Causal Inference: A Thought Experiment

Ezra Susser, Sharon Schwartz, Alfredo Morabia and Evelyn J. Bromet

in Psychiatric Epidemiology

Published in print July 2006 | ISBN: 9780195101812
Published online September 2009 | e-ISBN: 9780199864096 | DOI:

Series: Oxford Psychiatry Series

Causal Inference: A Thought Experiment

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  • Public Health and Epidemiology
  • Medical Statistics and Methodology


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A cohort study is always a kind of ‘thought experiment’. One needs to imagine what results ‘would have been’ if the exposed and the unexposed groups had in fact been fully comparable. This chapter sets up a framework for conducting this thought experiment in a systematic way. The exposed and unexposed may differ on (1) other causes of the disease (confounding); (2) the length of time over which they are observed (unequal attrition); and (3) the accuracy with which cases are ascertained (differential misclassification). Each of these factors may account for part, or even all, of an apparent association between the exposure and the disease. They can also suppress an association or reverse it. The process of causal inference depends upon the identification and evaluation of these alternative explanations for results. This chapter shows how confounding, unequal attrition, and differential misclassification can produce an association between exposure and disease.

Keywords: causation; confounding; unequal attrition; differential misclassification; cohort study

Chapter.  3679 words.  Illustrated.

Subjects: Public Health and Epidemiology ; Medical Statistics and Methodology

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