Glossary

What it is: The actual likelihood that an outcome occurs in a population.

Does not mean legally: Absolute risk does not predict what will happen to a specific person.

What it is: A statistical relationship between two variables.

Does not mean legally: Association alone does not establish causation.

What it is: The underlying frequency of an outcome in a population.

Does not mean legally: Ignoring base rates can exaggerate the significance of individual evidence.

What it is: Systematic error that distorts study results.

Does not mean legally: The presence of bias does not automatically invalidate a study, but it limits the strength of conclusions.

Definition: A case series or case report describes outcomes or characteristics of one person or a small group without a comparison group.

Evidence quality: These designs are near the bottom of the evidence pyramid because they cannot test hypotheses or causation.

Court use: Courts should not rely on case reports to establish risk, causation, or standard of care beyond illustrating that an outcome is possible.

Definition: A case-control study compares people with a specific outcome to those without it, looking backward to assess prior exposures.

Evidence quality: Case-control studies provide moderate-quality evidence and are more vulnerable to bias than cohort studies.

Court use: Courts may consider these studies as evidence of association, but they cannot establish causation or individual liability.

What it is: A relationship in which one factor produces an outcome.

Does not mean legally: Scientific causation at the population level does not automatically establish legal causation in an individual case.

What it is: The medical condition or injury that directly led to death.

Does not mean legally: Cause of death does not assign blame, intent, or legal responsibility.

What it is: Whether a finding has meaningful real-world impact.

Does not mean legally: Statistical significance does not imply legal relevance or material harm.

Definition: A cohort study follows groups of people over time to compare outcomes between those exposed to a factor and those who are not.

Evidence quality: Cohort studies occupy the middle of the evidence pyramid and provide strong evidence of association but not definitive causation.

Court use: Courts may infer increased or decreased risk, but should not conclude that the exposure directly caused the outcome in an individual case.

Definition: A commentary or editorial expresses opinions or interpretations about research, policy, or practice rather than presenting original data.

Evidence quality: Commentaries sit near the bottom of the evidence pyramid because they do not generate empirical evidence.

Court use: Courts should not treat commentaries as scientific evidence, though they may help explain differing professional viewpoints.

What it is: A range showing uncertainty around a study’s estimate.

Does not mean legally: A confidence interval does not guarantee the true value lies within the range, nor does it validate causation.

What it is: When another factor influences both the exposure and outcome, creating a misleading association.

Does not mean legally: An observed association cannot be assumed causal when confounding has not been adequately addressed.

What it is: An official responsible for death investigation who may or may not have medical training, depending on jurisdiction.

Does not mean legally: A coroner’s opinion does not carry inherent medical authority or scientific expertise unless independently established.

Definition: A cross-sectional study examines a population at a single point in time to describe characteristics or conditions.

Evidence quality: These studies rank lower on the evidence pyramid because they cannot determine temporal order or causality.

Court use: Courts may use cross-sectional studies to describe prevalence or patterns, but not to infer cause and effect.

What it is: A pattern where greater exposure corresponds to greater effect.

Does not mean legally: Dose–response strengthens inference but does not prove causation in a specific individual.

What it is: The error of applying group-level findings to individuals.

Does not mean legally: Population statistics cannot be used to infer what caused an outcome in a specific person.

What it is: The extent to which findings apply to other populations or settings.

Does not mean legally: Results cannot be assumed to apply to different individuals, jurisdictions, or circumstances.

What it is: The attempt to assign causation to a specific person or event.

Does not mean legally: Most epidemiologic studies are not designed to support individual attribution.

What it is: The degree to which a study accurately measures what it intends to measure.

Does not mean legally: High internal validity does not guarantee applicability beyond the study setting.

What it is: A classification (e.g., natural, accident, homicide) describing how death occurred.

Does not mean legally: Manner of death is not a legal conclusion and does not establish criminal or civil liability.

What it is: A physician, often a forensic pathologist, who determines cause and manner of death using medical evidence.

Does not mean legally: The medical examiner’s conclusions are not legal determinations of fault, intent, or liability.

Definition: A meta-analysis statistically combines results from multiple studies to estimate an overall effect more precisely than any single study.

Evidence quality: Meta-analyses represent the highest level of evidence when based on rigorous, comparable studies.

Court use: Courts may treat well-conducted meta-analyses as strong evidence of an association or effect, but conclusions depend on the quality and consistency of the underlying studies.

What it is: Incorrect labeling of exposure or outcome status.

Does not mean legally: Numerical precision does not imply factual accuracy if classification is flawed.

Definition: A narrative review summarizes selected research based on the author’s perspective without a systematic search or appraisal process.

Evidence quality: Narrative reviews rank low on the evidence pyramid due to potential selection bias and lack of transparency.

Court use: Courts may consider narrative reviews as background context but should not treat them as comprehensive or definitive evidence.

What it is: A measure comparing the odds of an outcome between two groups.

Does not mean legally: An odds ratio does not describe the probability that an outcome occurred in a specific person.

What it is: A statistical measure estimating how likely a result could occur by chance if there were no true effect.

Does not mean legally: A p-value does not prove causation, importance, or relevance to an individual case.

Definition: Popular press or media reports translate research or events for a general audience, often simplifying complex findings.

Evidence quality: Media reports are not part of the evidence pyramid and do not constitute scientific evidence.

Court use: Courts should not rely on media reports to establish scientific facts, causation, or standards of care.

What it is: Risk measured across groups rather than individuals.

Does not mean legally: Population risk cannot determine individual causation or liability.

Definition: A professional society statement reflects consensus recommendations developed by experts based on research evidence and clinical experience.

Evidence quality: These statements sit lower on the evidence pyramid because they rely on expert interpretation rather than new empirical data.

Court use: Courts may consider these statements as guidance on professional standards, but they should not be treated as independent scientific proof.

Definition: A qualitative study uses interviews, focus groups, or observation to understand experiences, beliefs, and decision-making.

Evidence quality: Qualitative research does not rank on the traditional evidence pyramid because it does not test frequency or causation.

Court use: Courts may rely on qualitative studies to understand lived experience and context, but not to estimate risk or prove causation.

Definition: An RCT randomly assigns participants to an intervention or comparison group to test whether the intervention causes a specific outcome.

Evidence quality: RCTs rank just below systematic reviews and meta-analyses because randomization reduces bias and supports causal inference.

Court use: Courts may reasonably infer causation within the study’s defined conditions, but should not assume findings automatically apply to different populations or settings.

What it is: Error caused by inaccurate memory of past events, often in retrospective studies.

Does not mean legally: Self-reported data does not equate to objective proof of exposure or timing.

What it is: A comparison of outcome probabilities between exposed and unexposed groups.

Does not mean legally: Relative risk does not establish that an exposure caused an outcome in an individual.

What it is: Bias arising when study participants are not representative of the target population.

Does not mean legally: Findings cannot be assumed to apply broadly or to the individual before the court.

What it is: What a reasonably competent professional would do under similar circumstances.

Does not mean legally: Standard of care is not defined by a single study, guideline, or outcome.

What it is: A study’s ability to detect a true effect if one exists.

Does not mean legally: A non-significant finding does not prove absence of risk or effect.

Definition: A systematic review carefully identifies, evaluates, and summarizes all relevant high-quality studies on a specific question using predefined methods.

Evidence quality: Systematic reviews sit at the top of the evidence pyramid because they synthesize multiple studies and minimize bias.

Court use: Courts may rely on systematic reviews to understand the overall state of scientific evidence but should still consider the quality and relevance of the included studies.

What it is: The requirement that a cause precede an effect.

Does not mean legally: Temporal sequence alone is insufficient to prove causation.

Definition: A white paper synthesizes data and analysis to inform policy or decision-making rather than to test scientific hypotheses.

Evidence quality: White papers vary widely in quality and generally rank below peer-reviewed research on the evidence pyramid.

Court use: Courts may consider white papers for policy context or economic impact, but should not treat them as equivalent to scientific studies.