Evidence map›Paper›PMID 27748680›Full record

ArticleEpidemiology (Cambridge, Mass.)2017

Bias Due to Confounders for the Exposure-Competing Risk Relationship.

Catherine R Lesko, Bryan Lau

Abstract read
In one paragraph

Article in Epidemiology (Cambridge, Mass.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed.

  1. Article
  2. Article
  3. Association of nonstandardized model for end-stage liver disease score exceptions with waitlist mortality in adult liver transplant candidates.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025
    Article
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  13. Article
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  15. Observational
  16. SIMULATION IN PRACTICE: THE BALANCING INTERCEPT.American journal of epidemiology · 2021
    Article
  17. Causal inference in the face of competing events.Current epidemiology reports · 2020
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Catherine R LeskoFrom the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Bryan Lau

Funding

Vaccine Response and Immunotherapeutics SWGP30AI094189 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Richard E. Chaisson · 2012 to 2026
$67.0M
North American AIDS Cohorts on Collaboration and Design (NAACCORD)U01AI069918 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Keri Nicole Althoff, RICHARD Douglas MOORE · 2006 to 2026
$65.2M
Johns Hopkins HIV Clinical CohortU01DA036935 · NIDA · JOHNS HOPKINS UNIVERSITY · PI MOORE, RICHARD DOUGLAS · 2014 to 2024
$14.9M
3/4 Alcohol Research Consortium in HIV - Epidemiological Research Arm (ARCH-ERA)U01AA020793 · NIAAA · UNIVERSITY OF WASHINGTON · PI CRANE, HEIDI M., LAU, BRYAN · 2011 to 2020
$5.8M
Lung and HIV Analytical Data Coordinating Center (LHAD-CC)U01HL121812 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI LAU, BRYAN · 2013 to 2017
$3.4M
Global Immunological Response to Effective Antiretroviral Therapy (GiREAT:CD4)R56AI102622 · NIAID · JOHNS HOPKINS UNIVERSITY · PI LAU, BRYAN · 2013 to 2013
$354k
NHLBI NIH HHS U01 HL121812NIAAA NIH HHS U01 AA020793NIAID NIH HHS P30 AI094189NIAID NIH HHS R56 AI102622NIAID NIH HHS U01 AI069918NIDA NIH HHS U01 DA036935
6 · The paper itself

Abstract

backgroundEpidemiologic studies that aim to estimate a causal effect of an exposure on a particular event of interest may be complicated by the existence of competing events that preclude the occurrence of the primary event. Recently, many articles have been published in the epidemiologic literature demonstrating the need for appropriate models to accommodate competing risks when they are present. However, there has been little attention to variable selection for confounder control in competing risk analyses.

methodsWe employ simulation to demonstrate the bias in two variable selection strategies include covariates that are associated with the exposure and (1) which change the cause-specific hazard of any of the outcomes; or (2) which change the cause-specific hazard of the specific event of interest.

resultsWe demonstrated minimal to no bias in estimators adjusted for confounders of exposure and either the event of interest or the competing event, but bias of varying magnitude in almost all estimators adjusted only for confounders of exposure and the primary outcome. DISCUSSION: When estimating causal effects for which there are competing risks, the analysis should control for confounders of both the exposure-primary outcome effect and of the exposure-competing outcome effect.

Indexed as

BiasCausalityConfounding Factors, EpidemiologicHumansModels, StatisticalProportional Hazards ModelsRisk

Identifiers

PMID27748680
PMCPMC5489237

What OpenQuestion holds

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Registered trials

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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.