10 Questions
What is the main difference between association and causation?
Association refers to a relationship between two variables, while causation indicates a cause-and-effect relationship.
What is the purpose of the Bradford-Hill criteria?
To judge when an association might be causal.
What is one of the key features of a strong association?
The relative risk is high (>1).
Which of the following is one of the Bradford-Hill criteria?
Plausibility.
What was the significance of the 1964 US Surgeon General's report on smoking?
It implicated tobacco as a cause of lung cancer.
What is the primary difference between association and causation?
Association is a statistical observation, while causation implies a true mechanism.
What is a necessary condition for establishing causality?
The exposure must precede the disease.
Which of the following is a threat to study validity?
Bias
What is the definition of a cause in the context of disease?
An event, condition, or characteristic that plays an important role in producing a disease.
When does an association imply causation?
When the association is accompanied by a true mechanism.
Study Notes
Evidence-Based Medicine
- Causality is a critical concept in evidence-based medicine.
Causality vs. Association
- Association is an identifiable relationship between an exposure and a disease, implying that the exposure might cause the disease.
- Causation implies a true mechanism that leads from exposure to disease.
- Association does not necessarily imply causation.
The Concept of Cause
- A cause is an event, condition, or characteristic that plays an important role in producing a disease.
- A cause must precede the disease.
- Removing exposure can reduce the disease rate.
- It's not necessary to understand all causal factors to prevent disease.
Bradford-Hill Criteria
- Strength: Is the risk so large that other factors can be ruled out?
- Consistency: Have the results been replicated by different researchers and under different conditions?
- Specificity: Is the exposure associated with a very specific disease?
- Temporality: Did the exposure precede the disease?
- Biological gradient: Are increasing exposures associated with increasing risks of disease?
- Plausibility: Is there a credible scientific mechanism that can explain the association?
- Coherence: Is the association consistent with the natural history of the disease?
- Experimental evidence: Does a physical intervention show results consistent with the association?
Strength of Association
- Strong associations are less likely to be caused by chance or bias.
- A strong association is one in which the relative risk is high (>1) or low (<1).
Examples of Causality
- Cigarette smoking causes lung cancer.
- HIV causes AIDS.
- Certain tampons cause toxic shock syndrome.
- Air pollution causes asthma.
- Zika virus causes microcephaly.
- SARS-Cov2 causes Covid-19.
This quiz covers the differences between association and causation, criteria for establishing causality, and threats to study validity in the context of evidence-based medicine.
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