Å·±¦ÓéÀÖ

This review starts with the audio version and moves on to the printed book.

This topic is very interesting but audio is a terrible format for this book. The narrator is reading out equations. The whole point of the book is to use diagrams. There is a PDF with the audiobook, but the figures are not meaningful on their own. I have ordered the print version. If that makes sense, I will bump up the rating for that.

There were important things I just didn’t understand clearly. For example, he seems to be bashing Sir Austin Bradford Hill, saying that the way epidemiologists figured out that smoking causes lung cancer is somehow pathetic compared with his approach. The Hill approach saved millions of lives. What was wrong with it? What is the equivalent accomplishment of his little arrows? He says Hill wasn’t quantitative, but that’s not really true because the Hill Criteria include magnitude of effect, etc. And of course, the whole smoking/cancer thing is long before Pearl’s work but is an example of what he labels his “revolution� , i.e. that observational data can give us evidence of causality. I have a feeling the emperor is naked here, but I will check on it more before lowering the score, and I won’t need a diagram to figure it out.

--Update February 2019:
I went over the smoking chapter in detail. The emperor is naked.

The idea that one can establish causality without randomized trials is extremely important, but as Pearl himself points out, it predates the causal diagrams. This book does not make a clear case for the causal diagrams being the amazing conceptual revolution that the author claims they are. Perhaps he should diagram that causal pathway.

Pearl leaves out some important details of the tobacco story (like the Readers' Digest article that alerted the American public to the risk of cigarettes) but even just going by what Pearl includes in his version, there was actually a very rapid penetration of the idea that cigarettes caused the lung cancer pandemic. Doll and Hill STARTED their study in 1948. In 1953, EVEN THE TOBACCO COMPANY SCIENTISTS accepted as fact that cigarettes cause lung cancer.

The problem with wider dissemination was that there was a massive campaign of disinformation by the tobacco industry and their minions. The Hill Criteria helped to seal the deal at a broader level despite the propaganda. There is no evidence offered that things would have moved along faster if people had been using causal diagrams. It is very easy in retrospect to say now that of course we could have convinced people about the dangers of smoking if only ... except that as Pearl illustrates, some people were never convinced no matter what.

If causal diagrams have stopped a pandemic and saved millions of lives, then tell us that story.

For a better and beautiful book on epidemiology for a general audience, I would recommend:
Investigating Disease Patterns: The Science of Epidemiology