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Generalizability: beyond plausibility and handwaving.

Eyal Shahar1

  • 1Division of Epidemiology, University of Minnesota, Minneapolis, MN 55454, USA. shahar@epi.umn.edu

Journal of Evaluation in Clinical Practice
|June 6, 2003
PubMed
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This essay explores applying biomedical knowledge to healthcare using determinism and indeterminism causal models. Both models offer testable hypotheses for generalizability, with indeterminism uniquely supporting individual patient treatment decisions.

Area of Science:

  • Biomedical Science
  • Causal Inference
  • Philosophy of Science

Background:

  • Debates persist regarding the generalizability and applicability of biomedical science knowledge to medical and public health practices.
  • Existing frameworks often struggle to reconcile theoretical knowledge with practical application in diverse patient populations.

Purpose of the Study:

  • To interpret generalizability from the perspectives of two distinct causal models: determinism and indeterminism.
  • To propose that generalizability theories can be formulated based on both deterministic and indeterministic frameworks.
  • To differentiate the implications of determinism and indeterminism for clinical decision-making.

Main Methods:

  • Conceptual analysis of generalizability through the lens of causal inference.

Related Experiment Videos

  • Comparative examination of deterministic and indeterministic models in scientific theory formulation.
  • Exploration of how each causal model informs decisions regarding patient treatment.

    • Main Results:

    • Theories of generalizability can be constructed from both deterministic and indeterministic causal models.
    • Generalizability theories, irrespective of the causal model, manifest as testable yet unverifiable hypotheses, a characteristic shared by all scientific theories.
    • A key distinction emerges: determinism indirectly supports decisions for individual patient treatment, while indeterminism directly accommodates both general and individual treatment decisions.

    Conclusions:

    • Both determinism and indeterminism provide viable frameworks for understanding and formulating theories of generalizability in biomedical science.
    • Indeterminism offers a more direct pathway for rationalizing treatment decisions for individual patients compared to determinism.
    • The choice of causal model has significant implications for how biomedical knowledge is translated into clinical practice and public health strategies.