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The Importance of Epidemiology in Establishing Causality
The relationship between cigarettes and lung cancer was never established using an RCT. But the epidemiology was so compelling there that we are very confident in making bold claims policy-wise and medically about those things. The more you smoked, the more likely you were to have a higher hazard ratio of smoking than eating certain food or drinking certain water. This is now how we have to get to medicine 3.0 because what you've highlighted is a very important point that also gets lost in the culture of only the RCT is valuable.