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Neuropsychol Rev. 2008 Sep;18(3):194-213. doi: 10.1007/s11065-008-9066-x. Epub 2008 Sep 26.

Methodological challenges in causal research on racial and ethnic patterns of cognitive trajectories: measurement, selection, and bias.

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Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA.


Research focused on understanding how and why cognitive trajectories differ across racial and ethnic groups can be compromised by several possible methodological challenges. These difficulties are especially relevant in research on racial and ethnic disparities and neuropsychological outcomes because of the particular influence of selection and measurement in these contexts. In this article, we review the counterfactual framework for thinking about causal effects versus statistical associations. We emphasize that causal inferences are key to predicting the likely consequences of possible interventions, for example in clinical settings. We summarize a number of common biases that can obscure causal relationships, including confounding, measurement ceilings/floors, baseline adjustment bias, practice or retest effects, differential measurement error, conditioning on common effects in direct and indirect effects decompositions, and differential survival. For each, we describe how to recognize when such biases may be relevant and some possible analytic or design approaches to remediating these biases.

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