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Strength in causality: discerning causal mechanisms in the sufficient cause model
European Journal of Epidemiology ( IF 13.6 ) Pub Date : 2021-09-26 , DOI: 10.1007/s10654-021-00798-6
Etsuji Suzuki 1 , Eiji Yamamoto 2
Affiliation  

The assessment of causality is fundamental to epidemiology and biomedical sciences. One well-known approach to distinguishing causal from noncausal explanations is the nine Bradford Hill viewpoints. A recent article in this journal revisited the viewpoints to incorporate developments in causal thinking, suggesting that the sufficient cause model is useful in elucidating the theoretical underpinning of the first of the nine viewpoints—strength of association. In this article, we discuss how to discern the causal mechanisms of interest in the sufficient cause model, which pays closer attention to the relationship between the sufficient cause model and the Bradford Hill viewpoints. To this end, we explicate the link between the sufficient cause model and the potential-outcome model, both of which have become the cornerstone of causal thinking in epidemiology and biomedicine. A clearer understanding of the link between the two models provides significant implications for interpretation of the observed risks in the subpopulations defined by exposure and confounder. We also show that the concept of potential completion times of sufficient causes is useful to fully discerning completed sufficient causes, which leads us to pay closer attention to the fourth of the nine Bradford Hill viewpoints—temporality. Decades after its introduction, the sufficient cause model may be vaguely understood and thus implicitly used under unreasonably strict assumptions. To strengthen our assessment in the face of multifactorial causality, it is significant to carefully scrutinize the observed associations in a complementary manner, using the sufficient cause model as well as its relevant causal models.



中文翻译:

因果关系的力量:在充分原因模型中辨别因果机制

因果关系的评估是流行病学和生物医学科学的基础。区分因果解释和非因果解释的一种众所周知的方法是布拉德福德希尔的九种观点。该杂志最近的一篇文章重新审视了这些观点,以纳入因果思维的发展,表明充分原因模型有助于阐明九种观点中第一种观点的理论基础——强度协会的。在本文中,我们讨论了如何在充分原因模型中识别感兴趣的因果机制,该模型更关注充分原因模型与 Bradford Hill 观点之间的关系。为此,我们解释了充分原因模型和潜在结果模型之间的联系,这两者都已成为流行病学和生物医学中因果思维的基石。更清楚地了解这两个模型之间的联系,对于解释由暴露和混杂因素定义的亚群中观察到的风险具有重要意义。我们还表明,充分原因的潜在完成时间的概念对于完全辨别已完成的充分原因很有用,暂时性。在引入几十年后,充分原因模型可能被模糊地理解,因此在不合理的严格假设下隐含地使用。为了加强我们面对多因素因果关系的评估,使用充分原因模型及其相关因果模型以互补的方式仔细审查观察到的关联非常重要。

更新日期:2021-09-28
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