Causal and Associational Language in Observational Health Research: A Systematic Evaluation. Issue 12 (4th August 2022)

• Record Type: Journal Article
• 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;
• Is Part Of: American journal of epidemiology. Volume 191:Issue 12(2022)
• Page Start: 2084
• Page End: 2097
• Publication Date: 2022-08-04
• Subjects: association -- causal inference -- causal language -- observational study; Epidemiology -- Periodicals; Public health -- Periodicals; 614.4
• DOI: 10.1093/aje/kwac137
• Languages: English
• ISSNs: 0002-9262

Abstract

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.