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What criteria should we use for interpreting epidemiology?

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  • What criteria should we use for interpreting epidemiology?

    Dear all,

    Lately in my professional reading I have noticed that the standards of
    evidence varies greatly between different fields. For instance, the
    mode of establishing causality used in science (which was devised by
    Jakob Henle and Robert Koch for research in bacteriology) requires that
    in every single instance the effect follows the cause. By contrast
    epidemiology uses a system of causal inference that is based on the
    philosophies of David Hume and John Stuart Mill (Morabia, 2005). The
    question of identifying causes in epidemiology has always been a subject
    of controversy. For instance, the controversy over the
    interpretation of the statistical relationship between smoking and lung
    cancer caused a landmark debate in that field in the second half of the
    twentieth century. It led Bradford Hill to formulate the "pragmatics" of
    risk factor epidemiology in 1965 (Berlivet, 2005). His model for
    establishing causation ("The Hill causation model") is well known in the
    public health field and widely used. For example Hill's nine proposed
    "criteria" for determining causation were used was used to classify
    Chrysotile asbestos as a cause of mesothelioma (Lemen, 2004); it met all
    nine of them. However, "multiple causation" is the canon of contemporary
    epidemiology and its "web of causation" is widely accepted though it is
    a very poorly elaborated model (Krieger, 1994). Sadly public heath
    debates these days are often based on evidence that use it in
    questionable ways and this topic clearly deserves further debate. Has
    anyone found a good review of criteria currently in use for interpreting


    David McFarlane MAppSc (Ergonomics)
    Ergonomist, WorkCover NSW


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