Document Detail

Some conceptual problems in multivariable analyses of perinatal mortality.
MedLine Citation:
PMID:  1881835     Owner:  NLM     Status:  MEDLINE    
Biostatisticians, epidemiologists and other researchers in maternal and child health have often used multivariable analysis to investigate associations with perinatal and infant mortality. A review of reports of such multivariable analyses published over the last 35 years revealed four problems that occur repeatedly. (1) Variables that are intermediate in the causal pathway between some study variables and perinatal death ('intervening variables') are controlled as though they were confounders. (2) When birthweight is analysed as an intervening variable, it is entered into the analysis in a few large categories, such as above and below 2500 g. This is not an adequate way of controlling for birthweight. (3) Social and demographic variables often interact statistically with birthweight in their effects on perinatal mortality, but these interactions have not been analysed in most multivariable studies. (4) Highly intercorrelated variables that represent similar theoretical constructs are entered simultaneously into one regression analysis. Solutions to these problems are suggested. Analytical approaches in which investigators use knowledge of biological and medical subject matter to make judgements about confounding and causal inference are encouraged.
J L Kiely
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  5     ISSN:  0269-5022     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  1991 Jul 
Date Detail:
Created Date:  1991-10-03     Completed Date:  1991-10-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  243-57     Citation Subset:  IM    
Gertrude H. Sergievsky Center, Faculty of Medicine, Columbia University, New York, New York.
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MeSH Terms
Birth Weight
Confounding Factors (Epidemiology)
Epidemiologic Methods
Infant Mortality*
Infant, Newborn
Multivariate Analysis*
Grant Support

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