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Cause and effect: The epidemiological approach 

Cause and effect: The epidemiological approach
Cause and effect: The epidemiological approach

Raj S. Bhopal

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date: 25 October 2020

Cause and effect understanding is the highest form of scientific knowledge. In epidemiology, demonstrating causality is difficult because of the long and complex natural history of many human diseases and because of ethical restraints. Epidemiologists should: hold the attitude that all judgements of cause and effect are tentative; understand that causal thinking demands a judgement; be alert for the play of chance, error, and bias; always consider reverse causality and confounding, utilize the power of causal models that broaden causal perspectives; apply guidelines for causality as an aid to thinking and not as a checklist; and look for corroboration of causality from other scientific frameworks for assessment of cause and effect. The ultimate aim of epidemiology is to use knowledge of cause and effect to break links between disease and its causes and to improve health. The application of erroneous knowledge has serious repercussions.

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