SynthesisBMC medical research methodology2020
Evaluation of confounding in epidemiologic studies assessing alcohol consumption on the risk of ischemic heart disease.
Synthesis in BMC medical research methodology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 12 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
28 citing papers in PubMed, 12 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- A review of the relationship between dimensions of alcohol consumption and the burden of disease: 2026 update including Mendelian randomisation studies.Addiction (Abingdon, England) · 2026Pooled it
- Is There Any Association Between Periodontitis and Prostatic Alterations? A Systematic Review.The Prostate · 2025Pooled it
- Evaluating agreement between individual nutrition randomised controlled trials and cohort studies - a meta-epidemiological study.BMC medicine · 2025Pooled it
- Grilling the data: application of specification curve analysis to red meat and all-cause mortality.Journal of clinical epidemiology · 2024Pooled it
- Characterization and critical appraisal of physiotherapy intervention research in Nigeria: a systematic review.BMC musculoskeletal disorders · 2024Pooled it
- Alcohol consumption and its association with cancer, cardiovascular, liver and brain diseases: a systematic review of Mendelian randomization studies.Frontiers in epidemiology · 2024Pooled it
- Is there any association between the presence of biomarkers and apical periodontitis? A systematic review.Frontiers in immunology · 2024Pooled it
- Association of health benefits and harms of Christmas dessert ingredients in recipes from The Great British Bake Off: umbrella review of umbrella reviews of meta-analyses of observational studies.BMJ (Clinical research ed.) · 2023Pooled it
- Critical appraisal of confounding factors of observational studies on the association between dentofacial features and dental trauma in a Brazilian population.Evidence-based dentistry · 2023Pooled it
- Is there an association between periodontal disease and root caries? A systematic review and meta-analysis.PloS one · 2023Pooled it
- Are there non-linear relationships between alcohol consumption and long-term health?: a systematic review of observational studies employing approaches to improve causal inference.BMC medical research methodology · 2022Pooled it
- A Systematic Review of MicroRNA Signatures Associated with the Progression of Leukoplakia with and without Epithelial Dysplasia.Biomolecules · 2021Pooled it
- Ventricular cardiac magnetic resonance traits and schizophrenia risk: a UK Biobank and Mendelian randomization study.Frontiers in psychiatry · 2026Article
- Novel approach to substantiate cause-and-effect relationships: combining study ranking and statistical modelling, with a crucial role of data sharing.European journal of nutrition · 2025Article
- The burden of cardiovascular disease attributable to dietary risk factors in China, 1990-2021.Scientific reports · 2025Article
- COPD Management: Bridging the Gap Between Living Well and Living Longer.International journal of chronic obstructive pulmonary disease · 2025Article
- Tea intake and non-alcoholic fatty liver disease risk: A two-sample Mendelian randomization study.Metabolism open · 2024Article
- Global rural health disparities in Alzheimer's disease and related dementias: State of the science.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Review
- Article
- Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020.Lancet (London, England) · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAmong different investigators studying the same exposures and outcomes, there may be a lack of consensus about potential confounders that should be considered as matching, adjustment, or stratification variables in observational studies. Concerns have been raised that confounding factors may affect the results obtained for the alcohol-ischemic heart disease relationship, as well as their consistency and reproducibility across different studies. Therefore, we assessed how confounders are defined, operationalized, and discussed across individual studies evaluating the impact of alcohol on ischemic heart disease risk.
methodsFor observational studies included in a recent alcohol-ischemic heart disease meta-analysis, we identified all variables adjusted, matched, or stratified for in the largest reported multivariate model (i.e. potential confounders). We recorded how the variables were measured and grouped them into higher-level confounder domains. Abstracts and Discussion sections were then assessed to determine whether authors considered confounding when interpreting their study findings.
results85 of 87 (97.7%) studies reported multivariate analyses for an alcohol-ischemic heart disease relationship. The most common higher-level confounder domains included were smoking (79, 92.9%), age (74, 87.1%), and BMI, height, and/or weight (57, 67.1%). However, no two models adjusted, matched, or stratified for the same higher-level confounder domains. Most (74/87, 85.1%) articles mentioned or alluded to "confounding" in their Abstract or Discussion sections, but only one stated that their main findings were likely to be affected by residual confounding. There were five (5/87, 5.7%) authors that explicitly asked for caution when interpreting results.
conclusionThere is large variation in the confounders considered across observational studies evaluating the impact of alcohol on ischemic heart disease risk and almost all studies spuriously ignore or eventually dismiss confounding in their conclusions. Given that study results and interpretations may be affected by the mix of potential confounders included within multivariate models, efforts are necessary to standardize approaches for selecting and accounting for confounders in observational studies.
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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.