Bias analyses to investigate the impact of differential participation : Application to a birth defects case-control study

© 2023 John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA..

BACKGROUND: Certain associations observed in the National Birth Defects Prevention Study (NBDPS) contrasted with other research or were from areas with mixed findings, including no decrease in odds of spina bifida with periconceptional folic acid supplementation, moderately increased cleft palate odds with ondansetron use and reduced hypospadias odds with maternal smoking.

OBJECTIVES: To investigate the plausibility and extent of differential participation to produce effect estimates observed in NBDPS.

METHODS: We searched the literature for factors related to these exposures and participation and conducted deterministic quantitative bias analyses. We estimated case-control participation and expected exposure prevalence based on internal and external reports, respectively. For the folic acid-spina bifida and ondansetron-cleft palate analyses, we hypothesized the true odds ratio (OR) based on prior studies and quantified the degree of exposure over- (or under-) representation to produce the crude OR (cOR) in NBDPS. For the smoking-hypospadias analysis, we estimated the extent of selection bias needed to nullify the association as well as the maximum potential harmful OR.

RESULTS: Under our assumptions (participation, exposure prevalence, true OR), there was overrepresentation of folic acid use and underrepresentation of ondansetron use and smoking among participants. Folic acid-exposed spina bifida cases would need to have been ≥1.2× more likely to participate than exposed controls to yield the observed null cOR. Ondansetron-exposed cleft palate cases would need to have been 1.6× more likely to participate than exposed controls if the true OR is null. Smoking-exposed hypospadias cases would need to have been ≥1.2 times less likely to participate than exposed controls for the association to falsely appear protective (upper bound of selection bias adjusted smoking-hypospadias OR = 2.02).

CONCLUSIONS: Differential participation could partly explain certain associations observed in NBDPS, but questions remain about why. Potential impacts of other systematic errors (e.g. exposure misclassification) could be informed by additional research.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - year:2023

Enthalten in:

Paediatric and perinatal epidemiology - (2023) vom: 15. Dez.

Sprache:

Englisch

Beteiligte Personen:

Petersen, Julie M [VerfasserIn]
Kahrs, Jacob C [VerfasserIn]
Adrien, Nedghie [VerfasserIn]
Wood, Mollie E [VerfasserIn]
Olshan, Andrew F [VerfasserIn]
Smith, Louisa H [VerfasserIn]
Howley, Meredith M [VerfasserIn]
Ailes, Elizabeth C [VerfasserIn]
Romitti, Paul A [VerfasserIn]
Herring, Amy H [VerfasserIn]
Parker, Samantha E [VerfasserIn]
Shaw, Gary M [VerfasserIn]
Politis, Maria D [VerfasserIn]
National Birth Defects Prevention Study [VerfasserIn]

Links:

Volltext

Themen:

Bias
Congenital abnormalities
Differential participation
Journal Article
Quantitative bias analysis
Selection bias
Sensitivity analysis

Anmerkungen:

Date Revised 12.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1111/ppe.13026

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365935573