Radiation biology. Radioecology
ISSN: 0869-8031

Archives → 2020 → V. 60. № 2. → pp. 115–152

Article

Hill’s Criteria “Temporality”. Reverse Causation and its Radiation Aspect

A. N. Koterova, L. N. Ushenkova, and A. P. Biryukov

A.I. Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia

Abstract

The review considers various aspects of the causality criterion «Temporality» and the corresponding confounders within the framework of temporal bias, including facts for radiation epidemiology. It is noted that this guideline is the only criterion in all sets of rules for assessing causation for non-experimental (descriptive) disciplines, since falsification of it immediately eliminates the likelihood of causality. The exact terminology of the criterion, its philosophical essence, going back to the works of D. Hume and J. Mill (the cause must be before the effect), the epidemiological meaning (the need to observe a plausible latent period for the pathology under study), as well as the difficulties of establishing time dependence in retrospective studies and its non-absoluteness for individual disciplines and situations in the biomedical field are analyzed. The definitions of the concept «reverse causation» (protopathic bias) from fundamental sources, as well as confounders close to it within the framework of temporal biases (indications, contraindications and severity of pathology/prognosis) are presented. Listed approaches to eliminate these temporal biases. There are numerous examples of reverse causation from both everyday life (sociology, political science and psychology), and from the field of epidemiology and medicine. The facts of reverse causation for carcinogenesis in radiation epidemiology are considered in detail, all of which are within the framework of diagnostic or therapeutic irradiation, often prescribed to patients with pre-existing conditions for malignant neoplasms. The most important example is irradiation of children and young people during computed tomography; the paper briefly reviewed all large-scale epidemiological studies on this theme (2012–2019) in relation to the problem of reverse causation. It is concluded that the review can serve for better orientation in the facts of reverse causation not only in epidemiology and medicine, but also in everyday life.

Keywords

temporal biases, criterion of causality “Temporality”, reverse causation, protopathic bias, confounding by indication, confounding by severity/prognosis, diagnostic exposure, CT scan