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How to estimate the association between change in a risk factor and a health outcome?

2020/12/21 by Michail Katsoulis, Katsoulis, Michail, Alvina G. Lai +18
Economics, Econometrics and Finance · Medicine · #62-07 (in MSC2010) or 62R07 (in MSC2020) #FOS: Computer and information sciences #Health Systems, Economic Evaluations, Quality of Life #Methodology (stat.ME) #Nutrition and Health in Aging #Obesity, Physical Activity, Diet

paper · pdf · doi:10.48550/arxiv.2012.11291

openalex publication_date 2020/12/21 · openalex created_date 2021/01/05 · openalex updated_date 2026/07/28

Abstract

Estimating the effect of a change in a particular risk factor and a chronic disease requires information on the risk factor from two time points; the enrolment and the first follow-up. When using observational data to study the effect of such an exposure (change in risk factor) extra complications arise, namely (i) when is time zero? and (ii) which information on confounders should we account for in this type of analysis? From enrolment or the 1st follow-up? Or from both?. The combination of these questions has proven to be very challenging. Researchers have applied different methodologies with mixed success, because the different choices made when answering these questions induce systematic bias. Here we review these methodologies and highlight the sources of bias in each type of analysis. We discuss the advantages and the limitations of each method ending by making our recommendations on the analysis plan.

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