Causality in Epidemiology and Comprehensive Architecture of Healthand Disease

Summary

The authors try to explain the term causality, the more detailed analysis of which leads to a morerealistic view of the disease, as a deviant position of a comprehensive adaptive system. Itssub-systems - genotype, phenotype, environmental constituents and lifestyle - in mutualinteraction create the comprehensive architecture of health and disease. The natural interestis detection of factors which cause disease (causal factors, causes) and those which at least makethe prognosis of its development more accurate (risk factors). Assessment of the true causewhich is necessary for introducing a rational therapeutic and preventive procedure calls foradequate understanding of the complex reality, incl. description of the relationship betweenlevels of exposure and consequence. This process is usually complicated by different systematicerrors which occur in different stages of research. The assembled findings should be discussedwith regard to criteria of causality to make the statement of a causal relationship moretrustworthy. The epidemiological method penetrates due to the more advanced application ofthe principle of causality to an increasing extent into many medical disciplines, it is the maintool for suggesting and testing preventive and therapeutic procedures in medicine in general.It is expedient with regard to the natural development of disease which proceeds from the actionof conditioning (risk) factors via the latent pre/subclinical stage to the clinical manifestation ofthe disease that general practitioners who have the main responsibility for primary andsecondary prevention can become familiar with one of the present views of the given problem.

Key words:
epidemiology - causality - risk factor - exposure - bias - criteria of causality -reductionism - comprehensive architecture of health - disease.