Theory and methods
Causation in epidemiology
M Parascandola, D L Weed
Cancer
Prevention Fellowship Program, Office of Preventive Oncology, National
Cancer Institute, Executive Plaza South, Suite T-41, 6120 Executive
Blvd, MSC 7105, Bethesda, MD 20892-7105, USA
Correspondence to: Dr Parascandola (paramark{at}mail.nih.gov)
Accepted for publication 22 May 2001
Causation is an essential concept in epidemiology, yet there is
no single, clearly articulated definition for the discipline. From a
systematic review of the literature, five categories can be delineated:
production, necessary and sufficient, sufficient-component, counterfactual, and probabilistic. Strengths and weaknesses of these
categories are examined in terms of proposed characteristics of a
useful scientific definition of causation: it must be
specific enough to distinguish causation from mere correlation, but
not so narrow as to eliminate apparent causal phenomena from
consideration. Two categories
production and counterfactualare
present in any definition of causation but are not themselves
sufficient as definitions. The necessary and sufficient cause
definition assumes that all causes are deterministic. The
sufficient-component cause definition attempts to explain probabilistic
phenomena via unknown component causes. Thus, on both of these views,
heavy smoking can be cited as a cause of lung cancer only when the
existence of unknown deterministic variables is assumed. The
probabilistic definition, however, avoids these assumptions and appears
to best fit the characteristics of a useful definition of causation. It
is also concluded that the probabilistic definition is consistent with
scientific and public health goals of epidemiology. In debates in the
literature over these goals, proponents of epidemiology as pure science
tend to favour a narrower deterministic notion of causation models while proponents of epidemiology as public health tend to favour a
probabilistic view. The authors argue that a single definition of
causation for the discipline should be and is consistent with both of
these aims. It is concluded that a counterfactually-based probabilistic
definition is more amenable to the quantitative tools of epidemiology,
is consistent with both deterministic and probabilistic phenomena, and
serves equally well for the acquisition and the application of
scientific knowledge.
Keywords: causality; counterfactual; philosophy
© 2001 by Journal of Epidemiology and Community Health
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Aranaz-Andres, J M, Aibar-Remon, C, Vitaller-Murillo, J, Ruiz-Lopez, P, Limon-Ramirez, R, Terol-Garcia, E, the ENEAS work group,
(2008). Incidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events. J. Epidemiol. Community Health
62: 1022-1029
[Abstract] [Full Text] -
Macleod, J.
(2007). Cannabis use and psychosis: the origins and implications of an association. Adv. Psychiatr. Treat.
13: 400-411
[Abstract] [Full Text] -
Shields, P. G.
(2006). Understanding population and individual risk assessment: the case of polychlorinated biphenyls.. Cancer Epidemiol. Biomarkers Prev.
15: 830-839
[Abstract] [Full Text] -
Hoffmann, K., Heidemann, C., Weikert, C., Schulze, M. B., Boeing, H.
(2006). Estimating the Proportion of Disease due to Classes of Sufficient Causes. Am J Epidemiol
163: 76-83
[Abstract] [Full Text] -
Thygesen, L. C., Andersen, G. S., Andersen, H.
(2005). A philosophical analysis of the Hill criteria. J. Epidemiol. Community Health
59: 512-516
[Abstract] [Full Text] -
Rychetnik, L., Hawe, P., Waters, E., Barratt, A., Frommer, M.
(2004). A glossary for evidence based public health. J. Epidemiol. Community Health
58: 538-545
[Abstract] [Full Text] -
Macleod, J, Davey Smith, G
(2003). Psychosocial factors and public health: a suitable case for treatment?. J. Epidemiol. Community Health
57: 565-570
[Abstract] [Full Text] -
Tam, C C, Lopman, B A
(2003). Determinism versus stochasticism: in support of long coffee breaks. J. Epidemiol. Community Health
57: 477-478
[Full Text] -
Olsen, J
(2003). What characterises a useful concept of causation in epidemiology?. J. Epidemiol. Community Health
57: 86-88
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
