Bradford Hill criteria

The Bradford Hill criteria, otherwise known as Hill's criteria for causation, are a group of 9 principles, established in 1965 by the English epidemiologist Sir Austin Bradford Hill. They can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect and have been widely used in public health research. Their exact application and limits of the criteria continue to be debated. The Bradford Hill criteria, otherwise known as Hill's criteria for causation, are a group of 9 principles, established in 1965 by the English epidemiologist Sir Austin Bradford Hill. They can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect and have been widely used in public health research. Their exact application and limits of the criteria continue to be debated. In 1965, the English statistician Sir Austin Bradford Hill proposed a set of nine criteria to provide epidemiologic evidence of a causal relationship between a presumed cause and an observed effect. (For example, he demonstrated the connection between cigarette smoking and lung cancer.) The list of the criteria is as follows: Bradford Hill's criteria had been widely accepted as useful guidelines for investigating causality in epidemiological studies but their value has been questioned because they have become somewhat outdated. In addition, their method of application is debated. Some proposed options how to apply them include: An argument against the use of Bradford Hill criteria as exclusive considerations in proving causality is that the basic mechanism of proving causality is not in applying specific criteria—whether those of Bradford Hill or counterfactual argument—but in scientific common sense deduction. Others argue that the specific study from which data has been produced is important, and while the Bradford Hill criteria may be applied to test causality in these scenarios, the study type may rule out deducing or inducing causality, and the criteria are only of use in inferring the best explanation of this data. Debate over the scope of application of the criteria includes, whether they can be applied to social sciences. The argument proposes that there are different motives behind defining causality; the Bradford Hill criteria applied to complex systems such as health sciences are useful in prediction models where a consequence is sought; explanation models as to why causation occurred are deduced less easily from Bradford Hill criteria because the instigation of causation, rather than the consequence, is needed for these models. Researchers have applied Hill’s criteria for causality in examining the evidence in several areas of epidemiology, including connections between ultraviolet B radiation, vitamin D and cancer, vitamin D and pregnancy and neonatal outcomes, alcohol and cardiovascular disease outcomes, infections and risk of stroke, nutrition and biomarkers related to disease outcomes, and sugar-sweetened beverage consumption and the prevalence of obesity and obesity-related diseases. They have also been used in non-human epidemiological studies, such as on the effects of neonicotinoid pesticides on honey bees. Their use in quality improvement of health care services has been proposed, highlighting how quality improvement methods can be used to provide evidence for the criteria. Since the description of the criteria, many methods to systematically evaluate the evidence supporting a causal relationship have been published, for example the five evidence-grading criteria of the World Cancer Research Fund (Convincing; Probable; Limited evidence – suggestive; Limited evidence – no conclusion; Substantial effect on risk unlikely).