An Interactive Annotated World Bibliography of Printed and Digital Works in the History of Medicine and the Life Sciences from Circa 2000 BCE to 2022 by Fielding H. Garrison (1870-1935), Leslie T. Morton (1907-2004), and Jeremy M. Norman (1945- ) Traditionally Known as “Garrison-Morton”

15951 entries, 13922 authors and 1934 subjects. Updated: November 30, 2023

HILL, Sir Austin Bradford

2 entries
  • 3215.2

Smoking and carcinoma of the lung. Preliminary report.

Brit. med. J., 2, 739-48, 1950.

A study of 1,465 cases of lung cancer and 1,465 matched controls, which confirmed and extended the studies of Wynder and Graham, and others. See also later papers by the same authors in Brit. med. J., 1952, 2,1271-86; 1956, 2, 1071-81; 1964, 1, 1399-1410.

Subjects: EPIDEMIOLOGY, ONCOLOGY & CANCER › Carcinoma, RESPIRATION › Respiratory Diseases, TOXICOLOGY › Drug Addiction
  • 10883

The Environment and disease: Association or causation?

Proc. roy. Soc. Med., 58, 295-300., 1965.

"In 1965, the English statistician Sir Austin Bradford Hill proposed a set of nine criteria to provide epidemiologic evidence of a causal relationship between a presumed cause and an observed effect. (For example, he demonstrated the connection between cigarette smoking and lung cancer.) The list of the criteria is as follows:[1]

  1. Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.
  2. Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.
  3. Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.[1]
  4. Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
  5. Biological gradient: Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence.[1]
  6. Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).
  7. Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that "... lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations".
  8. Experiment: "Occasionally it is possible to appeal to experimental evidence".
  9. Analogy: The use of analogies or similarities between the observed association and any other associations.
  10. Some authors consider also, the Reversibility: If the cause is deleted then the effect should disappear as well" (Wikipedia article on Bradford Hill criteria, accessed 7-2019)