Confounding in Health Research

Author:

Greenland Sander12,Morgenstern Hal12

Affiliation:

1. Department of Epidemiology, Los Angeles School of Public Health, University of California, Los Angeles, California 90095-1772;

2. Department of Statistics, Los Angeles College of Letters and Science, University of California, Los Angeles, California 90095

Abstract

▪ Abstract  Consideration of confounding is fundamental to the design, analysis, and interpretation of studies intended to estimate causal effects. Unfortunately, the word confounding has been used synonymously with several other terms, and it has been used to refer to at least four distinct concepts. This paper provides an overview of confounding and related concepts based on a counterfactual model of causation. In this context, which predominates in nonexperimental research, confounding is a source of bias in the estimation of causal effects. Special attention is given to the history of definitions of confounding, the distinction between confounding and confounders, problems in the control of confounding, the relations of confounding to exchangeability and collapsibility, and confounding in randomized trials.

Publisher

Annual Reviews

Subject

Public Health, Environmental and Occupational Health,General Medicine

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