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    The Control of Confounding

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    samuel
    There are several methods to control for confounding in epidemiological studies, including randomization, restriction, and matching in study design, as well as stratification and statistical modeling in analysis. Randomization evenly distributes confounding variables between study groups, restriction limits participation to control for specific variables, and matching pairs cases and controls on confounding factors. Stratification measures associations within categories of confounding variables, while statistical modeling controls for multiple variables simultaneously.

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    The Control of Confounding

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    samuel
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    There are several methods to control for confounding in epidemiological studies, including randomization, restriction, and matching in study design, as well as stratification and statistical modeling in analysis. Randomization evenly distributes confounding variables between study groups, restriction limits participation to control for specific variables, and matching pairs cases and controls on confounding factors. Stratification measures associations within categories of confounding variables, while statistical modeling controls for multiple variables simultaneously.

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    The control of confounding

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    There are several methods to control for confounding in epidemiological studies, including randomization, restriction, and matching in study design, as well as stratification and statistical modeling in analysis. Randomization evenly distributes confounding variables between study groups, restriction limits participation to control for specific variables, and matching pairs cases and controls on confounding factors. Stratification measures associations within categories of confounding variables, while statistical modeling controls for multiple variables simultaneously.

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    43 views2 pages

    The Control of Confounding

    Uploaded by

    samuel
    There are several methods to control for confounding in epidemiological studies, including randomization, restriction, and matching in study design, as well as stratification and statistical modeling in analysis. Randomization evenly distributes confounding variables between study groups, restriction limits participation to control for specific variables, and matching pairs cases and controls on confounding factors. Stratification measures associations within categories of confounding variables, while statistical modeling controls for multiple variables simultaneously.

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    Basic Epidemiology, by Bonita: Pages 55-57

    The control of confounding

    Several methods are available to control confounding, either through study design or during the analysis
    of results.

    The methods commonly used to control confounding in the design of an epidemiological study are:

    􀁸 Randomization

    􀁸 Restriction

    􀁸 Matching.

    At the analysis stage, confounding can be controlled by:

    􀁸 Stratification

    􀁸 Statistical Modeling/ Logistical Regression

    Explanation

    Randomization

    In experimental studies, randomization is the ideal method for ensuring that potential confounding
    variables are equally distributed among the groups being compared. The sample sizes have to be
    sufficiently large to avoid random maldistribution of such variables. Randomization avoids the
    association between potentially confounding variables and the exposure that is being considered.

    Restriction

    One way to control confounding is to limit the study to people who have particular characteristics. For
    example, in a study on the effects of coffee on coronary heart disease, participation in the study could
    be restricted to nonsmokers, thus removing any potential effect of confounding by cigarette smoking.

    Matching
    Matching is used to control confounding by selecting study participants so as to ensure that potential
    confounding variables are evenly distributed in the two groups being compared. For example, in a case-
    control study of exercise and coronary heart disease, each patient with heart disease can be matched
    with a control of the same age group and sex to ensure that confounding by age and sex does not occur.
    Matching has been used extensively in case-control studies but it can lead to problems in the selection
    of controls if the matching criteria are too strict or too numerous; this is called overmatching.

    Matching can be expensive and time-consuming, but is particularly useful if the danger exists of there
    being no overlap between cases and controls, such as in a situation where the cases are likely to be
    older than the controls.

    Stratification and statistical modelling

    In large studies it is usually preferable to control for confounding in the analytical phase rather than in
    the design phase. Confounding can then be controlled by stratification, which involves the measurement
    of the strength of associations in well-defined and homogeneous categories (strata) of the confounding
    variable. If age is a confounder, the association may be measured in, say, 10-year age groups; if sex or
    ethnicity is a confounder, the association is measured separately in men and women or in the different
    ethnic groups. Methods are available for summarizing the overall association by producing a weighted
    average of the estimates calculated in each separate stratum.

    Although stratification is conceptually simple and relatively easy to carry out, it is often limited by the
    size of the study and it cannot help to control many factors simultaneously, as is often necessary. In this
    situation, multivariate statistical modeling is required to estimate the strength of the associations while
    controlling for several confounding variables simultaneously; a range of statistical techniques is available
    for these analyses

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