Association and Causation Discussion

Association and Causation Discussion essay assignment

The differences between association and causation. Association is when two variables are related, we say that there is an association between them. When researchers find a correlation, which can also be called an association, what they are saying is that they found a relationship between two, or more, variables. Causal has one variable that has a direct influence on the other, this is called a causal relationship. Causality can only be determined by reasoning about how the data were collected. The data values themselves contain no information that can help you to decide. If two variables are causally related, it is possible to conclude that changes to the explanatory variable, X, will have a direct impact on Y. If one variable causally affects the other, then adjusting the value of that variable will cause the other to change. Obviously, it is much more difficult to prove causation than it is to prove an association.

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The Bradford Hill criteria are widely used in epidemiology as a framework with which to assess whether an observed association is likely to be causal. 1. Strength of association, 2. Consistency, 3. Specificity, 4. Temporal sequence, 5. Biological gradient, 6. Biological plausibility, 7. Coherence, 8. Experiment, 9. Analogy. Although widely used, the criteria are not without criticism. Rothman argues that Hill did not propose these criteria as a checklist for evaluating whether a reported association might be interpreted as causal, but they have been widely applied in this way. He contends that the Bradford Hill criteria fail to deliver on the hope of clearly distinguishing causal from non-causal relations. For example, the first criterion ‘strength of association’ does not take into account the fact that not every component cause will have a strong association with the disease it produces, or that strength of association also depends on the prevalence of other factors. In terms of the third criterion, ‘specificity’, which suggests that a relationship is more likely to be causal if the exposure is related to a single outcome, Rothman argues that this criterion is misleading as a cause may have many effects, for example, smoking. The fifth criterion, ‘biological gradient’ suggests that the plausibility of a causal association is increased if a dose-response curve can be demonstrated. However, such relationships may also result from confounding or other biases (Association and Causation, 2018).

If a relationship is causal, four types of causal relationships are possible: (1) necessary and sufficient; (2) necessary, but not sufficient; (3) sufficient, but not necessary; and (4) neither sufficient nor necessary. The aim of this study was to analyze the difference between association and causation, applying the criteria of causality to the specific case of the association between endodontic disease and systemic diseases, taking as an example the case of diabetes mellitus. The association between the outcome of RCT (Root canal treatment) and diabetes seems to fulfill most of Hill’s causation criteria, the design of the studies on which this conclusion is based does not rule out the presence of confounding variables. In particular, the higher percentage of RFT (Root filled teeth) with apical periodontitis and lower retention of RFT teeth in diabetics could reflect not only the success rate of RCT and the healing of AP (Apical periodontitis) but also the incidence of caries and periodontal disease in diabetic subjects. Unfortunately, studies relating these variables (diabetes, caries, periodontal disease, AP, RFT and extractions, including the primary cause of extraction) are lacking. These conclusions should be translated to the clinical practice. Dentists should be aware of the relationship between DM and the outcome of RCT, considering diabetes as a preoperative factor that could influence the outcome of the root canal treatment (Segura? Egea, Cabanillas? Balsera, Jiménez? Sánchez, & Martín? González, 2019).

References

Association and Causation. (2018). Retrieved from https://www.healthknowledge.org.uk/public-health-t…

Segura? Egea, J.J., Cabanillas? Balsera, D., Jiménez? Sánchez, M.C., & Martín? González, J. (2019). Endodontics and diabetes: association versus causation. International Endodontic Journal. 52. pp 790– 802. doi.org/10.1111/iej.13079.

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Association and Causation Discussion