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Assessing causality in drug policy analyses: How useful are the Bradford Hill criteria in analysing take‐home naloxone programs?
Author(s) -
Olsen Anna,
McDonald David,
Lenton Simon,
Dietze Paul M.
Publication year - 2018
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1111/dar.12523
Subject(s) - causality (physics) , causal inference , (+) naloxone , inference , certainty , public economics , order (exchange) , public health , psychology , actuarial science , medicine , political science , economics , computer science , nursing , econometrics , finance , mathematics , physics , receptor , quantum mechanics , artificial intelligence , opioid , geometry
The Bradford Hill criteria for assessing causality are useful in assembling evidence, including within complex policy analyses. In this paper, we argue that the implementation of take‐home naloxone (THN) programs in Australia and elsewhere reflects sensible, evidence‐based public health policy, despite the absence of randomised controlled trials. However, we also acknowledge that the debate around expanding access to THN would benefit from a careful consideration of causal inference and health policy impact of THN program implementation. Given the continued debate around expanding access to THN, and the relatively recent access to new data from implementation studies, two research groups independently conducted Bradford Hill analyses in order to carefully consider causal inference and health policy impact. Hill's criteria offer a useful analytical tool for interpreting current evidence on THN programs and making decisions about the (un)certainty of THN program safety and effectiveness.