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Rothman's concept of sufficient causes [ 14, 15] describes scenarios in which multiple causal mechanisms can all lead to the development of a disease.
In addition, most of the gene clusters were not only consistently observed in all the datasets but also clustered HT patients into distinct groups, suggesting multiple causal mechanisms for HT.
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Multiple gene clusters, each of which identified a distinct group of subjects, imply multiple causal pies (disease mechanisms) for young-onset hypertension and may help to identify disease sub-types.
In addition, the same causal mechanism may have different outcomes in different contexts while different causal mechanisms and multiple causes for the same effect may be at play in the same context.
Risk factor analysis, even with modification, faces limits in its capacity to examine causal mechanisms at multiple scales (Susser and Susser 1996a); it may adeptly explain who is at risk but not why risks exist or differ within and between populations (Krieger 1994; Rose 1985; Susser 2004).
It illustrates in particular the challenges of identifying causal mechanisms during 'rising tides' when multiple policy pressures and the emergence of professional and scientific consensus combine to produce improvements across the board.
10, 86 Although causal mechanisms are unclear, regular exercise likely impacts multiple modifiable risk factors that result in improved brain health and cognitive performance in older adults.
There are several causal mechanisms by which a genetic variant may be associated with multiple risk factors (11).
By extension, a multiple interventions meta-analysis allows us to explore and compare different bundles of causal mechanisms to see which one is most effective.
Here as elsewhere, Mr. Gladwell promotes a cultural explanation for success no matter how indirect the causal mechanisms.
The appeal of this approach to bureaucrats is fairly obvious: like Beer's central planners, they can be effective while remaining ignorant of the causal mechanisms at play.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com