ArticleBMC medical research methodology2017
Can statistic adjustment of OR minimize the potential confounding bias for meta-analysis of case-control study? A secondary data analysis.
Article in BMC medical research methodology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- The added value of coronary CTA in chronic total occlusion percutaneous coronary intervention: a systematic review and meta-analysis.European radiology · 2024Pooled it
- Effect of calcium-channel blockers on the risk of active tuberculosis and mortality: systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- An umbrella review of the evidence linking oral health and systemic noncommunicable diseases.Nature communications · 2022Pooled it
- The association between alcohol consumption and osteoarthritis: a meta-analysis and meta-regression of observational studies.Rheumatology international · 2021Pooled it
- Response to the comment on "Anti-neutrophil cytoplasmic antibodies in interstitial lung disease: results from a cross-sectional study and meta-analysis".Immunologic research · 2026Article
- Sedentary Duration and Systemic Health Burden: Nonlinear Associations with Muscle, Fat, and Vascular Phenotypes in a US Population-Based Study.Healthcare (Basel, Switzerland) · 2025Article
- Exploring Predictors of Type 2 Diabetes Within Animal-Sourced and Plant-Based Dietary Patterns with the XGBoost Machine Learning Classifier: NHANES 2013-2016.Journal of clinical medicine · 2025Article
- Cognitive impairment after tooth extraction: appraising literature and recommendations for future research.Acta odontologica Scandinavica · 2024Article
- Review
- Risk of endometrial, ovarian, and breast cancers in women with polycystic ovary syndrome: A systematic review and meta-analysis.International journal of reproductive biomedicine · 2022Review
- Effect of Oral Antidiabetic Drugs on Tuberculosis Risk and Treatment Outcomes: Systematic Review and Meta-Analysis.Tropical medicine and infectious disease · 2022Review
- Article
- Periodontal disease as a non-traditional risk factor for acute coronary syndrome: a systematic review and meta-analysis.Le infezioni in medicina · 2022Review
- Can statistical adjustment guided by causal inference improve the accuracy of effect estimation? A simulation and empirical research based on meta-analyses of case-control studies.BMC medical informatics and decision making · 2020Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferent confounder adjustment strategies were used to estimate odds ratios (ORs) in case-control study, i.e. how many confounders original studies adjusted and what the variables are. This secondary data analysis is aimed to detect whether there are potential biases caused by difference of confounding factor adjustment strategies in case-control study, and whether such bias would impact the summary effect size of meta-analysis.
methodsWe included all meta-analyses that focused on the association between breast cancer and passive smoking among non-smoking women, as well as each original case-control studies included in these meta-analyses. The relative deviations (RDs) of each original study were calculated to detect how magnitude the adjustment would impact the estimation of ORs, compared with crude ORs. At the same time, a scatter diagram was sketched to describe the distribution of adjusted ORs with different number of adjusted confounders.
resultsSubstantial inconsistency existed in meta-analysis of case-control studies, which would influence the precision of the summary effect size. First, mixed unadjusted and adjusted ORs were used to combine individual OR in majority of meta-analysis. Second, original studies with different adjustment strategies of confounders were combined, i.e. the number of adjusted confounders and different factors being adjusted in each original study. Third, adjustment did not make the effect size of original studies trend to constringency, which suggested that model fitting might have failed to correct the systematic error caused by confounding.
conclusionsThe heterogeneity of confounder adjustment strategies in case-control studies may lead to further bias for summary effect size in meta-analyses, especially for weak or medium associations so that the direction of causal inference would be even reversed. Therefore, further methodological researches are needed, referring to the assessment of confounder adjustment strategies, as well as how to take this kind of bias into consideration when drawing conclusion based on summary estimation of meta-analyses.
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