Confounding Effect in Clinical Research of Otolaryngology and Its Control

Yu Yong-qiang; Huang Dong-yan; Armijo Olivo Susan; Yang Huai-an; Bambanini Yagesh; Sonnenberg Lyn; Clark Brenda; Constantinescu Gabriela; Qian Yu Jason; Zhang Ming

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Confounding Effect in Clinical Research of Otolaryngology and Its Control

Chinese Medical Sciences Journal Vol. 30, Issue 2, Pages: 121-130(2015)

Review | Updated：2024-04-10

- Confounding Effect in Clinical Research of Otolaryngology and Its Control
- Affiliations：
  
  1. 1Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
  2. 2Department of Otorhinolaryngology Head and Neck Surgery, Clinical Division of Surgery, General Hospital of Chinese People’s Liberation Army, Beijing 100853, China
  3. 3Research Center, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
  4. 4Department of Otolaryngology, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
  5. 5Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
  6. 6Department of Developmental Pediatrics, Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
  7. 7Institute for Reconstructive Science in Medicine, Edmonton, AB T5R 4H5, Canada
  8. 8Alberta School of Business, University of Alberta, Edmonton, AB T6G 2R6, Canada
  9. 9Department of Audiology, Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
  10. 10Department of Surgery-Otolaryngology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Author bio：
  
  *Corresponding author E-mail: yyu2@ualberta.ca
- Funds：
- DOI：
  CLC：
- Received：21 October 2014，
  
  Published Online：20 April 2015，
  
  Published：2015-04
- Accepted：
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Yu Yong-qiang, Huang Dong-yan, Armijo Olivo Susan, et al. Confounding Effect in Clinical Research of Otolaryngology and Its Control[J]. Chinese medical sciences journal, 2015, 30(2): 121-130.
DOI：

Yu Yong-qiang, Huang Dong-yan, Armijo Olivo Susan, et al. Confounding Effect in Clinical Research of Otolaryngology and Its Control[J]. Chinese medical sciences journal, 2015, 30(2): 121-130. DOI：

摘要

Abstract

Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research’s conclusion. In this review

we introduce the definition of confounding effect

the methods of verifying and controlling the effect. Confounding effect can be prevented by research’s design

and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research’s design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely

and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.

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references

Hennekens CH , Buring JE. Epidemiology in Medicine. Philadelphia: Lippincott Williams & Wilkins ; 1987 .

Bailey L , Vardulaki K , Langham J , et al. Introduction to Epidemiology. Berkshire : Open University Press ; 2005 .

Kestenbaum B. Methods to control for confounding. In: Epidemiology and Biostatistics. An introduction to clinical research . New York : Springer ; 2009 .

Wunsch G. Confounding and control. Demographic Res 2007 ; 16 : 97 - 120 .

Petrie A , Sabin C. Bias and confounding. Medical statistics at a glance. 3rd ed . Oxford: Wiley-Blackwell ; 2009 .

Szumilas M . Explaining Odds Ratios . J Can Acad Child Adolesc Psychiatry 2010 ; 19 : 227 - 9 .

Choi SY , Cho YS , Lee NJ , et al. Factors associated with quality of life after ear surgery in patients with chronic otitis media. Arch Otolaryngol Head Neck Surg 2012 ; 138 : 840 - 5 .

Avetisyan N , Lautermann J. Ear diseases and diabetes mellitus. J HNO 2014 ; 62 : 823 - 32 .

9.Orji FT , Dike BO , Oji O . Determinants of non-healing ear discharge in chronic suppurative otitis media in a developing country . Eur Arch Otorhinolaryngol 2014 ; [Epub ahead of print].

Schisterman EF , Cole SR , Plattc RW. Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 2009 ; 20 : 488 - 95

Weinberg CR. Can DAGs clarify effect modification? Epidemiology 2007 ; 18 : 569 - 72 .

Vanderweele TJ , Robins JM. Directed Acyclic Graphs, sufficient causes, and the properties of conditioning on a common effect. Am J Epid 2007 ; 166 : 1096 - 104 .

Nowak K , Banaszewski J , Dabrowski P , et al. Tinnitus in systemic diseases. Otolaryngol Pol 2002 ; 56 : 213 - 6 .

Horwitz RI , McFarlane MJ, Brennan TA , et al . The role of susceptibility bias in epidemiologic research. Arch Intern Med 1985 ; 145 : 909 - 12 .

Kramer MS. Clinical epidemiology and biostatistics. New York: Springer ; 1988 . p. 54 - 6 .

Greenland S , Morgenstern H. Confounding in health research. Ann Rev Public Health 2001 ; 22 : 189 - 212 .

Lobo FS , Wagner S , Gross CR , et al. Addressing the issue of handling bias in observational studies with propensity scores analysis. Res Social Adm Pharm 2006 ; 2 : 143 - 51 .

Jager KJ , Zoccali C , Macleod A , et al. Confounding: What it is and how to deal with it. Kidney Int 2008 ; 73 : 256 - 60 .

Rothman JJ. Modern epidemiology. 6th ed. Boston: Little Brown and Company ; 1986 . p. 84 - 94 .

Jaeschke R , Sackett DL. Research methods for obtaining primary evidence. Int J Technol Assess Health Care 1989 ; 5 : 503 - 19 .

Bland JM , Altman DG. Statistics notes: Matching. BMJ 1994 ; 309 : 1128 .

Bland JM , Altman DG. Matching in case-control studies. BMJ 1995 ; 310 : 329 - 30 .

Marsh JL , Hutton JL , Binks K. Removal of radiation dose response effects: An example of over-matching. BMJ 2002 ; 325 : 327 - 30 .

Hajian-Tilaki KO. Evaluation of the rule of matching in case-control and cohort studies. Proceeding of the 6th International Statistics Conference. Tehran: Tarbiat Modarres University ; 2002 . p. 32 .

Oesterling JE , Cooner WH , Jaconsen SJ , et al. Influence of patient age on serum PSA concentration. An important clinical observation. Urol Clin North Am 1993 ; 20 : 671 - 80 .

Brookhart MA , Sturmer T , Glynn RJ , et al. Confounding control in healthcare database research: Challenges and potential approaches. Med Care 2010 ; 48 : 114 - 20 .

Gordis L. More on causal inferences: Bias, confounding and interaction. 4th ed. Philadelphia: Saunders Elsevier ; 2009 . p. 247 - 65 .

van Stralen KJ , Dekker FW , Zoccali C . Confounding. Nephron Clin Pract 2010 ; 116 : c143 - 7 .

Farrokhyar F , Bajammal S , Kahnamoui K , et al. Practical tips for surgical research. Ensuring balanced groups in surgical trials. Can J Surg 2010a ; 53 : 418 - 23 .

Farrokhyar F , Karanicolas PJ , Thoma A , et al. Randomized controlled trials of surgical interventions. Ann Surg 2010b ; 251 : 409 - 16 .

Egger M , Schneider M , Davey SG. Spurious precision? Meta-analysis of observational studies. BMJ 1998 ; 316 : 140 - 4 .

Tripepi G , Jager KJ , Dekker FW. Stratification for confounding—part 1: The Mantel-Haenszel formula. Nephron Clin Pract 2010 ; 116 : c317 - 21 .

Fisher L , Patil K. Matching and unrelatedness. Am J Epidemol 1974 ; 100 : 347 .

Simpson EH. The interpretation of interaction in contingency tables. J R Stat Soc Series 1951 ; B13 : 238 - 41 .

Wagner CH. Simpson's paradox in real life. Am Stat 1982 ; 36 : 46 - 8 .

Greenland S , Pearl J , Robins JM. Causal diagrams for epidemiologic research. Epidemiology 1999 ; 10 : 37 - 48 .

Keppel G. Design and analysis: A researcher's handbook. 3rd ed. Englewood Cliffs: Prentice-Hall Inc. ; 1991 .

Howell DC. Statistical methods for psychology. 7th ed. Belmont: Cengage Wadsworth ; 2009 .

McNamee R . Regression modelling and other methods to control confounding. Occup Environ Med 2005 ; 62 : 500 - 6 .

Tabachnick BG , Fidell LS. Using multivariate statistics. 5th ed. Boston: Allyn and Bacon ; 2007 .

Kutner MH , Nachtsheim CJ , Neter J , et al. Applied Linear Statistical Models.5th ed. New York: McGraw-Hill/ Irwin ; 2005 .

Tripepi G , Jager KJ , Dekker FW. Linear and logistic regression analysis. Kidney Int 2008 ; 73 : 806 - 10 .

Blackstone EH. Comparing apples and oranges. J Thorac Cardiovasc Surg 2002 ; 123 : 8 - 15 .

Morshed S , Tornetta P Ⅲ , Bhandari M. Analysis of observational studies: A guide to understanding statistical methods. J Bone Joint Surg Am 2009 ; 91 : 50 - 60 .

Good PI , Hardin JW. Common Errors in Statistics (And How to Avoid Them). 3rd ed. New Jersey: Wiley ; 2009 .

Peduzzi P , Concato J , Kemper E. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996 ; 49 : 1373 - 9 .

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