ArticleInternational journal of epidemiology2009
Estimating the odds ratio when exposure has a limit of detection.
Article in International journal of epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed, 124 citations in OpenAlex.
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- A data-driven single substitution to overcome bias from conventional single substitution for LOD missingness in covariates in least squares regression.Journal of applied statistics · 2026Article
- Harmonizing HIV-1 RNA laboratory measurements in a longitudinal cohort collaboration.American journal of epidemiology · 2026Article
- Multiplex polymerase chain reaction for pathogen identification and antibiotic stewardship in human immunodeficiency virus-associated diarrhea: A retrospective study and systematic review.SAGE open medicine · 2026Review
- Associations of urinary phytoestrogen biomarkers with uric acid and hyperuricemia, and the mediating role of kidney function.Nutrition journal · 2025Article
- The association between urinary cadmium exposure levels and overactive bladder syndrome in the U.S. adults from NHANES database.Scientific reports · 2025Article
- Association between five novel anthropometric indices and erectile dysfunction in US adults from NHANES database.Scientific reports · 2025Article
- Radiodensities of Skeletal Muscle and Visceral Adipose Tissues Are Prognostic Factors in Clear-Cell Renal Cell Carcinoma.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Associations of per- and polyfluoroalkyl substances with maternal early second trimester sex-steroid hormones.International journal of hygiene and environmental health · 2024Article
- Causal mediation analysis with mediator values below an assay limit.Statistics in medicine · 2024Article
- The association between urinary organophosphate insecticide metabolites and erectile dysfunction in the United States.International journal of impotence research · 2024Article
- Laparoscopically confirmed endometriosis and anti-Müllerian hormone levels: Findings from the Nurses' Health Study II.Maturitas · 2024Article
- Making Sense of Censored Covariates: Statistical Methods for Studies of Huntington's Disease.Annual review of statistics and its application · 2024Article
- Association between 2,4-dichlorophenoxyacetic acid and cognitive impairment in older adults: a cross-sectional study from NHANES 2001-2002 and 2011-2014.Journal of exposure science & environmental epidemiology · 2024Article
- Article
- Urinary arsenic and spontaneous pregnancy loss - a hypothesis-generating case-control investigation in western Romania.Chemosphere · 2023Article
- Biobehavioral Influences of Stress and Inflammation on Mucositis in Adolescents and Young Adults with Cancer: Results from a Pilot Study.Journal of adolescent and young adult oncology · 2023Article
- Exposure of preterm neonates receiving total parenteral nutrition to phthalates and its impact on neurodevelopment at the age of 2 months.Scientific reports · 2023Article
- Reference intervals for cd, hg, Mn and Pb in the general children population (3-14 years) of Kinshasa, Democratic Republic of Congo (DRC) between June 2019 and June 2020.Archives of public health = Archives belges de sante publique · 2023Article
- Semiparametric analysis of a generalized linear model with multiple covariates subject to detection limits.Statistics in medicine · 2022Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIn epidemiologic research, little emphasis has been placed on methods to account for left-hand censoring of 'exposures' due to a limit of detection (LOD).
methodsWe calculate the odds of anti-HIV therapy naiveté in 45 HIV-infected men as a function of measured log(10) plasma HIV RNA viral load using five approaches including ad hoc methods as well as a maximum likelihood estimate (MLE). We also generated simulations of a binary outcome with 10% incidence and a 1.5-fold increased odds per log increase in a log-normally distributed exposure with 25, 50 and 75% of exposure data below LOD. Simulated data were analysed using the same five methods, as well as the full data.
resultsIn the example, the estimated odds ratio (OR) varied by 1.22-fold across methods, from 1.45 to 1.77 per log(10) copies of viral load and the standard error for the log OR varied by 1.52-fold across methods, from 0.31 to 0.47. In the simulations, use of full data or the MLE was unbiased with appropriate confidence interval (CI) coverage. However, as the proportion of exposure below LOD increased, substituting LOD, LOD/ radical 2 or LOD/2 was increasingly biased with increasingly inappropriate CI coverage. Finally, exclusion of values below LOD was unbiased but imprecise.
conclusionsIn this example and the settings explored by simulation, and among methods readily available to investigators (i.e. sans full data), the MLE provided an unbiased and appropriately precise estimate of the exposure-outcome OR.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.