Confounding.ppt

Confounding * Learning objectives To understand the role of confounders in a study To learn relationship between an exposure, disease and potential confounding factors To understand difference between confounding and effect modification To learn methods to control confounding in study designs and in data analysis * Performance objectives After this lecture the student will be able to: Differentiate the role of a confounder and a exposure in a study Use methods to control effects of confounders in research projects * Confounding Confounding occurs when two factors are associated with each other, or “travel together” and the effect of one is confused with or distorted by the effect of the other. A confounder is a variable which is associated with the exposure, and independent of that exposure is a risk factor of the disease * Confounding Examples: Study one: found an association with smoking and loss of hairs. The study was confounded by age Study two: found improved outcome for maternal centers when compared to hospitals Study might be confounded by highly motivated volunteers that may have selected these centers as an option * Confounding Confounders are generally correlates of other causal factors HSV-2 Sexual activity HPV Cervical cancer A confounder cannot be an intermediate link in the causal pathway between exposure and disease * Confounding In other words, confounding is a variable that is associated with the predictor variable and is a cause of the outcome variable Aside from bias, confounding is often the likely alternative explanation to cause-effect and the most important one to try to rule out. In contrast to bias, confounding can be controlled at several levels of a study Delete sample documenticons and replace with working document icons as follows: From Insert Menu, select Object... Click “Create from File” Locate File name in “File” box Make sure “Display as Icon” is checked Click OK Select icon From Slide Show Menu, Select “Actio