The Bradford Hill criterion that CANNOT be adequately assessed using ecological study data is:
- A Strength of association
- B Temporality ✓
- C Biological plausibility
- D Dose-response relationship
Correct answer: B. Temporality
Explanation
Temporality — the requirement that cause must precede effect — demands individual-level longitudinal data to establish the sequence of exposure before outcome. Ecological studies use group-level aggregate data and cannot determine the temporal order at the individual level, making them susceptible to the ecological fallacy. Strength, plausibility, and dose-response can be estimated from ecological correlations, but temporal precedence cannot.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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