The Bradford Hill considerations on causality: a counterfactual perspective

Area of Science:

• Epidemiology
• Causal Inference
• Biostatistics

Background:

• Bradford Hill's 1965 criteria significantly influenced distinguishing causal from non-causal associations.
• These criteria were often misused as a checklist, deviating from Hill's original intent.
• Hill did not explicitly define "causal effect" in his considerations.

Purpose of the Study:

• To provide a novel perspective on Hill's causality considerations through the lens of counterfactual causality.
• To explore how counterfactual arguments inform the application of Hill's criteria.
• To discuss the implications for study design and data analysis.

Main Methods:

• Counterfactual causality framework.
• Analysis of the complexity and heuristic value of Hill's considerations within causal systems.
• Discussion of multiple bias modeling (Bayesian methods, Monte Carlo sensitivity analysis).

Main Results:

• Counterfactual arguments are crucial for determining the appropriate application of Hill's considerations.
• The heuristic value of some criteria diminishes with increasing system complexity, raising the risk of misapplication.
• Multiple bias modeling is identified as a key tool for assessing the applicability of Hill's considerations.

Conclusions:

• Counterfactual causality offers a valuable framework for understanding and applying Hill's considerations.
• Careful consideration of system complexity is needed to avoid misinterpreting associations.
• Increased utilization of multiple bias modeling is recommended for robust causal inference.