# Unit 14: The Question of Causation

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1 Unit 14: The Question of Causation Prerequisites Even though there are no specific mathematical or statistical prerequisites, the ideas presented are too sophisticated for most pre-secondary students. Unit 12, Correlation, is helpful for full appreciation of this unit, but it is not an essential prerequisite. This video can also be shown in connection with science, because the issue of how to get evidence for cause-and-effect arises there. Activity Description In this activity, students are asked to use the Internet to find retrospective and prospective studies that have been conducted. To help narrow student searches, physical activity is specified as a suspected risk factor or protective factor for the retrospective study. For the prospective study, the outcome is specified as some disease or disorder. Question 3 is open and students are free to find any retrospective or prospective study. Give students an opportunity to share some of the studies they have found with the class. Unit 14: The Question of Causation Faculty Guide Page 1

2 The Video Solutions 1. People who have a higher standard of living are more likely to own multiple cars. Also, people who have more money tend to live longer, probably because they can afford excellent medical care and good quality food. The variable responsible for the car-lifespan association is wealth. 2. There could be a lurking variable, perhaps some gene, that made some people more apt to smoke but that also caused lung cancer. Hence, the lurking variable was the cause for the cancer, not the smoking. 3. A retrospective study takes a group of people say a group with lung cancer and looks back to see what characteristics members of the group have in common. With the lung cancer group, smoking stood out. A prospective study takes a group of people say a group that contains both smokers and nonsmokers but otherwise have many similar characteristics and then follows the group members over time. For example, years later the cancer rates in the smoking and nonsmoking group could be compared. 4. The smokers chose to smoke. Smoking was not imposed as a treatment on these group members. 5. The animal studies showed that smoking caused cancer in animals hence, it was carcinogenic. Unit 14: The Question of Causation Faculty Guide Page 2

3 Unit Activity Solutions 1. Sample study: Study involved 21 Type 2 diabetics; found increased physical activity associated with decreased healthcare costs. Data were gathered from participants previous medical records. This study does not prove that increased physical activity causes a decrease in healthcare costs. More evidence is needed. 2. Sample study: A prospective study involved 3,875 young adults (age 20 32) who were not diabetic at the time of the study. The study was conducted to assess whether there was an association between mercury levels (determined from toenail clippings) and incidence of diabetes. These young adults were followed for 18 years. The study found that there was a significantly higher risk of diabetes associated with greater levels of mercury exposure. Because this is not an experiment, the study does not prove that mercury exposure causes diabetes. 3. Sample study: A prospective study to see if emotions of younger adults were more affected by physical activity and sleep than older adults. Participants reported in diaries their current day s mood and physical activity, as well as how many hours of sleep they got the night before. They recorded this information for four weeks. Findings of the study indicate that emotions of younger adults were more affected by physical activity and sleep than emotions of older adults. Prospective studies do not prove cause-and-effect relationships. Unit 14: The Question of Causation Faculty Guide Page 3

5 records that were available. Study 1 is the prospective study. In that study, the group was all workers. Researchers had to wait until a worker was injured before following up to see if the worker had physical therapy or returned to work. b. Study 1 would be more costly. Researchers have to work over a period of years to both collect and analyze the data. In addition, the outcome of missed work due to a low-back injury is probably somewhat rare. So, the group to be followed would have to be pretty large. c. Sample answer: Even though prospective studies are generally preferred, in this case, the outcome, low-back pain due to injury, is probably somewhat uncommon. So, the cost and time required to conduct a prospective study makes it not feasible in this situation. Sources of the data for the retrospective study have already been identified. So, that study would be more cost-effective and faster to conduct. Unit 14: The Question of Causation Faculty Guide Page 5

6 Review Questions Solutions 1. Economic conditions may have improved over time, especially if the program was started during an economic downturn. Perhaps a major employer moved into the region during the four years. (Any change over the four years that helps employment is confounded with the training program.) 2. Positive association does not imply causation. Education, mental health, and home environment are other variables that might affect both marijuana usage and relationship problems for teens a number of years later. 3. This is not an experiment because nothing is actually done to the subjects. They are just observed over time. In particular, they choose whether to exercise. An experiment would assign subjects to different amounts of exercise. Instead, this is a prospective study. The two groups are chosen because they differ in the suspected cause (regular exercise) of reduced risk for heart disease. We follow them forward in time to observe the outcome of interest, whether they have heart attacks. 4. a. Clearly, Study 1 is a retrospective study. The men are dead so, it would not be possible to do a prospective study. b. Study 2 is a prospective study. The women joined the study and then the study followed them over time. c. Breast cancer rates are relatively low (even though it is a common cancer), so the group size being studied would need to be large. If not sufficiently large, there would be a risk that none of the participants in the study develop breast cancer. In a large group, it is likely that there will be sufficient numbers of women who develop breast cancer. In Study 1, since it is a retrospective study, we already have a sizable group of white men who had heart disease. We don t have to wait to see if the disease develops in a retrospective study. Unit 14: The Question of Causation Faculty Guide Page 6

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