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

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 l...

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Published in:	American journal of epidemiology Vol. 191; no. 12; pp. 2084 - 2097
Main Authors:	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, Clémence, 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, Peña, Sebastián, Axfors, Cathrine, Khan, Palwasha, Rivera Aguirre, Ariadne E, Odo, Nnaemeka U, Schmid, Ian, Fox, Matthew P
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 19-11-2022
Subjects:	Biomedical Research Causality Humans Language Medicin och hälsovetenskap Practice of Epidemiology association causal inference causal language observational study
Online Access:	Get full text
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0002-9262 1476-6256 1476-6256
DOI:	10.1093/aje/kwac137