Document Detail


Assessing the sensitivity of regression results to unmeasured confounders in observational studies.
MedLine Citation:
PMID:  9750244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This paper presents a general approach for assessing the sensitivity of the point and interval estimates of the primary exposure effect in an observational study to the residual confounding effects of unmeasured variable after adjusting for measured covariates. The proposed method assumes that the true exposure effect can be represented in a regression model that includes the exposure indicator as well as the measured and unmeasured confounders. One can use the corresponding reduced model that omits the unmeasured confounder to make statistical inferences about the true exposure effect by specifying the distributions of the unmeasured confounder in the exposed and unexposed groups along with the effects of the unmeasured confounder on the outcome variable. Under certain conditions, there exists a simple algebraic relationship between the true exposure effect in the full model and the apparent exposure effect in the reduced model. One can then estimate the true exposure effect by making a simple adjustment to the point and interval estimates of the apparent exposure effect obtained from standard software or published reports. The proposed method handles both binary response and censored survival time data, accommodates any study design, and allows the unmeasured confounder to be discrete or normally distributed. We describe applications on two major medical studies.
Authors:
D Y Lin; B M Psaty; R A Kronmal
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Biometrics     Volume:  54     ISSN:  0006-341X     ISO Abbreviation:  Biometrics     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-11-03     Completed Date:  1998-11-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370625     Medline TA:  Biometrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  948-63     Citation Subset:  IM    
Affiliation:
Department of Biostatistics, University of Washington, Seattle 98195, USA. danyu@biostat.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Appetite Depressants / adverse effects
Biometry / methods*
Case-Control Studies
Cohort Studies
Fenfluramine / adverse effects
Heart Catheterization / mortality
Humans
Hypertension, Pulmonary / etiology
Proportional Hazards Models
Prospective Studies
Regression Analysis*
Sensitivity and Specificity
Survival Analysis
Grant Support
ID/Acronym/Agency:
AI29168/AI/NIAID NIH HHS; CA39929/CA/NCI NIH HHS; GM47845/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Appetite Depressants; 458-24-2/Fenfluramine
Comments/Corrections
Comment In:
Biometrics. 1999 Dec;55(4):1316-7   [PMID:  11315091 ]
Biometrics. 1999 Sep;55(3):990-1   [PMID:  11315040 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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