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Arthur J. Reynolds, PhD

Arch Pediatr Adolesc Med. 2008;162(11):1101.

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The most widely accepted causal relationship in the behavioral sciences is smoking and lung cancer. Support for this inference is completely based on observational studies with critical attention to substantive knowledge and the well-known causal criteria of gradient (dose-response), consistency and specificity of observed effects, magnitude, and coherence, which is assessed through the identification of causal mechanisms.¹ Applied to interventions, such comprehensive analysis is consistent with confirmatory evaluation.²

The perspective advocated by Olds seems to assume falsely that only RCTs can provide scientifically valid inferences about effects and that they do not create "limits that deserve consideration." As research on smoking shows, true validity is based on a critical analysis of evidence within the context of substantive and theoretical knowledge about causal mechanisms. Our studies have followed a similar comprehensive framework.^3-4 Selection of a particular approach is not absolute. It should be based on . . . [Full Text of this Article]

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