Kenneth J. Rothman and multicausality in epidemiology

Abstract

BackgroundThe sufficient-component cause model is one of several conceptual models for causation that appeared in the 1970s in response to the problem of multicausality in chronic diseases. MethodsThe aim of this article is to present the Rothman model as he introduced it in his seminal article “Causes,” written in 1976. ResultsWe show that: the notion of sufficiency and necessity, as opposed to the notion of probability, succeeded in forming a valid concept of cause; that this theoretical model recently introduced in other models of causality in epidemiology did not always succeed in solving the several practical problems related to multicausality, which Rothman wanted to solve by defending a working definition of causality. ConclusionDespite its weaknesses, the Rothman model has contributed significantly to the understanding of what a cause is in epidemiology, making it possible to address this question from a point of view unfamiliar to the “risk factor” approach to diseases.