Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders

<p>Questions of mediation are often of interest in reasoning about mechanisms, and methods have been developed to address these questions. However, these methods make strong assumptions about the absence of confounding. Even if exposure is randomized, there may be mediator-outcome confounding...

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Main Authors: Tyler J VanderWeele, Yasutaka Chiba
Format: Article
Language:English
Published: Milano University Press 2014-03-01
Series:Epidemiology, Biostatistics and Public Health
Online Access:http://ebph.it/article/view/9027
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author Tyler J VanderWeele
Yasutaka Chiba
author_facet Tyler J VanderWeele
Yasutaka Chiba
author_sort Tyler J VanderWeele
collection DOAJ
description <p>Questions of mediation are often of interest in reasoning about mechanisms, and methods have been developed to address these questions. However, these methods make strong assumptions about the absence of confounding. Even if exposure is randomized, there may be mediator-outcome confounding variables. Inference about direct and indirect effects is particularly challenging if these mediator-outcome confounders are affected by the exposure because in this case these effects are not identified irrespective of whether data is available on these exposure-induced mediator-outcome confounders. In this paper, we provide a sensitivity analysis technique for natural direct and indirect effects that is applicable even if there are mediator-outcome confounders affected by the exposure. We give techniques for both the difference and risk ratio scales and compare the technique to other possible approaches.</p>
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series Epidemiology, Biostatistics and Public Health
spelling doaj-art-a9cb6e539b2a45acb9dd260af819f8d62025-08-20T02:00:45ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302014-03-0111210.2427/90279372Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confoundersTyler J VanderWeele0Yasutaka Chiba1Harvard School of Public HealthKinki University<p>Questions of mediation are often of interest in reasoning about mechanisms, and methods have been developed to address these questions. However, these methods make strong assumptions about the absence of confounding. Even if exposure is randomized, there may be mediator-outcome confounding variables. Inference about direct and indirect effects is particularly challenging if these mediator-outcome confounders are affected by the exposure because in this case these effects are not identified irrespective of whether data is available on these exposure-induced mediator-outcome confounders. In this paper, we provide a sensitivity analysis technique for natural direct and indirect effects that is applicable even if there are mediator-outcome confounders affected by the exposure. We give techniques for both the difference and risk ratio scales and compare the technique to other possible approaches.</p>http://ebph.it/article/view/9027
spellingShingle Tyler J VanderWeele
Yasutaka Chiba
Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
Epidemiology, Biostatistics and Public Health
title Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
title_full Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
title_fullStr Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
title_full_unstemmed Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
title_short Sensitivity analysis for direct and indirect effects in the presence of exposure-induced mediator-outcome confounders
title_sort sensitivity analysis for direct and indirect effects in the presence of exposure induced mediator outcome confounders
url http://ebph.it/article/view/9027
work_keys_str_mv AT tylerjvanderweele sensitivityanalysisfordirectandindirecteffectsinthepresenceofexposureinducedmediatoroutcomeconfounders
AT yasutakachiba sensitivityanalysisfordirectandindirecteffectsinthepresenceofexposureinducedmediatoroutcomeconfounders