EPID 620/PUBH 801: Epidemiologic Methods I

WINGILA MPAMILA

 Understand various forms of bias and how they affect measures of association

1) To describe collider stratification bias using the language of DAGs, you might say “A collider
is the common outcome of two other variables. If there are no other links between the two
variables, they are independent of one another. However, if we condition on the collider,
we open the pathway between the two other variables and induce a biased (non-causal)
association between them.” Please use the language of DAGs to describe confounding (2
pts).

Confounding bias can be reduced by the directed acyclic graphs hence the relationship btn
them is that the DAGs are used to reduce confounding bias by opening either one or more
of the pathways.

2) You are conducting a logistic regression to assess the effect of X on Y. The crude OR is 2.0
but is not statistically significant. When you adjust for Z, the OR becomes 3.5 and is
statistically significant. Is this evidence that Z is a confounder, and why or why not? (2pts)

Yes, this shows that z was the confounder in this logistic regression.

3) You are conducting a case-control study to see if drinking coffee is associated with heart
palpitations. You select cases from a hospital. You select controls from a Starbucks. In
terms of the 4 broad categories of bias (confounding, selection bias, information bias, and
random error) from lecture 11, what form of bias might this create and why (2 pts)?

This will create a selection bias because the exposure status is known to the researcher as
the researcher has specifically selected the controls from Starbucks where the coffee
consumption is.

4) You are conducting a cohort study to see if drinking coffee is associated with stomach
ulcers. You notice that several coffee drinkers are dropping out of the study, and you
become concerned that they are leaving the study because of acid reflux, which is often a
precursor to stomach ulcers. What form of bias might this create and why (1 pt)? Imagine
the true RR is 1.5. In what direction would this bias move the estimated RR (1 pt)?

This might create a differential misclassification bias because the misclassification bias is not
equal to the exposed and unexposed group.
The estimated bias will be moved towards the null height in the work difficult
5) You are conducting a cohort study to see if childhood exposure to a certain kind of
bacterium is associated with latent TB infection. The skin test for latent TB is less accurate
 EPID 620/PUBH 801: Epidemiologic Methods I

among people with previous exposure to the bacteria; in particular, it is just as sensitive but
less specific. Is this differential or non-differential misclassification (1 pt)? If the true RR is
1, how will this bias affect the estimated RR (1 pt)?

This is differential misclassification because the misclassification bias is not equal to the
exposed and unexposed group.
The estimated RR will be moved away from the null