The surgeon general's "epidemiologic criteria for causality": a criticism of Burch's critique

In this paper, it has not been possible to critically and objectively assess each of the points made by Burch, since it would be time-consuming both for this author as well as for the reader. However, the major areas of concern expressed by Burch have been reviewed and evaluated. This has in many instances required going back to the original reports of studies to which Burch refers. In doing so, it came as a complete surprise to note that Burch has incompletely presented the findings of several studies or has omitted discussing others more fully. This is, needless to say, most disturbing. In viewing the issue of the causal interpretation of the cigarette smoking--lung cancer relationship, it would appear that Burch would not be satisfied unless there is a randomized controlled experiment in humans. However, since such an experiment seems hardly feasible, one must depend upon a synthesis of findings of epidemiologic observations, experimental work on animals and studies of chemical constituents of tobacco and cigarette smoke. However, these do not seem to satisfy Burch, who has developed a theoretical conceptual framework for the etiology of cancer and many other diseases, based upon statistical models and equations. Such an approach is extremely limited. Scientific information and inferences are in the public domain, thereby allowing criticism and evaluation. It is customary, in the experimental sciences, for a scientist who is dissatisfied with the findings of another scientist, to attempt to repeat the experiment to see if his findings are the same or different. This should also be expected in the cigarette smoking-lung cancer issue.(ABSTRACT TRUNCATED AT 250 WORDS)