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International Journal of Epidemiology, Vol 26, 1137-1141, Copyright © 1997 by International Epidemiological Association
DL Weed
BACKGROUND: Two recent accounts of the use of causal criteria make opposite
claims: that criteria should be used more often to avoid bias in
assessments of weak associations and, in direct contrast, that criteria are
scientifically invalid. METHODS: A recent review of the current practice of
causal inference in epidemiology, as well as some more theoretical
concerns, reveals errors in the two claims. RESULTS: In practice,
epidemiologists often use the criteria of consistency, strength,
dose-response, and biological plausibility, but not often temporality, when
judging weak associations. These criteria are used for causal assessments
as well as for making public health recommendations. In theory, causal
criteria can be used to either refute or predict causal effects.
CONCLUSION: Research on causal inference methodology should be encouraged,
including research on underlying theory, methodology, and additional
systematic descriptions of how causal inference is practised. Specific
research questions include: to what extent can consensus be achieved on
definitions and accompanying rules of inference for criteria, the
relationship of meta- analysis to the criterion of consistency, and the
interrelationships of criteria such as consistency, strength of
association, and biological plausibility.
ARTICLES
On the use of causal criteria
Preventive Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
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