American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which of the following is not one of the Bradford Hill Criteria?

1. Social desirability

2. Strength

3. Specificity

4. Biological gradient

The correct answer is: Social desirability

The Bradford Hill Criteria are a set of nine principles that help to establish a causal relationship between a presumed cause and an observed effect in epidemiology. Among these criteria, concepts such as strength, specificity, and biological gradient are indeed recognized components used to support causality. Strength refers to the intensity of the association between the exposure and the outcome; a strong association is more likely to indicate causation. Specificity relates to the idea that a cause should lead to a specific effect, meaning a particular exposure corresponds to a particular effect. Biological gradient, also known as a dose-response relationship, describes a situation where increasing levels of exposure lead to increasing levels of effect, further supporting the argument for causation. In contrast, social desirability is not one of the Bradford Hill Criteria. It pertains more to the bias that occurs in self-reported data, where respondents may alter their answers to be seen favorably in the eyes of others. Since it does not relate to the assessment of causality, it falls outside the framework established by the Bradford Hill Criteria.