to constitute a good criterion for choosing among different definitions of a pathological entity. In section (1) I introduce the controversy about MetS, in section (2) I propose some remarks about medical definitions and their 'causal import', and in section (3) I suggest that the different attitudes towards the definition of MetS are relevant to evaluate their explicative power.
KW - Causal models
KW - Mechanistic property clusters
KW - Medical definitions
KW - Metabolic syndrome
KW - Natural kinds
UR - http://www.scopus.com/inward/record.url?scp=85056899545&partnerID=8YFLogxK
U2 - 10.1515/disp-2017-0018
DO - 10.1515/disp-2017-0018
M3 - Article
SN - 0873-626X
VL - 9
SP - 553
EP - 580
JO - Disputatio
JF - Disputatio
IS - 47
ER -