Sir Austin Bradford Hill FRS (8 July 1897 - 18 April 1991),
EnglishEngland is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
epidemiologist and
statisticianA statistician is someone who works with theoretical or applied statistics. The profession exists in both the private and public sectors. The core of that work is to measure, interpret, and describe the world and human activity patterns within it...
, pioneered the randomized
clinical trialClinical trials are a set of procedures in medical research and drug development that are conducted to allow safety and efficacy data to be collected for health interventions...
and, together with
Richard DollSir William Richard Shaboe Doll CH OBE FRS was a British physiologist who became the foremost epidemiologist of the 20th century, turning the subject into a rigorous science. He was a pioneer in research linking smoking to health problems...
, was the first to demonstrate the connection between
cigaretteA cigarette is a small roll of finely cut tobacco leaves wrapped in a cylinder of thin paper for smoking. The cigarette is ignited at one end and allowed to smoulder; its smoke is inhaled from the other end, which is held in or to the mouth and in some cases a cigarette holder may be used as well...
smoking and
lung cancerLung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...
. Hill is widely known for pioneering the
"Bradford Hill" criteriaThe Bradford Hill criteria, otherwise known as Hill's criteria for causation, are a group of minimal conditions necessary to provide adequate evidence of a causal relationship between an incidence and a consequence, established by the English epidemiologist Sir Austin Bradford Hill in 1965.The...
for determining a causal association.
Early life
Son of Sir
Leonard Erskine HillSir Leonard Erskine Hill was a British physiologist. He was elected a Fellow of the Royal Society in 1900 and was knighted in 1930. One of his sons was the epidemiologist and statistician Austin Bradford Hill...
FRS a distinguished physiologist, Hill was born in
LondonLondon is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
, lived as a child at the family home, Osborne House,
LoughtonLoughton is a town and civil parish in the Epping Forest district of Essex. It is located between 11 and 13 miles north east of Charing Cross in London, south of the M25 and west of the M11 motorway and has boundaries with Chingford, Waltham Abbey, Theydon Bois, Chigwell and Buckhurst Hill...
, Essex; and educated at
Chigwell SchoolChigwell School is an English co-educational independent school/public school in Chigwell, in the Epping Forest district of Essex. It was founded in 1629 by Samuel Harsnett, a former Archbishop of York . There are around 730 pupils aged between 7 and 18 years...
,
EssexEssex is a ceremonial and non-metropolitan county in the East region of England, and one of the home counties. It is located to the northeast of Greater London. It borders with Cambridgeshire and Suffolk to the north, Hertfordshire to the west, Kent to the South and London to the south west...
. He served as a pilot in the First World War but was invalided out when he contracted
tuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. Two years in hospital and two years of convalescence put a medical qualification out of the question and he took a degree in
economicsEconomics is the social science that analyzes the production, distribution, and consumption of goods and services. The term economics comes from the Ancient Greek from + , hence "rules of the house"...
by correspondence at London University.
Career
In 1922 Hill went to work for the Industry Fatigue Research Board. He was associated with the medical statistician
Major GreenwoodMajor Greenwood FRS was an English epidemiologist and statistician.Major Greenwood junior was born in Shoreditch in London's East End, the only child of a doctor in general practice there...
and, to improve his statistical knowledge, Hill attended lectures by
Karl PearsonKarl Pearson FRS was an influential English mathematician who has been credited for establishing the disciplineof mathematical statistics....
. When Greenwood accepted a chair at the newly formed London School of Hygiene and Tropical Medicine, Hill moved with him, becoming Reader in Epidemiology and Vital Statistics in 1933 and Professor of Medical Statistics in 1947.
Hill had a distinguished career in research and teaching and as author of a very successful textbook,
Principles of Medical Statistics, but he is famous for two landmark studies. He was the statistician on the Medical Research Council Streptomycin in Tuberculosis Trials Committee and their study evaluating the use of streptomycin in treating tuberculosis, is generally accepted as the first randomised clinical trial. The use of randomisation in agricultural experiments had been pioneered by Ronald Aylmer Fisher. The second study was rather a series of studies with
Richard DollSir William Richard Shaboe Doll CH OBE FRS was a British physiologist who became the foremost epidemiologist of the 20th century, turning the subject into a rigorous science. He was a pioneer in research linking smoking to health problems...
on smoking and lung cancer. The first paper, published in 1950, was a case-control study comparing lung cancer patients with matched controls. Doll and Hill also started a long-term prospective study of smoking and health. This was an investigation of the smoking habits and health of over 30,000 British doctors for several years (
British doctors studyThe British Doctors Study is the generally accepted name of a prospective cohort study which ran from 1951 to 2001, and in 1956 provided convincing statistical proof that tobacco smoking increased the risk of lung cancer.-Context:...
). Fisher was in profound disagreement with the conclusions and procedures of the smoking/cancer work and from 1957 he criticised the work in the press and in academic publications.
Hill was made a fellow of the
Royal SocietyThe Royal Society of London for Improving Natural Knowledge, known simply as the Royal Society, is a learned society for science, and is possibly the oldest such society in existence. Founded in November 1660, it was granted a Royal Charter by King Charles II as the "Royal Society of London"...
in 1954. Fisher was actually one of the proposers. The certificate of election read
Has, by the application of statistical methods, made valuable contributions to our knowledge of the incidence and aetiology of industrial diseases, of the effects of internal migration upon mortality rates, and of the natural and experimental epidemiology of various infections, for example of the risks of an attack of poliomyelitisPoliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...
following inoculation procedures and of the risk of congenital abnormalities being precipitated by maternal rubella in the pregnant woman. Since the war he has demonstrated in an exact and controlled field survey the association between cigarette smoking and the incidence of cancer of the lung, and has been the leader in the development in medicine of the precise experimental methods now used nationally and internationally in the evaluation of new therapeutic and prophylactic agents.
In 1950-52 Hill was president of the
Royal Statistical SocietyThe Royal Statistical Society is a learned society for statistics and a professional body for statisticians in the UK.-History:It was founded in 1834 as the Statistical Society of London , though a perhaps unrelated London Statistical Society was in existence at least as early as 1824...
and was awarded its
Guy MedalThe Guy Medals are awarded by the Royal Statistical Society in three categories; Gold, Silver and Bronze. The Gold Medal is awarded triennially, the other two are awarded annually...
in Gold in 1953. He was knighted in 1961. On Hill's death
Peter ArmitagePeter Armitage is a statistician specialising in medical statistics.Peter Armitage attended Huddersfield College and went on to read mathematics at Trinity College, Cambridge. Armitage belonged to the generation of mathematicians who came to maturity in the Second World War...
wrote, "to anyone involved in medical statistics,
epidemiologyEpidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
or public health, Bradford Hill was quite simply the world’s leading medical statistician."
In 1965, built upon the work of
HumeDavid Hume was a Scottish philosopher, historian, economist, and essayist, known especially for his philosophical empiricism and skepticism. He was one of the most important figures in the history of Western philosophy and the Scottish Enlightenment...
and
PopperSir Karl Raimund Popper, CH FRS FBA was an Austro-British philosopher and a professor at the London School of Economics...
, Hill suggested several aspects of causality in medicine and biology (read more), which have remained in use by epidemiologists to date.
Discussion
- "Richard Doll (1994) Austin Bradford Hill, Biographical Memoirs of fellows of the Royal Society, 40, 129-140.
- "Peter Armitage (1991) Obituary: Sir Austin Bradford Hill 1897-1991, Journal of the Royal Statistical Society
The Journal of the Royal Statistical Society is a series of three peer-reviewed statistics journals published by Blackwell Publishing for the London-based Royal Statistical Society.- History :...
. Series A (Statistics in Society), 154, 482-484.
- A. Yoshioka Use of randomisation in the Medical Research Council's clinical trial of streptomycin in pulmonary tuberculosis in the 1940s, British Medical Journal,317:1220-1223 ( 31 October 1998) extract
- P. Armitage, W. Bodmer, I. Chalmers, R. Doll, H. Marks contribute to a Symposium on Bradford Hill and Fisher International Journal of Epidemiology, 32, (6), (2003), 922-948.
External links
Hill's well-known paper on causation is available on the web
Doll has some comments on his teacher and boss in
Photographs of Hill:
on University of York site on National Portrait Gallery site
The Royal Society information comes from their website