8-2 Activity: Causation


The relationship between exposure and a disease needs to be verified before epidemiologists can base a clinical decision on it. What seems to be a cause can turn out to be a bias or a random error, or even a confounding. Therefore, the relationship must be tested according to certain criteria to verify it is a sufficient component cause. You can use Hill’s guidelines to evaluate the causal evidence in a relationship between an exposure and a disease.


For this evaluation, select an exposure-disease relationship. Then assess the causal evidence of that relationship. Use at least four criteria from the following list of Hill’s guidelines and determine whether there is adequate evidence supporting each of the criteria.

  • Strength of association
  • Consistency
  • Specificity
  • Temporality
  • Biological gradient
  • Plausibility
  • Coherence
  • Experiment
  • Analogy

Specifically, you must address the following rubric criteria:

  • Exposure-Disease Relationship: State the exposure-disease relationship you selected.
  • Hill’s Guidelines: Identify four of Hill’s guidelines you can use to validate the causal relationship and explain why you selected these four guidelines for validation.
  • Causal Evidence: Provide one piece of evidence for each guideline you selected and explain how it supports the criteria and proves causality in the relationship. Evidence must be from scholarly sources.
  • Conclusion: Explain whether there is adequate evidence to prove the exposure-disease relationship.

What to Submit

Your submission should be a 2- to 3-page Word document. You must also include an APA-style title page. Use 12-point Times New Roman font, double spacing, and one-inch margins. Sources should be cited according to APA style.


Disease-exposure relationship to reference in assignment is: Smoking and lung cancer


Article that references Hills theory of causation

Shimonovich, M., Pearce, A., Thomson, H. et al. Assessing causality in epidemiology: revisiting Bradford Hill to incorporate developments in causal thinking. Eur J Epidemiol 36, 873–887 (2021). https://doi.org/10.1007/s10654-020-00703-7

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