Skip to main content
Article thumbnail
Location of Repository

Causality in medicine: getting back to the Hill top

By John Worrall

Abstract

Evidence from randomized controlled trials (RCTs) is almost universally regarded as setting the "gold standard" for medical evidence. Claims that RCTs carry special epistemic weight are often based on the notion that evidence from randomized studies, and only such evidence, can establish that any observed connection between treatment and outcome was caused by the treatment on trial. Any non-randomized trial, on the contrary, inevitably leaves open the possibility that there is some underlying connection independent of receiving the treatment between outcome and one or more differentiating characteristics between those in the experimental and control groups; and hence inevitably leaves open the possibility that treatment and an observed better outcome were "merely correlated" rather than directly causally connected. Here I scrutinize this argument and point towards a more tenable and more modest position by recalling some of the forgotten insights of the RCT pioneer, Austin Bradford Hill

Topics: R Medicine (General)
Publisher: Elsevier
Year: 2011
DOI identifier: 10.1016/j.ypmed.2011.08.009
OAI identifier: oai:eprints.lse.ac.uk:38908
Provided by: LSE Research Online
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • http://www.elsevier.com/wps/fi... (external link)
  • http://eprints.lse.ac.uk/38908... (external link)
  • Suggested articles


    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.