论文标题
使用边界的多偏置灵敏度分析
Multiple-bias sensitivity analysis using bounds
论文作者
论文摘要
未衡量的混杂,选择偏差和测量误差是流行病学研究中众所周知的偏见来源。评估这些偏见的方法有其自身的局限性。许多定量灵敏度分析方法可以单独考虑每种偏见,而更复杂的方法更难实施或需要许多假设。通过一次不一立即考虑多种偏见,研究人员可以低估或高估其共同影响。我们表明,由于这三个来源,有可能束缚总复合偏置,并使用这种偏见来评估风险比与这些偏见的任何组合的敏感性。在各种情况下,我们为总体复合偏见而得出了界限,从而为研究人员提供了评估其总潜在影响的工具。我们将此技术应用于一项研究,在该研究中,无法衡量的混杂和选择偏见既关注,又是另一项研究,其中可能的差异暴露误差和未衡量的混杂问题是关注点。我们还表明,“多偏置电子价值”可以描述观察到的风险比与无因果效应兼容(或与其他预先指定效应大小)所必需的关节偏置参数关联的最小强度。这可能提供有关每种偏见相对影响的直觉。我们描述的方法易于使用最小的假设实现,我们提供了R功能。
Unmeasured confounding, selection bias, and measurement error are well-known sources of bias in epidemiologic research. Methods for assessing these biases have their own limitations. Many quantitative sensitivity analysis approaches consider each type of bias individually, while more complex approaches are harder to implement or require numerous assumptions. By failing to consider multiple biases at once, researchers can underestimate -- or overestimate -- their joint impact. We show that it is possible to bound the total composite bias due to these three sources, and to use that bound to assess the sensitivity of a risk ratio to any combination of these biases. We derive bounds for the total composite bias under a variety of scenarios, providing researchers with tools to assess their total potential impact. We apply this technique to a study where unmeasured confounding and selection bias are both concerns, and to another study in which possible differential exposure misclassification and unmeasured confounding are concerns. We also show that a "multi-bias E-value" can describe the minimal strength of joint bias-parameter association necessary for an observed risk ratio to be compatible with a null causal effect (or with other pre-specified effect sizes). This may provide intuition about the relative impacts of each type of bias. The approach we describe is easy to implement with minimal assumptions, and we provide R functions to do so.