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From bad to worse: collider stratification amplifies confounding bias in the "obesity paradox".

TitleFrom bad to worse: collider stratification amplifies confounding bias in the "obesity paradox".
Publication TypeJournal Article
Year of Publication2015
AuthorsBanack HR
Secondary AuthorsKaufman JS
JournalEur J Epidemiol
Volume30
Issue10
Pagination1111-4
Date Published2015 Oct
ISSN1573-7284
KeywordsBias, Causality, Confounding Factors, Epidemiologic, Humans, Linear Models, Models, Statistical, Obesity, Selection Bias, Smoking
Abstract

Smoking is often identified as a confounder of the obesity-mortality relationship. Selection bias can amplify the magnitude of an existing confounding bias. The objective of the present report is to demonstrate how confounding bias due to cigarette smoking is increased in the presence of collider stratification bias using an empirical example and directed acyclic graphs. The empirical example uses data from the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort study of 15,792 men and women in the United States. Poisson regression models were used to examine the confounding effect of smoking. In the total ARIC study population, smoking produced a confounding bias of

DOI10.1007/s10654-015-0069-7
Alternate JournalEur J Epidemiol
PubMed ID26187718