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Etiology in a Taxonomy of Illnesses

Steurer, Johann ; Bachmann, Lucas ; Miettinen, Olli

In: European Journal of Epidemiology, 2006, vol. 21, no. 2, p. 85-89

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    Titre
    • Etiology in a Taxonomy of Illnesses
    Auteur
    • Steurer, Johann. Horten Center for Patient-oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland
    • Bachmann, Lucas. Horten Center for Patient-oriented Research and Knowledge Transfer, Department of Internal Medicine, University of Zurich, Zurich, Switzerland
    • Miettinen, Olli. Department of Epidemiology, Biostatistics and Occupational Health, and Department of Medicine, Faculty of Medicine, McGill University, Montreal, Canada
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Epidemiology, 2006, vol. 21, no. 2, p. 85-89. Kluwer Academic Publishers
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321298
    Summary
    According to what Robert Koch termed the etiological standpoint, illnesses are best understood and controlled by focusing on their causes, including in their definitions and, thus, in the construction of their taxonomies. In some ways flawed, this standpoint has been misunderstood and misapplied. A taxonomy based solely on etiology was an unrealistic dream in the context of ‘the bacteriological revolution', and it also is unrealistic in the present context of ‘the genetic revolution.' We argue that the illnesses in a taxonomy of them are in some cases best defined directly in terms of their respective somatic anomalies, in some others indirectly by the unique and universal etiology of that anomaly (left unspecified) in a ‘deeper' somatic anomaly, and in yet others as a combination of these; and when the somatic anomaly for direct definition remains unknown, it is to be defined indirectly by the clinical syndrome that is its patient-relevant manifestation, possibly in conjunction with a somatic cause. We note, also, that these taxonomic issues have no material bearing on epidemiologists' etiologic research for the knowledge base of community-level preventive medicine