Austin Bradford Hill

Austin Bradford Hill (July 8, 1897 - April 18, 1991), English epidemiologist and statistician, pioneered the randomized clinical trial and, together with Richard Doll, was the first to demonstrate the connection between cigarette smoking and lung cancer.

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Early life

Son of Sir Leonard Erskine Hill FRS a distinguished physiologist, Hill was born in London and 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.

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.

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 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 over 30,000 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.

Hill was made a fellow of the Royal Society in 1954. Fisher was actually 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.

In 1950-52 Hill was president of the Royal Statistical Society and in 1961 he was knighted. On Hill's death Peter Armitage wrote, "to anyone involved in medical statistics, epidemiology or public health, Bradford Hill was quite simply the world’s leading medical statistician."

Bibliography

Note that Austin Bradford Hill's surname was Hill and he always used the name Hill, AB in publications. However, he is often referred to as Bradford Hill. To add to the confusion, his friends called him Tony.

• "Principles of Medical Statistics (1937) London: The Lancet, 1937.
• "Medical Research Council (1948) Streptomycin in Tuberculosis Trials Committee. Streptomycin treatment of pulmonary tuberculosis. British Medical Journal, 2: 769-83.
• "Doll R, Hill AB. (1950) Smoking and carcinoma of the lung. Preliminary report, British Medical Journal, 2: 739-748.
• "Doll R, Hill AB. (1954) The mortality of doctors in relation to their smoking habits. British Medical Journal, 228:1451-5.
• Hill AB. (1965). The environment and disease: association or causation? Proceedings of the Royal Society of Medicine, 58, 295-300. [1]

Discussion

• "Richard Doll (1994) Austin Bradford Hill, Biographical Memoirs of fellows of the Royal Society, 40, 129-140.
• "Peter Armitage (1991) Obituary: Sir Austin Bradford Hill 1897-1991, Journal of the Royal Statistical Society. Series A (Statistics in Society), 154, 482-484.
• A. Yoshioka Use of randomisation in the Medical Research Council's clinical trial of streptomycin in pulmonary tuberculosis in the 1940s, British Medical Journal,317:1220-1223 ( 31 October 1998) extract
• P. Armitage, W. Bodmer, I. Chalmers, R. Doll, H. Marks contribute to a Symposium on Bradford Hill and Fisher International Journal of Epidemiology, 32, (6), (2003), 922-948.

Doll has some comments on his teacher and boss in

• Interview with Richard Doll

This article has a photograph of Hill. There is another at

• Sir Austin Bradford Hill on the Portraits of Statisticians page.

and another at

• Sir (Austin) Bradford ('Tony') Hill at the National Portrait Gallery

The Royal Society information comes from their website

• Royal Society