Bradford Hill Causation Criteria Explained for Legal Nurse Consultants

Understanding Medical Causation

Causation is critical in personal injury and workers' compensation cases. Determining whether an injury or condition was caused by a specific event requires systematic analysis. The Bradford Hill criteria provide a structured framework for evaluating medical causation in legal contexts.

Overview of the Bradford Hill Criteria

The nine considerations include:

• Temporality – Did the exposure precede the outcome?
• Strength of Association – How strong is the relationship?
• Dose-Response Relationship – Does increased exposure lead to increased effect?
• Consistency – Have different studies shown similar results?
• Plausibility – Is there a biological mechanism?
• Coherence – Does it align with existing knowledge?
• Experiment – Has it been demonstrated experimentally?
• Analogy – Are there similar cause-effect relationships?
• Specificity – Is the exposure associated with a specific outcome?

Applying the Criteria in Case Review

LNCs evaluate:

Timing of Exposure

Temporality is the only absolute criterion. For a workplace injury claim, the injury must occur after employment began and during work activities.

Pre-existing Conditions

Review medical history to identify conditions that existed before the alleged incident. Pre-existing conditions don't automatically negate causation, but they affect apportionment analysis.

Clinical Plausibility

Assess whether the proposed mechanism is medically plausible. Minor trauma is unlikely to cause severe injury without contributing factors.

AI's Supporting Role

AI tools can surface relevant evidence—highlighting temporal relationships, identifying pre-existing conditions, and extracting treatment patterns. However, interpretation remains human.

Conclusion

The Bradford Hill criteria offer a systematic approach to evaluating causation. While the framework provides structure, it does not provide definitive answers. LNCs must weigh all nine considerations in context to assist attorneys in building evidence-based arguments.