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    Confounding Variable

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    Tefera Asres
    A confounding variable is a third variable that is associated with both the exposure and outcome being studied, providing an alternative explanation for their association. Common ways to control for confounding include randomization, restriction, matching, stratification, and multivariate analysis. When evaluating study results, it is important to consider whether all important confounders were accounted for and whether residual confounding could be influencing the observed association.

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    Confounding Variable

    Uploaded by

    Tefera Asres
    22 views3 pages
    A confounding variable is a third variable that is associated with both the exposure and outcome being studied, providing an alternative explanation for their association. Common ways to control for confounding include randomization, restriction, matching, stratification, and multivariate analysis. When evaluating study results, it is important to consider whether all important confounders were accounted for and whether residual confounding could be influencing the observed association.

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    A confounding variable is a third variable that is associated with both the exposure and outcome being studied, providing an alternative explanation for their association. Common ways to control for confounding include randomization, restriction, matching, stratification, and multivariate analysis. When evaluating study results, it is important to consider whether all important confounders were accounted for and whether residual confounding could be influencing the observed association.

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    Confounding Variable

    Uploaded by

    Tefera Asres
    A confounding variable is a third variable that is associated with both the exposure and outcome being studied, providing an alternative explanation for their association. Common ways to control for confounding include randomization, restriction, matching, stratification, and multivariate analysis. When evaluating study results, it is important to consider whether all important confounders were accounted for and whether residual confounding could be influencing the observed association.

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    Confounding variable

    The term confounding refers to a situation in which a non-causal association between a given
    exposure and an outcome is observed because of the influence of a third variable (group of
    variables), usually designated as a confounding variable, or merely confounder. Confounding
    provides an alternative explanation for an association between an exposure and an outcome. It
    occurs when an observed association between an exposure and an outcome is distorted because
    the exposure of interest is correlated with another risk factor. This additional risk factor is also
    associated with the outcome, but independently of the exposure of interest.

    Characteristic of confounding variables


     The confounding variable is a risk factor for the outcome of interest
     The confounding variable is associated with the exposure interest
     Is not an intermediate variable in the causal pathway between exposure and outcome of
    interests

    The effects of confounding by a third factor:


     may totally or partially account for the apparent effect
     may mask an underlying true association
     may reverse the actual direction of the association

    Ways for controlling confounders

    Confounding can be dealt with at the study design stage or in the analysis, as long as data on
    potential confounders have been collected.
    Randomization: It is the best method to control for confounding, because it helps to ensure that
    known (and even unknown) confounding variables are distributed evenly between the study
    groups. However, this method can only be used in intervention studies.

    Restriction: Simply limits the study to include people who are similar in relation to the
    confounder. For example, if sex is known to be a confounder, the study may be designed only to
    include men. However, this does then mean that the results of that study can only be applied to
    men.

    Matching: It is usually only used in case–control studies and ensures that controls are selected
    who are similar to cases in terms of potential confounder.

    Stratification: It can be thought of as an extension of restriction. However, rather than only


    studying people who are similar in relation to the confounder, the confounding variable can be
    split into groups (e.g. men and women), and associations between exposure and outcome
    analyzed separately in each group. However, a problem with stratification in the analysis of any
    study design is that the more the original sample is stratified the smaller the sample size of each
    sub-sample becomes, and hence the power to detect associations is reduced.

    Multivariate analysis: This is the use of statistical modeling techniques, whereby data on
    potential confounders are included in the statistical model, which then simultaneously adjusts for
    all confounding variables.

    Matched analysis: Stratification and statistical modeling are techniques usually carried out on
    non-randomized studies, as in randomized studies patient characteristics should be equally
    distributed in each group.

    Questions that should be raised while observed association tested for the possibility of
    confounding effect:

     Have the authors considered all-important confounders and controlled for them in their
    analysis?
     Could there be residual confounding by variables that have not been considered or
    because of incomplete adjustment for factors that have?
     If so, what effect might this have had on the study results?
     Again, the important thing is to think practically: in which direction is any residual
    confounding likely to operate?

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