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    Biostatistics. 2010 Jul;11(3):572-82. doi: 10.1093/biostatistics/kxq007. Epub 2010 Mar 4.

    On quantifying the magnitude of confounding.

    Source

    Vaccine and Infectious Disease Institute and Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North M2-C200, Seattle, WA 98109, USA. hjanes@scharp.org

    Abstract

    When estimating the association between an exposure and outcome, a simple approach to quantifying the amount of confounding by a factor, Z, is to compare estimates of the exposure-outcome association with and without adjustment for Z. This approach is widely believed to be problematic due to the nonlinearity of some exposure-effect measures. When the expected value of the outcome is modeled as a nonlinear function of the exposure, the adjusted and unadjusted exposure effects can differ even in the absence of confounding (Greenland , Robins, and Pearl, 1999); we call this the nonlinearity effect. In this paper, we propose a corrected measure of confounding that does not include the nonlinearity effect. The performances of the simple and corrected estimates of confounding are assessed in simulations and illustrated using a study of risk factors for low birth-weight infants. We conclude that the simple estimate of confounding is adequate or even preferred in settings where the nonlinearity effect is very small. In settings with a sizable nonlinearity effect, the corrected estimate of confounding has improved performance.

    PMID:
    20203259
    [PubMed - indexed for MEDLINE]
    PMCID:
    PMC2883302
    Free PMC Article

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