Unit 5Evaluating Associations.ppt

MISCLASSIFICATION Non-differential misclassification: The proportion of subjects misclassified on exposure does not depend on disease status OR The proportion of subjects misclassified on disease does not depend on exposure status * * Unit 5: Evaluating Associations Unit 5 Learning Objectives: Understand the concepts of “valid” and “causal” statistical associations. Understand the possible explanations for statistical associations: Chance Bias Confounding Distinguish between the major types of bias in epidemiologic studies. Distinguish between “internal validity” and “external validity.” Unit 5 Learning Objectives (cont.): Understand the concept of confounding and methods to assess its presence. Understand the concept of causality, including necessary and sufficient causes. Understand pros and cons of guidelines used to evaluate causal associations in epidemiology. Assigned Readings: Textbook (Gordis): Chapter 14, pages 206-222 (from association to causation) Chapter 15, pages 224-230 (bias and confounding) Evaluating Associations If we observe an exposure/disease association, we must consider: 1. Is the association valid? (do the study findings reflect the true relationship between the exposure and disease?) 2. Is the association causal? (Is there sufficient evidence to infer that a causal association exists between the exposure and the disease?) Evaluating Associations EVALUATING THE VALIDITY OF AN ASSOCATION: In any epidemiologic study, there are at least 3 possible explanations for the observed results: 1. CHANCE 2. BIAS 3. CONFOUNDING These explanations are not mutually exclusive -- more than one can be present in the same study CHANCE 1. Rarely can we study an entire population, so inference is attempted from a sample of the population 2. There will always be random variation from sample to sample 3. In general, smaller samples have less precision, reliability, and statis