B4094 - CAUSALITY IN MEDICINE

Conoscenze e abilità da conseguire

tudents who successfully complete this course will be able to:

• Design epidemiological and translational research and describe the advantages and limitations of each design for addressing specific problems, as well as the practical aspects of their uses
• Use appropriate methods of measurement (exposures and outcomes) and determine the validity and reliability of the instruments
• Identify and minimize sources of bias
• Combine evidence; make judgments about causal association, in particular in weak associations; and interpret the research results and their clinical/scientific/preventive relevance
• Assess false positive results and negative evidence
• Integrate different lines of epidemiologic research as well as mechanistic and experimental data
• Describe the main theories that try to explain biological aging.
• Describe the role of genes, lifestyle, and chance in influencing human longevity.

Programma/Contenuti

Module 1. Causality between science and philosophy

Francesco Bianchini, FILCOM

The concept of causality has a long history in philosophical and scientific thought and precedes the very birth of modern science. The module will be an introduction to the concept of causality both from a historical-philosophical and historical-scientific point of view from antiquity to the modern era, and from a theoretical and epistemological point of view. It will present the main contemporary approaches to causality and its relation to the notions of scientific explanation and mechanism. Finally, some specific philosophical questions related to causality in the world of life sciences, in particular biology and medicine, will be addressed.

The module will be divided into the following lessons:

Class 1: Causality in philosophy and the philosophy of science

Class 2: The scientific explanation and the relationship with causality

Class 3: Contemporary approaches to causality (including regularity, mechanistic approach, and interventionist approach)

Class 4: Philosophical aspects of causality in the life sciences.

The module will be taught in Italian or (on request) in English

Module 2. Causality in epidemiology and beyond

Paolo Boffetta, DIMEC

The module will review methods to review, summarize and integrate results from human and non-human studies to derive evidence-based judgments on the causal nature of associations observed in humans. The theoretical presentations will be supplemented by practical examples of associations whose causal scope has (or has not) been confirmed. The last session will consist of a practical on a real case; students will be provided with background documents during the previous sessions and will have to prepare short presentations on different aspects of the process of causality assessment (details will depend on the number and expertise of the students). Topics will include:

Class 1. Integration of human studies; meta-analyses

Class 2. Integration of human and non-human lines of evidence

Class 3. Classic guidelines for causality in observational studies and their evolution

Class 4. Practical: water chlorination byproducts and bladder cancer risk.

The module will be taught in English.

Module 3. Causality in biological aging

Antonello Lorenzini, DIBINEM

The aging process is considered by most experts as a spontaneous unplanned process. However, a comparative view shows that longevity is a characteristic closely linked to the species and therefore dependent on their genome. The recent discovery of epigenetic clocks that estimate chronological age with great accuracy suggests that strategies may exist to modulate this process at the same time allowing a rapid evaluation of the results. The module will stimulate discussion on the primary causes of aging and the molecular, cellular and systemic responses that have evolved to counter it. Topics will include:

Aging as programmed or stochastic process

Is Aging a pathology?

Mutations and aging

Epigenetic clocks

Calorie restriction and obesity

Role of genetics, chance and lifestyle on longevity

The module will be held either in Italian or (on request) in English.

Testi/Bibliografia

There is no textbook for the course. Reading materials will be distributed during the classes.

Modalità di verifica dell'apprendimento

The final grade comprises three components:

1. 30% of the grade will be based on attendance, class participation and participation in discussions held following or before lectures;
2. 50% of the grade will be based on an assay to be provided before the last class;
3. 20% of the grade will be based on the discussion (in English) of the assay during the final exam.

The assay (at least 3000 words or 12 slides) can be either individual- or group-based as long as the individual's contribution is clearly identifiable. It must be agreed with one of the lecturers, in agreement with the coordinator of the course.

Orario di ricevimento

Consulta il sito web di Paolo Boffetta

Consulta il sito web di Francesco Bianchini

Consulta il sito web di Antonello Lorenzini