Causal and Associational Language in Observational Health Research: A Systematic Evaluation

Haber, Noah A.; Wieten, Sarah E.; Rohrer, Julia M.; Arah, Onyebuchi A.; Tennant, Peter W. G.; Stuart, Elizabeth A.; Murray, Eleanor J.; Pilleron, Sophie; Lam, Sze Tung; Riederer, Emily; Howcutt, Sarah Jane; Simmons, Alison E.; Leyrat, Clemence; Schoenegger, Philipp; Booman, Anna; Dufour, Mi-Suk Kang; O'Donoghue, Ashley L.; Baglini, Rebekah; Do, Stefanie; Takashima, Mari De la Rosa; Evans, Thomas Rhys; Rodriguez-Molina, Daloha; Alsalti, Taym M.; Dunleavy, Daniel J.; Meyerowitz-Katz, Gideon; Antonietti, Alberto; Calvache, Jose A.; Kelson, Mark J.; Salvia, Meg G.; Parra, Camila Olarte; Khalatbari-Soltani, Saman; McLinden, Taylor; Chatton, Arthur; Seiler, Jessie; Steriu, Andreea; Alshihayb, Talal S.; Twardowski, Sarah E.; Dabravolskaj, Julia; Au, Eric; Hoopsick, Rachel A.; Suresh, Shashank; Judd, Nicholas; Pena, Sebastian; Axfors, Cathrine; Khan, Palwasha; Aguirre, Ariadne E. Rivera; Odo, Nnaemeka U.; Schmid, Ian und Fox, Matthew P. (2022): Causal and Associational Language in Observational Health Research: A Systematic Evaluation. In: American Journal of Epidemiology, Vol. 191, No. 12: pp. 2084-2097

Abstract

We estimated the degree to which language used in the high-profile medical/public health/epidemiology literature implied causality using language linking exposures to outcomes and action recommendations;examined disconnects between language and recommendations;identified the most common linking phrases;and estimated how strongly linking phrases imply causality. We searched for and screened 1,170 articles from 18 high-profile journals (65 per journal) published from 2010-2019. Based on written framing and systematic guidance, 3 reviewers rated the degree of causality implied in abstracts and full text for exposure/outcome linking language and action recommendations. Reviewers rated the causal implication of exposure/outcome linking language as none (no causal implication) in 13.8%, weak in 34.2%, moderate in 33.2%, and strong in 18.7% of abstracts. The implied causality of action recommendations was higher than the implied causality of linking sentences for 44.5% or commensurate for 40.3% of articles. The most common linking word in abstracts was associate (45.7%). Reviewers' ratings of linking word roots were highly heterogeneous;over half of reviewers rated association as having at least some causal implication. This research undercuts the assumption that avoiding causal words leads to clarity of interpretation in medical research.

• Item Type: Journal article
• Faculties: Medicine; Medicine > Institute and Polyclinic for Occupational, Social and Environmental Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 0002-9262
• Language: English