CAUSAL INFERENCE Flashcards

1
Q

Making judgment about causality; has process to follow

A

Causal Inference

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2
Q

Process of using different statistical methods to characterize the association between variables.

A

Statistical Association
(Statistical dependence between two variables
There is an identifiable relationship bet 2 variables
Association/ relationship is either positive or negative)

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3
Q

Process of ascribing causal relationships to associations between variables
An example of an association

A

Causal Inference

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4
Q

Factor that plays an essential role in producing an outcome
Event, condition, and characteristics
Presence of this factor should result to an outcome

A

Cause
Cause = Exposure, Outcome = disease
Ex: great intake of sugar = diabetes

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5
Q

Identifiable relationship between exposure (factor) and disease (outcome)
Cannot tell yet which one is the factor and which one is the outcome
Relationship could be co-existence: bidirectional: Cannot say yet that the exposure is the cause of the disease or that the factor is the cause of the outcome

A

Association
Cannot say yet that the exposure is the cause of the disease or that the factor is the cause of the outcome
Ex: poor lack of education, intelligence success in life

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6
Q

Presence of mechanism that leads from exposure to disease
Relationship is cause-effect: one direction: unidirectional: causal
There is really a cause that leads to the effect

A

Cause
Cause must precede the effect; cause first then effect
Ex: Mycobacterium tuberculosis —> TB, x —> y, infectious agent —> disease

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7
Q

Types of Association: (Causal vs Non-causal)
direct: Alteration in the frequency or quality of one event is followed by a change in the other
Direct relationship; one increase/ decreased the other increases/ decreases too

A

Causal

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8
Q

Types of Association: (Causal vs Non-causal)
indirect: Association is a result of the relationship of both factor and disease with a third variable
There is a relationship between the 2 variable because of the presence of a third/ confounder

A

Non Causal
Third variable: confounder: only variable that makes the 2 variables related
Associated to exposure and will be the risk factor for the outcome of interest
Confounder should be eliminated to be a causal association/ direct

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9
Q

Process/ Steps of Causal Inference : (Step 1 or Step 2)
Rule out chance, bias, confounding as explanation of the observed association
If ruled out = association is valid
If not ruled out, the association is not valid
Chance: external validity; random errors
Bias and confounding: internal validity; systematic errors

A

Step 1

Determine the validity of the association

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10
Q

Process/ Steps of Causal Inference : (Step 1 or Step 2)

Consider totality of evidence taken from a number of sources

A

Step 2

Determine if observed association is causal

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11
Q

Causal Inference: Step 1: Validity of the Association
(Internal vs External)
Bias and confounding
Estimate of the effect measure is accurate. Association should not be due to systematic error

A

Internal Validity

Validity within the study

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12
Q

Causal Inference: Step 1: Validity of the Association
(Internal vs External)
Chance
Estimate generalizable to a bigger population. Not due to random error

A

External Validity

Validity beyond the study

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13
Q

TRUE OR FALSE:

The goal of epidemiologic studies is to estimate the value of the parameter (population) with little error

A

TRUE

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14
Q

Sources of errors:
sampling errors; chance
Difference between population value of parameter being investigated and the estimate value based on the different samples
Inference will be inaccurate due to chance

A

Random Errors

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15
Q

Generalization about the group on the basis of data from the sample of the group

A

Chance

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16
Q
Sources of errors: 
distortion in the estimation of the magnitude of association between Exposure and Disease (over or under estimation)
Deviation from the truth 
Bias: Selection and Information 
Confounding
A

Systematic errors

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17
Q

Types of Bias:
non-representative sample; not valid
Sample respondents are not representative of the population or general respondents

A

Selection Bias

18
Q

Types of Bias:
inaccurate information collected from sample
Misclassification: Differential (non-random) and Non-differential (random)

A

Information Bias

19
Q

Sources of Bias:
anything used to collect the data
Ex: weighing scale that was not calibrated = inaccurate info
Questionnaires that have vague instructions

A

Instrument

20
Q

Sources of Bias:
respondents can give inaccurate information
Due to old age, not want to disclose information

21
Q

interactive responses; responses are modified because of the knowledge that they are being studied or observed

A

Hawthorne effect

22
Q

deals with instrument or there is a random fluctuations in some of the biological factors of interest

A

Biologic variability

23
Q

Sources of Bias:
researchers should not have an influence or prior knowledge before collecting the data; researchers are the one that modifies the answers of the respondents or results

24
Q

strategy to avoid observers’ bias wherein researchers are not involved in data collection

25
Mixing the effect of the exposure on the disease with that of a 3rd factor Associated with the exposure: bidirectional Risk factor of the disease/ outcome: unidirectional —>
Confounding | Presence of Confounder can lead to over or under estimation of the association
26
Methods to Control Confounding: Design Stage aim is random distribution of confounders between study groups Random assignments of individuals in the study Can only be done in experimental studies
Randomization
27
Methods to Control Confounding: Design Stage restrict entry to study of individuals with confounding factor Limiting the participants to one category of the confounding variable
Restriction
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Methods to Control Confounding: Design Stage aim for equal distribution of confounders Mostly used in case-control studies Confounders are identically distributed among each of the study groups
Matching
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Methods to Control Confounding: Analysis stage | confounders are distributed evenly within each stratum
Stratified analysis
30
Methods to Control Confounding: Analysis stage | analysis of data that takes into account a number of variables simultaneously.
Multivariate analysis
31
tool that can be used to assess if observed association is causal
Bradford Hill’s 9 Criteria for Causal Inference HILL’S CRITERIA -Biostatistician and epidemiologist
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Bradford Hill’s 9 Criteria for Causal Inference: stronger the relationship between the 2 variables the less likely the relationship is due to the confounder Can check the risks and odds ratio
Strength of association
33
Bradford Hill’s 9 Criteria for Causal Inference: exposure must occur first before the outcome Important and required for establishing causation If there is no temporality, there is no causal relationship
Temporality or time element
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Bradford Hill’s 9 Criteria for Causal Inference: relationship produces the same results even with different people, circumstances, and methods Outcome is consistent
Consistency
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Bradford Hill’s 9 Criteria for Causal Inference: knowledge: rational and theoretical basis for a relationship supported by known biological and other factors There is already an established or existing knowledge, theories, and studies about the factor, and is really the cause of the outcome
Theoretical plausibility
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Bradford Hill’s 9 Criteria for Causal Inference: facts stick together as a coherent whole Cause and effect interpretation fits with what is known regarding the diseases’ natural history, transmission or patterns
Coherence or Biological plausibility
37
Bradford Hill’s 9 Criteria for Causal Inference: | in an ideal situation, the effect or outcome should only have one cause for it to be a causal relationship
Specificity in the causes
38
Bradford Hill’s 9 Criteria for Causal Inference: | direct relationship between the dose and response or exposure and outcome
Dose-response relationship
39
Bradford Hill’s 9 Criteria for Causal Inference: strongest and most direct epidemiologic evidence to make judgement about the existence of the cause-effect relationship Conducted an experiment to see if the factor is really the cause of the outcome Strongest support for causality if it is done well
Experimental evidence
40
Bradford Hill’s 9 Criteria for Causal Inference: weakest and sometimes not considered criteria Commonly accepted phenomenon in one area can be applied to another area
Analogy