Day 036 - 13 Oct 94 - Page 06


     
     1        A.  Go ahead.  I think I have finished.
     2
     3   Q.   The identification of mechanisms, hypothetical or
     4        plausible and, if possible, certain, has an important role
     5        to play in the aetiology of disease, does it not?
     6        A.  Can you say that question again?
     7
     8   Q.   The identification of mechanisms, whether hypothetical,
     9        plausible and (one most hope occasionally) certain, has an
    10        important role to play in the aetiology of disease, does
    11        it not?
    12        A.  The identification of mechanisms ----
    13
    14   Q.   Yes.
    15        A. - plays an important role in research.
    16
    17   Q.   Yes.
    18        A.  And is certainly something that is useful for
    19        researchers to try to sort out, but it is not essential in
    20        determining cause-and-effect or in overall, nor is it
    21        essential for determining public health information and
    22        public health interventions.
    23
    24   Q.   My word is not "essential", it was "important".
    25
    26   MR. JUSTICE BELL:  "Important role" was what Mr. Rampton said.
    27
    28   MR. RAMPTON:  An important role.
    29        A.  I am having difficulty sorting out what you are asking
    30        me.  You are saying the identification of mechanisms is
    31        important in -----
    32
    33   Q.   The aetiology of disease.
    34
    35   MR. JUSTICE BELL:  What it may be is in seeking to identify the
    36        aetiology of disease.
    37
    38   MR. RAMPTON:  Yes.
    39
    40   MR. JUSTICE BELL:  Are you content with that?
    41        A.  Yes.
    42
    43   MR. RAMPTON:  Can I put it in rather, perhaps, plainer
    44        English?  I do not know whether it is plainer or not.  The
    45        trouble is with plainer English, one tends to go off the
    46        rails if one is not careful.  If we want to be as sure as
    47        we can be that X causes Y, it helps to be able to say what
    48        is the mechanism by which that is thought to happen, does
    49        it not?
    50        A.  When one can do that it is very, very helpful.  It is 
    51        not essential, but when one can do that it certainly is 
    52        helpful. 
    53
    54   Q.   That is all, I think, I was putting to you.  May I read
    55        on:  "However, the overall impact of diet and cancer rates
    56        throughout the world appears to be significant.  For
    57        populations in developed countries where cancer rates are
    58        highest and account for approximately one and a quarter of
    59        all deaths, some epidemiologists estimate that 30 to 40
    60        per cent of cancers in men and up to 60 per cent of

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