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  "path": "/t/thinking-clearly-about-association-studies-risk-factors-and-causal-salad-included/28679?page=2#post_25",
  "publishedAt": "2026-04-04T10:26:44.000Z",
  "site": "https://discourse.datamethods.org",
  "textContent": "The Kezios paper gives you the empirical foundation: among studies framed in associational language with a specific exposure-disease relationship of primary interest — her “seemingly causal” category — full alignment of goal, methods, and interpretation occurred in 4% of cases. The associational framing is not a neutral description of the study’s epistemic position. It is a framing that reliably predicts methodological misalignment, outcome-focused variable selection, and coefficient over-interpretation.\n\nThe specific target of the pushback should be the adjustment set claim. “We examined the association between X and Y adjusting for Z” contains an implicit causal structure. Adjustment is not a neutral act. It is a causal operation that changes what the estimate means — conditioning on a confounder removes a backdoor path, conditioning on a mediator blocks the effect of interest, conditioning on a collider opens a new non-causal path. If you perform adjustment without implicitly committing to a causal model of the relationships among X, Y, and Z. The association framing allows authors to perform this causal operation while avoiding accountability for the causal assumptions. That is the lack of accountability Kezios is describing.\n\nSo the pushback is not “you shouldn’t have adjusted” — it is “you adjusted, which means you had a causal model in mind, and you are obligated to show it.” If they cannot produce a DAG or a principled defense of the adjustment set in causal terms, the adjustment should be removed and the finding reported as a crude association, or the study should be reframed explicitly as causal and held to causal standards. Those are the two honest options. The current middle ground — adjust without justification, report as association, interpret as causal is what I think she pushes against.\n\nA paper that says “we found that X was independently associated with Y after adjustment for Z” and then recommends management changes based on that finding has silently upgraded itself from descriptive to causal somewhere between the Results and the Discussion.",
  "title": "Thinking Clearly about Association Studies (Risk Factors and Causal Salad included)"
}