Austin Bradford Hill

Sir Austin Bradford Hill
Sir Austin Bradford Hill
Born	8 July 1897; Hampstead, London, England
Died	18 April 1991 (aged 93); Ulverston, Cumbria, England
Nationality	British
Occupation(s)	Epidemiologist ; statistician
Known for	Randomised controlled trials; "Bradford Hill" criteria;
Awards	Guy Medal (Gold, 1953)

Sir Austin Bradford Hill^[a] CBE FRS^[3] (8 July 1897 – 18 April 1991) was an English epidemiologist who pioneered the modern randomised clinical trial and, together with Richard Doll, demonstrated the connection between cigarette smoking and lung cancer. Hill is widely known for pioneering the "Bradford Hill" criteria for determining a causal association.^[4]^[5]

Early life

Hill was born in London, son of Sir Leonard Erskine Hill FRS, a distinguished physiologist, and Janet Alexander. He was the grandson of noted scholar George Birkbeck Hill. As a child he lived at the family home, Osborne House, Loughton, Essex; he was educated at Chigwell School, Essex. He served as a pilot in the First World War but was invalided out when he contracted tuberculosis. Two years in hospital and two years of convalescence put a medical qualification out of the question and he took a degree in economics by correspondence at London University.

Career

In 1922, Hill went to work for the Industry Fatigue Research Board. He was associated with the medical statistician Major Greenwood and, to improve his statistical knowledge, Hill attended lectures by Karl Pearson. When Greenwood accepted a chair at the newly formed London School of Hygiene and Tropical Medicine, Hill moved with him, becoming Reader in Epidemiology and Vital Statistics in 1933 and Professor of Medical Statistics in 1947. In 1947, he was appointed Honorary Director of the Medical Research Council's Statistical Research Unit.^[4]

Hill had a distinguished career in research and teaching and as author of a very successful textbook, Principles of Medical Statistics, but he is famous for two landmark studies. He was the statistician on the Medical Research Council Streptomycin in Tuberculosis Trials Committee and their study evaluating the use of streptomycin in treating tuberculosis,^[6] is generally accepted as the first modern randomised clinical trial. The use of randomisation in agricultural experiments had been pioneered by Ronald Aylmer Fisher. The second study was rather a series of studies with Richard Doll on smoking and lung cancer. The first paper, published in 1950, was a case-control study comparing lung cancer patients with matched controls. Doll and Hill also started a long-term prospective study of smoking and health. This was an investigation of the smoking habits and health of 40,701 British doctors for several years (British doctors study). Fisher was in profound disagreement with the conclusions and procedures of the smoking/cancer work and from 1957 he criticised the work in the press and in academic publications.

In 1965, built upon the work of Hume and Popper, Hill suggested several aspects of causality in medicine and biology, which have remained in use by epidemiologists to date.

On Hill's death in 1991, Peter Armitage wrote, "to anyone involved in medical statistics, epidemiology or public health, Bradford Hill was quite simply the world's leading medical statistician."

Honours

In 1950–52, Hill was president of the Royal Statistical Society.^[7] He was awarded its Guy Medal in Gold in 1953,^[8] and the Harben Gold Medal of the Institute of Public Health and Hygiene.^[4] The Society awards a medal in the field of medical statistics in Hill's name.^[9]

Hill was made a Fellow of the Royal Society (FRS) in 1954. Fisher was one of the proposers. The certificate of election read:

Has, by the application of statistical methods, made valuable contributions to our knowledge of the incidence and aetiology of industrial diseases, of the effects of internal migration upon mortality rates, and of the natural and experimental epidemiology of various infections, for example of the risks of an attack of poliomyelitis following inoculation procedures and of the risk of congenital abnormalities being precipitated by maternal rubella in the pregnant woman. Since the war he has demonstrated in an exact and controlled field survey the association between cigarette smoking and the incidence of cancer of the lung, and has been the leader in the development in medicine of the precise experimental methods now used nationally and internationally in the evaluation of new therapeutic and prophylactic agents.

He was appointed a Commander of the Order of the British Empire (CBE) in the 1951 Birthday Honours^[10] and knighted in the 1961 Birthday Honours.^[11]

Bibliography

"Principles of Medical Statistics" (1937) London: The Lancet, 1937.
Doll, R.; Hill, A. B. (1 September 1950). "Smoking and Carcinoma of the Lung". British Medical Journal. 2 (4682): 739–748. doi:10.1136/bmj.2.4682.739. ISSN 0007-1447. PMC 2038856. PMID 14772469.
Doll, R.; Hill, A. B. (1954). "The mortality of doctors in relation to their smoking habits; a preliminary report". British Medical Journal. 1 (4877): 1451–1455. doi:10.1136/bmj.1.4877.1451. PMC 2085438. PMID 13160495.
Hill, A. B. (1965). "The Environment and Disease: Association or Causation?". Proceedings of the Royal Society of Medicine. 58 (5): 295–300. doi:10.1177/003591576505800503. PMC 1898525. PMID 14283879. [1]
Chalmers, I. (2003). "Fisher and Bradford Hill: Theory and pragmatism?". International Journal of Epidemiology. 32 (6): 922–924, discussion 924–8. doi:10.1093/ije/dyg295. PMID 14681246.
Armitage, Peter (2003). "Fisher, Bradford Hill, and randomization". International Journal of Epidemiology. 32 (6): 925–928, discussion 928–8. doi:10.1093/ije/dyg286. PMID 14681247.
Doll, R. (2003). "Fisher and Bradford Hill: Their personal impact". International Journal of Epidemiology. 32 (6): 929–931, discussion 931–8. doi:10.1093/ije/dyg287. PMID 14681248.
"Fisher and Bradford Hill: A discussion". International Journal of Epidemiology. 32 (6): 945–948. 2003. doi:10.1093/ije/dyg316.

Notes

^ Note that Austin Bradford Hill's surname was Hill and he went by the name "Tony".^[1]^[2] He published under the name "A.B. Hill" in early articles, "A. Bradford Hill" beginning in the 1930s (to distinguish himself from A.V. Hill), and "Sir Austin Bradford Hill" after he was knighted in 1961. He is often referred to as Bradford Hill, sometimes with a misleading hyphen as in "Bradford-Hill criteria."

References

^ Armitage, P (May 1991). "Obituary: Sir Austin Bradford Hill, 1897–1991". Journal of the Royal Statistical Society, Series A (Statistics in Society). 154 (3): 482–484. doi:10.1111/j.1467-985X.1991.tb00329.x.
^ Doll, Richard (1993). "Austin Bradford Hill, 1897–1991". Statistics in Medicine. 12 (8): 795–808. doi:10.1002/sim.4780120808. PMC 1848247. PMID 20326855.
^ Doll, R. (1994). "Austin Bradford Hill. 8 July 1897 – 18 April 1991". Biographical Memoirs of Fellows of the Royal Society. 40: 128–140. doi:10.1098/rsbm.1994.0032.
^ ^a ^b ^c Farewell, V.; Johnson, T. (2010). "Woods and Russell, Hill, and the emergence of medical statistics". Statistics in Medicine. 29 (14): 1459–1476. doi:10.1002/sim.3893. PMC 2991772. PMID 20535761.
^ Armitage, P. (1991). "Obituary: Sir Austin Bradford Hill, 1897–1991". Journal of the Royal Statistical Society. 154 (3): 482–484. doi:10.1111/j.1467-985X.1991.tb00329.x. JSTOR 2983156.
^ Yoshioka, A. (1998). "Use of randomisation in the Medical Research Council's clinical trial of streptomycin in pulmonary tuberculosis in the 1940s". BMJ. 317 (7167): 1220–1223. doi:10.1136/bmj.317.7167.1220. PMC 1114162. PMID 9794865.
^ "Past presidents". RSS. Royal Statistical Society. Retrieved 19 March 2024.
^ "Previous recipients of Gold Medals" (PDF). Royal Statistical Society. Retrieved 19 March 2024.
^ "Bradford Hill Medal". RSS. Royal Statistical Society. Retrieved 19 March 2024.
^ "No. 39243". The London Gazette (Supplement). 1 June 1951. p. 3071.
^ "No. 42370". The London Gazette (Supplement). 2 June 1961. p. 4144.

External links

Doll has some comments on his teacher and boss in Interview with Richard Doll
Photographs of Hill: on University of York site on National Portrait Gallery site

[3] Note that Austin Bradford Hill's surname was Hill and he went by the name "Tony".^[1]^[2] He published under the name "A.B. Hill" in early articles, "A. Bradford Hill" beginning in the 1930s (to distinguish himself from A.V. Hill), and "Sir Austin Bradford Hill" after he was knighted in 1961. He is often referred to as Bradford Hill, sometimes with a misleading hyphen as in "Bradford-Hill criteria."

[1] Armitage, P (May 1991). "Obituary: Sir Austin Bradford Hill, 1897–1991". Journal of the Royal Statistical Society, Series A (Statistics in Society). 154 (3): 482–484. doi:10.1111/j.1467-985X.1991.tb00329.x.

[2] Doll, Richard (1993). "Austin Bradford Hill, 1897–1991". Statistics in Medicine. 12 (8): 795–808. doi:10.1002/sim.4780120808. PMC 1848247. PMID 20326855.

[frs-4] Doll, R. (1994). "Austin Bradford Hill. 8 July 1897 – 18 April 1991". Biographical Memoirs of Fellows of the Royal Society. 40: 128–140. doi:10.1098/rsbm.1994.0032.

[Armitage_obit-5] Farewell, V.; Johnson, T. (2010). "Woods and Russell, Hill, and the emergence of medical statistics". Statistics in Medicine. 29 (14): 1459–1476. doi:10.1002/sim.3893. PMC 2991772. PMID 20535761.

[6] Armitage, P. (1991). "Obituary: Sir Austin Bradford Hill, 1897–1991". Journal of the Royal Statistical Society. 154 (3): 482–484. doi:10.1111/j.1467-985X.1991.tb00329.x. JSTOR 2983156.

[strepto-7] Yoshioka, A. (1998). "Use of randomisation in the Medical Research Council's clinical trial of streptomycin in pulmonary tuberculosis in the 1940s". BMJ. 317 (7167): 1220–1223. doi:10.1136/bmj.317.7167.1220. PMC 1114162. PMID 9794865.

[RSS_presidency-8] "Past presidents". RSS. Royal Statistical Society. Retrieved 19 March 2024.

[Guy_Medal-9] "Previous recipients of Gold Medals" (PDF). Royal Statistical Society. Retrieved 19 March 2024.

[RSS_BH_Medal-10] "Bradford Hill Medal". RSS. Royal Statistical Society. Retrieved 19 March 2024.

[11] "No. 39243". The London Gazette (Supplement). 1 June 1951. p. 3071.

[12] "No. 42370". The London Gazette (Supplement). 2 June 1961. p. 4144.

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v t e Presidents of the Royal Statistical Society
19th century	1834–1836 The Marquess of Lansdowne 1836–1838 Sir Charles Lemon, Bt 1838–1840 The Earl FitzWilliam 1840–1842 Viscount Sandon 1842–1843 The Marquess of Lansdowne 1843–1845 Lord Ashley 1845–1847 The Lord Monteagle of Brandon 1847–1849 The Earl FitzWilliam 1849–1851 The Earl of Harrowby 1851–1853 The Lord Overstone 1853–1855 The Earl FitzWilliam 1855–1857 The Earl of Harrowby 1857–1859 Lord Stanley 1859–1861 Lord John Russell 1861–1863 Sir John Pakington, Bt 1863–1865 William Henry Sykes 1865–1867 The Lord Houghton 1867–1869 William Ewart Gladstone 1869–1871 William Newmarch 1871–1873 William Farr 1873–1875 William Guy 1875–1877 James Heywood 1877–1879 George Shaw-Lefevre 1879–1880 Thomas Brassey 1880–1882 James Caird 1882–1884 Robert Giffen 1884–1886 Rawson W. Rawson 1886–1888 George Goschen 1888–1890 Thomas Graham Balfour 1890–1892 Frederic J. Mouat 1892–1894 Charles Booth 1894–1896 The Lord Farrer 1896–1897 John Biddulph Martin 1897 Alfred Edmund Bateman 1897–1899 Leonard Courtney 1899–1900 Henry Fowler 1900–1902 The Lord Avebury
20th century	1902–1904 Patrick George Craigie 1904–1905 Sir Francis Powell, Bt 1905–1906 The Earl of Onslow 1906–1907 Richard Martin 1907–1909 Sir Charles Dilke, Bt 1909–1910 Jervoise Athelstane Baines 1910–1912 Lord George Hamilton 1912–1914 Francis Ysidro Edgeworth 1914–1915 The Lord Welby 1915–1916 Lord George Hamilton 1916–1918 Bernard Mallet, Registrar General 1918–1920 Herbert Samuel 1920–1922 R. Henry Rew 1922–1924 The Lord Emmott 1924–1926 Udny Yule 1926–1928 The Viscount D'Abernon 1928–1930 A. William Flux 1930–1932 Sir Josiah Stamp 1932–1934 The Lord Meston 1934–1936 Major Greenwood 1936–1938 The Lord Kennet 1938–1940 Arthur Lyon Bowley 1940–1941 Henry William Macrosty 1941 Hector Leak 1941–1943 William Beveridge 1943–1945 Ernest Charles Snow 1945–1947 The Lord Woolton 1947–1949 David Heron 1949–1950 Sir Geoffrey Heyworth 1950–1952 Austin Bradford Hill 1952–1954 Ronald Fisher 1954–1955 The Lord Piercy 1955–1957 Egon Pearson 1957–1959 Harry Campion 1959–1960 Hugh Beaver 1960–1962 Maurice Kendall 1962–1964 Joseph Oscar Irwin 1964–1965 Sir Paul Chambers 1965–1966 L. H. C. Tippett 1966–1967 M. S. Bartlett 1967–1968 Frank Yates 1968–1969 Arthur Cockfield 1969–1970 R. G. D. Allen 1970–1971 Bernard Benjamin 1971–1972 George Alfred Barnard 1972–1973 Harold Wilson 1973–1974 D. J. Finney 1974–1975 Henry Daniels 1975–1977 Stella Cunliffe 1977–1978 Henry Wynn 1978–1980 Sir Claus Moser 1980–1982 David Cox 1982–1984 Peter Armitage 1984–1985 Walter Bodmer 1985–1986 John Nelder 1986–1987 James Durbin 1987–1989 John Kingman 1989–1991 Peter G. Moore 1991–1993 T. M. F. Smith 1993–1995 D. J. Bartholomew 1995–1997 Adrian Smith 1997–1999 Robert Nicholas Curnow 1999–2001 Denise Lievesley
21st century	2001–2003 Peter Green 2003–2005 Andy Grieve 2005–2007 Tim Holt 2008–2009 David Hand 2010–2010 Bernard Silverman (resigned Feb 2010; replaced pro tem by David Hand) 2011–2012 Valerie Isham 2013–2014 John Pullinger 2014–2016 Peter Diggle 2017–2018 David Spiegelhalter 2019– Deborah Ashby
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