© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 1, 11,
January 6, 1999
© 1999 Oxford University Press
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Austin Bradford Hill: A Pioneering Force Behind Clinical Trials
On paper, Austin Bradford Hill would seem a somewhat improbable scientist. Born into a prominent English family, he grew up with his heart set on becoming a doctor, but that hope was dashed when — as a pilot in the British Naval Air Service during World War I — he contracted pulmonary tuberculosis in the Greek islands and was sent home to die.
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That was in 1917 and death, in fact, spared him until April 1991 when he was almost 94. Nonetheless, recovery from TB eighty years ago was not to be rushed. Accordingly, he decided, once his survival seemed assured, to enroll at London University because it offered correspondence courses and he could do the work while convalescing in bed. In that way, he earned an undergraduate degree in economics in 1922.
Economics, however, was never a career he wanted to pursue. Instead, he sought out an old family friend at the Medical Research Council who helped him obtain a grant to determine why the death rate of young adults in rural areas was so high: an assignment that enabled him to audit some undergraduate lectures in statistics at University College, London, as well.
With that — but no further formal training in either statistics or medicine — he found his niche. He went on to become Professor and Chair of Epidemiology and Medical Statistics at the London School of Hygiene and Tropical Medical and director of the MRC's statistical unit; posts that he held simultaneously until his retirement in 1961.
Besides pioneering the randomization component of RCTs and writing extensively on medical statistics, Hill adopted the principles of epidemiology, which were originally developed for communicable illness, to non-infectious disorders.
Thus, he and Richard Doll, who has been his pupil, began in 1948 the study that linked smoking first to lung cancer and then to many other diseases: a list that — thanks to the generations of epidemiologists who have followed in their footsteps — has been growing ever since.
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