Stories of serendipitous discoveries in medicine incorrectly imply that\u00a0the path from an unexpected observation to major discovery is\u00a0straightforward or guaranteed.<\/p>\n
In this paper, I examine a case from the\u00a0field of research about chronic fatigue syndrome (CFS). In Norway, an\u00a0unexpected positive result during clinical care has led to the
\ndevelopment of a research programme into the potential for the\u00a0immunosuppressant drug rituximab to relieve the symptoms of CFS. The\u00a0media and public have taken up researchers’ speculations that their\u00a0research results indicate a causal mechanism for CFS – consequently,\u00a0patients now have great hope that ‘the cause’ of CFS has been found, and
\nthus, a cure is sure to follow.<\/p>\n
I argue that a monocausal claim cannot\u00a0be correctly asserted, either on the basis of the single case of an\u00a0unexpected, although positive, result or on the basis of the empirical
\nresearch that has followed up on that result. Further, assertion and\u00a0promotion of this claim will have specific harmful effects: it threatens\u00a0to inappropriately narrow the scope of research on CFS, might misdirect\u00a0research altogether, and could directly and indirectly harm patients.<\/p>\n
Therefore, the CFS case presents a cautionary tale, illustrating the\u00a0risks involved in drawing a theoretical hypothesis from an unexpected\u00a0observation. Further, I draw attention to the tendency in contemporary\u00a0clinical research with CFS to promote new research directions on the\u00a0basis of reductive causal models of that syndrome.\u00a0 Particularly, in the\u00a0case of CFS research, underdetermination and causal complexity undermine\u00a0the potential value of a monocausal claim.<\/p>\n
In sum, when an unexpected\u00a0finding occurs in clinical practice or medical research, the value of\u00a0following up on that finding is to be found not in the projected value\u00a0of a singular causal relationship inferred from the finding but rather\u00a0in the process of research that follows.<\/p>\n
Unexpected findings and promoting monocausal claims, a cautionary tale<\/a>, by\u00a0Samantha Marie Copeland in<\/span> Journal of Evaluation in Clinical Practice<\/em> [Published online 10 Jun 2016]<\/p>\n NB The Norwegian researchers have never made a ‘monocausal claim’ for CFS and there is no sign that research has been limited as a result of their speculation.<\/p>\n","protected":false},"excerpt":{"rendered":" Article abstract: Stories of serendipitous discoveries in medicine incorrectly imply that\u00a0the path from an unexpected observation to major discovery is\u00a0straightforward or guaranteed. In this paper, I examine a case from the\u00a0field of research about chronic fatigue syndrome (CFS). In Norway, … Continue reading