Hill, Austin Bradford

The best break we have had with cancer has come from epidemiology. Concerned with rising British mortality from lung cancer, the Medical Research Council, in 1947, commissioned Austin Bradford Hill (1897-1991) and Richard Doll (1912-) to analyse the possible causes. Their meticulous statistical survey (published in 1951) of patients from twenty London hospitals showed that smoking is a factor, and an important factor, in the production of cancer of the lung. ... 

Although many examples of clinical investigation can be found throughout the history of medicine, the RCT emerged in the mid-20th century as the most powerful and scientifically sound way to establish the efficacy and safety of medicines. In 1948, Austin Bradford Hill used the statistical method of randomization with concealment of the allocation code to reduce biases related to selection and analysis of patients... 

Silverman, W A., and I. Chalmers. Sir Austin Bradford Hill An Appreciation. Controlled Clinical Trials 13 (1992) 100-105. 

In 1965, Sir Austin Bradford Hill expanded on these criteia in his Environment and Disease Association or Causation (Hill 1965). The article has been widely cited in journal articles, by health risk assessors, and by health risk assessment gnid-ance including that of EPA (2005) and WHO (1999). In his article. Hill described what he referred to as aspects of an association between an environmental exposure and disease that should be considered before detemining that the environmental exposure is causally associated with the disease. These aspects have commonly been referred to as criteria in the Uterature, although Hill nevCT referred to them as such. The aspects that Hill described are ... 

The remainder of this chapter discusses the evidence for the various causal relationships between Pb exposure and toxicity and disease. As set forth in Table 21.2, adverse human health effects of lead are placed in causal context using the nine proofs-of-causality criteria first enunciated by British medical statistician Sir Austin Bradford Hill in 1965 and subsequently labeled Hill s Criteria of Causation. These criteria are relevant and of particular value in the environmental epidemiology of Pb, given the many contentious arguments over association versus cause that have been lodged against Pb s human health impacts, particularly in earlier eras of lead health research and in the evolution of Pb as a major public health factor. 

In the context of medical causation. Sir Austin Bradford Hill, suggested in 1965 that to imply causation from the observation of association we should consider its (1) strength, (2) consistency, (3) specificity - the restriction to specific conditions, (4) temporality - the order of events, (5) dose-response relationship, (6) theoretical plausibility, and (7) coherence - the consistency with other related phenomena. Although these guidelines were presented in the context of medicine and epidemiology, it would be very usefiil to keep these necessary conditions for causality in mind when evaluating crash causation on the basis of statistical associations. 

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