Causal inference in epidemiology: potential outcomes, pluralism and peer review

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Abstract
Now that two groups have challenged the idea that the potential outcomes (counterfactual) approach (POA) is the only legitimate approach to causal inference in epidemiology, I fully expect the supporters of that view to either defend their position or offer an olive branch to appease their critics. The debate is engaged and best left to those in academic towers where these arguments mean something. In the practice of epidemiology, despite what Vandenbroucke et al.1 and Krieger and Davey Smith2 contend, the presumed negative impact of POA has yet to be realized. No journal requires it. Sometimes counterfactuals and DAGs appear and often they do not. In the complex and ever-expanding worlds of regulation and litigation, where epidemiology plays a key role, POA is at best a whisper. Simply put, the debate about whether POA is the only legitimate approach to causal inference in epidemiology is as much about the power of individuals at certain academic institutions to gain attention as it is about the intellectual competitions that excite so-called ‘theoreticians’ of epidemiology. It remains to be seen if the exclusivity claim is really a critical issue for the future of epidemiology.

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