On Tuesday I sent the following query:

"The word 'determinant' seems to be used to describe a risk factor for an
outcome.  This always strikes me as a misleading usage - sounds as if having
the risk factor determines that I will get the outcome.

Is this an acceptable usage of the word?  It certainly seems quite common in
medical literature.

How do relevant scientific medical dictionaries define the word?  (Being in
Malawi (Africa) I don't have ready access to these.)"



Thanks to the following from whom I've received responses: Paul Marchant,
John Whittington, Teresa Allan, Alison Macfarlane, David Scott and Peter
Das.

In summary referring to a risk factor as 'a determinant' seems to be
accepted usage, though several respondents shared my concern, and prefer to
use one of the terms 'predictor', 'risk factor' or 'factor associated with'.
I'll certainly continue to avoid use of the term determinant, and discourage
others from using it, but I'll refrain from saying it is wrong.

One respondent pointed out that the associated article is important, ie 'a
determinant' indicates that the factor is one among many, whereas 'the
determinant' would indicate that it is the only factor.

Two gave me useful dictionary websites: www.onelook.com and
www.yourdictionary.com, which others may also find useful.  Searching in
onelook identified definitions in 16 general, 5 medical and 3 science
dictionaries.  Some of these were for the mathematical determinant of a
matrix.

Definitions in Medical dictionaries include the following:
1 'The factor that contributes to the generation of a trait.'
2 'That which serves to determine; that which causes determination'
3 'A factor that establishes the nature of an entity or event.'
4 'Any factor, whether event, characteristic, or other definable entity,
that brings about change in a health condition, or in other defined
characteristics' - from a glossary of Epidemiology terms.
They also give specific definitions for each of the following types of
determinants: allotypic, antigenic, hidden, immunogenic and sequential.

Among the general dictionaries these are typical:
5 'a factor that causes or influences something'
6 'An influencing or determining element or factor: "Education is the second
most important determinant of recreational participation" (John P.
Robinson)'
7 'That which serves to determine; that which causes determination'

There's a mixture of meanings, with some corresponding with the indefinite
article (eg 1) and others with the definite article (eg 2 and 4).

Appended below are extracts from responses which may be of interest to some
list-users.

thanks to all respondents,
Sarah White

Extracts from responses received:
I think this is more a question of _general_ usage of the word than
anything to do with scientific/medical usage.  It's all to do with the
associated 'article' .... 'a determinant' and 'the determinant' have very
different connotations in general usage.

I think it is perfectly reasonable, and 'standard practice' to talk about a
factor as being 'A determinant' of an outcome (NOT 'THE determinant') if it
is but one of many operative factors - and that does not imply that it is a
'stand-alone' factor.  For example, it's reasonable enough to say that
family history will often be 'a determinant' of the likelihood of an
individual developing a certain disease.

However, that's all a personal view/observation.  I can understand your
concern, so if one wishes to avoid the potential ambiguity, it's probably
best to stick to 'risk factor' or some such form of words.


The authoritative Dutch/Belgian "Codex Medicus" (10th ed. Elsevier 1996
, Eyskens, Feenstra, Meinders and Vandenbroucke, eds) mentions the word
1: under Medical genetics and molecular biology where it says that
Mendel called the gene the hereditary determinant,
2: as a general term indicating that a first phenomenon (=determinant)
influences a following second phenomenon (=result) and equates
determinant with the independent explanatory variable.