pubmed.ncbi.nlm.nih.gov

Causality and causal inference in epidemiology: the need for a pluralistic approach - PubMed

  • ️Fri Jan 01 2016

Causality and causal inference in epidemiology: the need for a pluralistic approach

Jan P Vandenbroucke et al. Int J Epidemiol. 2016.

Abstract

Causal inference based on a restricted version of the potential outcomes approach reasoning is assuming an increasingly prominent place in the teaching and practice of epidemiology. The proposed concepts and methods are useful for particular problems, but it would be of concern if the theory and practice of the complete field of epidemiology were to become restricted to this single approach to causal inference. Our concerns are that this theory restricts the questions that epidemiologists may ask and the study designs that they may consider. It also restricts the evidence that may be considered acceptable to assess causality, and thereby the evidence that may be considered acceptable for scientific and public health decision making. These restrictions are based on a particular conceptual framework for thinking about causality. In Section 1, we describe the characteristics of the restricted potential outcomes approach (RPOA) and show that there is a methodological movement which advocates these principles, not just for solving particular problems, but as ideals for which epidemiology as a whole should strive. In Section 2, we seek to show that the limitation of epidemiology to one particular view of the nature of causality is problematic. In Section 3, we argue that the RPOA is also problematic with regard to the assessment of causality. We argue that it threatens to restrict study design choice, to wrongly discredit the results of types of observational studies that have been very useful in the past and to damage the teaching of epidemiological reasoning. Finally, in Section 4 we set out what we regard as a more reasonable 'working hypothesis' as to the nature of causality and its assessment: pragmatic pluralism.

© The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

PubMed Disclaimer

Figures

Figure 1
Figure 1

Fitting the restricted potential outcomes approach (RPOA), as advocated in epidemiology, in a family tree of theories on causality.

Comment in

Similar articles

Cited by

References

    1. Hill AB. The Enviroment and Disease: Association of Causation? Proc R Soc Med 1965;58:295–300. - PMC - PubMed
    1. Bird A. The epistemological function of Hill’s criteria. Prev Med 2011;53:242–45. - PubMed
    1. Hernán MA, Robins JM. Causal Inference. July 2015. http://cdn1.sph.harvard.edu/wp-content/uploads/sites/1268/2015/07/hernan.... (14 August 2015, date last accessed).
    1. Hernan MA. Invited commentary: hypothetical interventions to define causal effects – afterthought or prerequisite? Am J Epidemiol 2005;162:618–20; discussion 621–12. - PubMed
    1. Hernan MA, Taubman SL. Does obesity shorten life? The importance of well-defined interventions to answer causal questions. Int J Obes (Lond) 2008;32Suppl 3):S8–14. - PubMed

Publication types

MeSH terms