Watch your language: An exploration of the use of causal wording in veterinary observational research

Abstract

Observational research may be conducted to predict an outcome or to identify associations between an intervention or risk factor (an “exposure”) and an outcome. However, the end goal of observational research often is to identify exposures that can be manipulated to improve an outcome, meaning that the aim is identify causal relationships. Causal inference from observational studies may be appropriate when an exposure-outcome of interest is identified, causal reasoning is used to identify confounders, confounders are adequately controlled, and theoretical issues, such as temporality, are considered. If these conditions are not met, causal inference cannot be made in an observational study. The objective of our study was to explore the use of causal language in veterinary observational studies, and to compare the use of causal language between studies that appear to be predictive or associational in purpose vs. those that appear to be exploring causal relationships. The dataset comprised 200 observational studies in veterinary species published between 2020 and 2022. The majority (117 out of 200) were cross-sectional studies. There were 48 studies that described an exposure-outcome of interest, and we considered these studies to be exploring potential causal relationships; of note, this liberal categorization would be anticipated to overestimate the proportion of studies suitably designed for causal inference. Overall, 172 studies (86%) used causal wording in at least one section of the article. Causal language was used in 128/152 (84%) of studies exploring predictions or associations; this language implies causation when it is not appropriate to do so. In studies designed such that causal inference might be possible, 44/48 (92%) used causal language in one or more sections. There were no substantive differences in the use of causal wording between observational study designs, exposure types, or whether the first author's affiliation was a country in which English is an official language. There is a need for authors of veterinary observational studies to explicitly state the purpose of the study (associational, predictive, or causal), and to use causal wording appropriately based on the aim of the study.