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To
distinguish cause from simple association several factors need to be considered. Hill’s
Criteria outline these. Strength of
association: the stronger the association between a putative cause and effect, the
more likely there is to be a connection between the two.
Timing: The cause should precede the effect. Never the
other way around.
Distribution: The spatial distribution of the disease should approximate to the
spatial distribution of the causal agent.
Gradient: The response should correlate with the dose; more
dose=more effect.
Consistency: The cause-effect relationship needs to be
duplicated in different studies in different places.
Specificity: People not exposed to the cause should not
develop the effect.
Biological plausibility: the biological activity of the
suspected cause should be consistent with its effects.
Experimental models: animal or other experimental models
should demonstrate the effect under experimental conditions.
Preventive trials: removal of the suspected cause should
lead to removal of the effect. |