Austin Bradford Hill
English epidemiologist who pioneered randomised trials and smoking–cancer link.
Sir Austin Bradford Hill (8 July 1897 – 18 April 1991) was an English epidemiologist. He is credited with creating the modern randomised clinical trial and, working with Richard Doll, established the link between smoking and lung cancer. He also developed the "Bradford Hill" criteria, a set of principles used to judge whether an observed association is causal.
Hill was born in London, the son of physiologist Sir Leonard Erskine Hill and Janet Alexander, and a grandson of scholar George Birkbeck Hill. He grew up at Osborne House in Loughton, Essex, and attended Chigwell School. During the First World War, he served as a pilot but was discharged after contracting tuberculosis. Two years in hospital and two more recovering made a medical career impossible, so he earned a degree in economics by correspondence from London University.
In 1922, Hill joined the Industry Fatigue Research Board. He worked with medical statistician Major Greenwood and, to strengthen his statistical skills, attended lectures by Karl Pearson. When Greenwood took a chair at the newly founded London School of Hygiene and Tropical Medicine, Hill followed, becoming Reader in Epidemiology and Vital Statistics in 1933 and Professor of Medical Statistics in 1947. That same year, he was named Honorary Director of the Medical Research Council's Statistical Research Unit.
Hill had a productive career in research and teaching, and wrote the influential textbook *Principles of Medical Statistics*. But he is best known for two landmark projects. As the statistician on the Medical Research Council’s Streptomycin in Tuberculosis Trials Committee, he helped evaluate the drug’s use against tuberculosis—generally considered the first modern randomised clinical trial. (Ronald Aylmer Fisher had earlier pioneered randomisation in agricultural experiments.) The second project was a series of studies with Richard Doll on smoking and lung cancer. Their first paper, in 1950, was a case-control study comparing lung cancer patients with matched controls. Doll and Hill also launched a long-term prospective study tracking the smoking habits and health of 40,701 British doctors over several years (the British doctors study). Fisher strongly disagreed with their conclusions and methods, and from 1957 he publicly criticised the work in both the press and academic journals.
In 1965, building on ideas from Hume and Popper, Hill proposed several aspects of causality in medicine and biology, which epidemiologists still use today. Upon his death in 1991, Peter Armitage said, “to anyone involved in medical statistics, epidemiology or public health, Bradford Hill was quite simply the world's leading medical statistician.”
Hill served as president of the Royal Statistical Society from 1950 to 1952, received its Guy Medal in Gold in 1953, and the Harben Gold Medal of the Institute of Public Health and Hygiene. The society now awards a medal in his name for medical statistics. He was elected a Fellow of the Royal Society in 1954, with Fisher among his proposers. His election certificate noted his statistical contributions to understanding industrial diseases, migration’s effect on mortality, and the epidemiology of infections—including the risk of polio after inoculations and congenital abnormalities from maternal rubella. It also highlighted his post-war work demonstrating the link between smoking and lung cancer, and his leadership in developing precise experimental methods for evaluating new treatments.
Hill was appointed a Commander of the Order of the British Empire in 1951 and knighted in 1961.
- born
- 8 July 1897, London, England
- died
- 18 April 1991
- field
- Epidemiology, Medical Statistics
- nationality
- English
- known_for
- Pioneering the modern randomised clinical trial; demonstrating link between smok
Verified Timeline
Lore & Background
Hill was born in London on 8 July 1897, one of the sons 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. 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. 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, is generally accepted as the first modern randomised clinical trial. 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.
Reader's Guide
Hill's significance rests on two foundational contributions. First, as statistician on the Medical Research Council Streptomycin in Tuberculosis Trials Committee, he helped design the study evaluating streptomycin for tuberculosis, generally accepted as the first modern randomised clinical trial. Second, with Richard Doll, he conducted the landmark case-control study published in 1950 comparing lung cancer patients with matched controls, and the long-term prospective British doctors study tracking the smoking habits and health of 40,701 British doctors. These studies faced criticism from Ronald Aylmer Fisher, who disagreed with their conclusions and procedures and from 1957 criticised the work in the press and 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. His textbook, Principles of Medical Statistics, was very successful. 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."
Did You Know?
- Hill served as a pilot in the First World War but was invalided out when he contracted tuberculosis.
- He took a degree in economics by correspondence at London University after tuberculosis prevented a medical qualification.
- Hill was the statistician on the Medical Research Council Streptomycin in Tuberculosis Trials Committee, whose study is generally accepted as the first modern randomised clinical trial.
- The British doctors study tracked the smoking habits and health of 40,701 British doctors for several years.
- Ronald Aylmer Fisher was in profound disagreement with the smoking/cancer work and from 1957 criticised it in the press and academic publications.
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