- Haber, Noah A;
- Wieten, Sarah E;
- Rohrer, Julia M;
- Arah, Onyebuchi A;
- Tennant, Peter WG;
- 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;
- De La Rosa Takashima, Mari;
- 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;
- Aguirre, Ariadne E Rivera;
- Odo, Nnaemeka U;
- Schmid, Ian;
- Fox, Matthew P
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.