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Association Vs Causality in Transfusion Medicine: Understanding Multivariable Analysis in Prediction Vs Etiologic Research.
MedLine Citation:
PMID:  23489995     Owner:  NLM     Status:  Publisher    
In the current medical literature, etiologic and prediction research aims are frequently confused. Investigators tend to use principles from prediction research for their etiologic research questions, which results in misleading interpretation of risk factor findings at hand. We used a questionnaire-based survey to quantify the proportion of International Society of Blood Transfusion (ISBT) 2012, Cancun, visitors who felt confident with a causal interpretation of a stepwise logistic regression model. We designed and distributed a short online questionnaire survey addressing questions about a constructed abstract entitled "Association of transfusion and clinical outcomes in a large cohort" among the participants of ISBT 2012, Cancun. In addition to asking questions about the demographics (age, sex, country of employment, and highest education level) of the participants, we designed 7 statements representing possible interpretations of the findings presented in the abstract and asked the participants to mark Agree, Disagree, or Do Not Know for each statement. Based on the responses to these statements, we quantified the proportion of participants who inferred causality from stepwise multivariable models built to examine a question of association (or prediction).Thirty percent to 40% of the respondents agreed that a stepwise model was a valid method to adjust for confounding, and 60% of them agreed to a causal interpretation of a model built for prediction purposes. These findings suggest that a large proportion of ISBT visitors confuse etiology with prediction in the published transfusion medicine research. Using the results as a platform, we aim to delineate the distinction between etiologic and prediction research, issues of confounding accompanying these research aims and how a multivariable model deals with confounding.
Saurabh Zalpuri; Rutger A Middelburg; Leo van de Watering; Eleftherios Vamvakas; Jaap Jan Zwaginga; Johanna G van der Bom
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-12
Journal Detail:
Title:  Transfusion medicine reviews     Volume:  -     ISSN:  1532-9496     ISO Abbreviation:  Transfus Med Rev     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709027     Medline TA:  Transfus Med Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Inc.
Center for Clinical Transfusion research, Sanquin Research, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
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