Adjustment for Missing Confounders in Studies Based on Observational Databases: 2-Stage Calibration Combining Propensity Scores From Primary and Validation Data
Adjustment for Missing Confounders in Studies Based on Observational Databases: 2-Stage Calibration Combining Propensity Scores From Primary and Validation Data
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DOI：
10.1093/aje/kwu130
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发表时间：
2014-08-01
影响因子：
5
通讯作者：
Chen, Yi-Hau
中科院分区：
文献类型：
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作者：
Lin, Hui-Wen;Chen, Yi-Hau
由于混杂因素信息缺失或不完整而导致的偏差构成了观察性研究中的一个重要挑战。将关于更详细混杂信息的外部数据纳入主要研究数据可能有助于消除混杂偏倚。这项工作的动机是研究慢性阻塞性肺疾病和带状疱疹之间的关联。分析是基于行政数据库，其中的重要混淆因素吸烟和饮酒的信息缺乏。我们考虑通过将验证样本与从小规模国家健康访谈调查研究中获得的吸烟和饮酒数据相结合来调整因缺失混杂因素而产生的混杂偏倚。我们提出了一种两阶段校准（TSC）方法，该方法通过倾向性得分总结混杂信息，并结合主样本和验证样本的分析结果，其中主样本的倾向性得分调整是粗略的，而验证样本的倾向性得分调整更精确。与现有方法不同，TSC方法的有效性不依赖于任何特定的测量误差模型。当将TSC方法应用于上述动机研究时，在调整累积吸烟和饮酒量后，带状疱疹与慢性阻塞性肺疾病相关的比值比为1.91（95%置信区间：1.62，2.26）。
Bias caused by missing or incomplete information on confounding factors constitutes an important challenge in observational studies. The incorporation of external data on more detailed confounding information into the main study data may help remove confounding bias. This work was motivated by a study of the association between chronic obstructive pulmonary disease and herpes zoster. Analyses were based on administrative databases in which information on important confounders-cigarette smoking and alcohol consumption-was lacking. We consider adjusting for the confounding bias arising from missing confounders by incorporating a validation sample with data on smoking and alcohol consumption obtained from a small-scale National Health Interview Survey study. We propose a 2-stage calibration (TSC) method, which summarizes the confounding information through propensity scores and combines the analysis results from the main and the validation study samples, where the propensity score adjustment from the main sample is crude and that from the validation sample is more precise. Unlike the existing methods, the validity of the TSC approach does not rely on any specific measurement error model. When applying the TSC method to the motivating study above, the odds ratio of herpes zoster associated with chronic obstructive pulmonary disease is 1.91 (95% confidence interval: 1.62, 2.26) after adjustment for cumulative smoking and alcohol consumption.