Module4_CausationBiasConfounding_Feldmanmodule4_causationbias和confounding_feldman.pptVIP

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Module4_CausationBiasConfounding_Feldmanmodule4_causationbias和confounding_feldman.ppt

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Module4_CausationBiasamp;Confounding_Feldmanmodule4_causationbias和confounding_feldman.ppt

Epidemiology and Applied Statistics Review Module 4 – Causation, Bias Confounding American College of Veterinary Preventive Medicine Review Course Katherine Feldman, DVM, MPH, DACVPM kfeldman@ 301-314-6820 Plan Students review modules on their own Send questions by email to Katherine Feldman (kfeldman@) by Friday March 23 a.m. Conference call Friday March 23 2-3 p.m. Watch email and Blackboard for conference call details References Gordis L. Epidemiology, 3rd ed. Elsevier Saunders, Philadelphia, 2004. $47.95 from A Norman GR, Streiner DL. PDQ statistics, 3rd ed. BC Decker Inc., Hamilton, 2003. $17.79 from A Explanations for an Association If we determine an association between an exposure and an outcome exists (i.e., there is a significant OR or RR), there are a number of possibilities to explain the association It’s REAL SELECTION bias (who gets into the study) accounts for it INFORMATION bias (how information is collected for the study) accounts for it It’s CONFOUNDING the association between another risk factor and disease It’s due to error in conducting the study It’s due to CHANCE Bias Any systematic error in the design, conduct or analysis of a study that results in a mistaken estimate of an exposure’s effect on the risk of disease Two major categories Selection bias Information bias Selection Bias Can occur whenever identification of individual subjects for inclusion results in a mistaken estimate of the measure of effect More simply, selection bias is a problem with who is in the study Some examples Detection (aka surveillance or diagnostic) bias – persons followed more closely by health care providers because of some exposure are more likely to be diagnosed as a case Self-selection bias – subjects differentially self-refer Non-response bias – subjects differentially do not participate Inappropriate comparison group – comparison group does not appropriately represent the population from which cases arose Information Bias Systematic error in the