A method of assessing the sensitivity of the Cochran-Mantel-Haenszel test to an unobserved confounder.

Full Abstract

Observational studies, including the case-control design frequently used in epidemiology, are subject to a number of biases and possible confounding factors. Failure to adjust with them may lead to an erroneous conclusion about the existence of a causal relationship between exposure and disease. The Cochran-Mantel-Haenszel (CMH) test is widely used to measure the strength of the association between an exposure and disease or response, after stratifying on the observed covariates. Thus, observed confounders are accounted for in the analysis. In practice, there may be causal variables that are unknown or difficult to obtain. Hence, they are not incorporated into the analysis. Sensitivity analysis enables investigators to assess the robustness of the findings. A method for assessing the sensitivity of the CMH test to an omitted confounder is presented here. The technique is illustrated by re-examining two datasets:
one concerns the effect of maternal hypertension as a risk factor for low birth weight infants and the other focuses on the risk of allopurinol on having a rash. The computer code performing the sensitivity analysis is provided in appendix A.

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Author information

Author/s: Yu, Binbing (B); Gastwirth, Joseph L (JL);

Affiliation: Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD 20892, USA. yubi(-atsign-)mail.nih.gov

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Intramural; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Philosophical transactions. Series A, Mathematical, physical, and engineering sciences (Philos Transact A Math Phys Eng Sci), published in England. (Language: eng)

Reference: 2008-Jul; vol 366 (issue 1874) : pp 2377-88

Dates: Created 2008/05/22; Completed 2008/08/13;

PMID: 18407900, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Allopurinol - adverse effects
Biometry - methods
Databases, Factual
Drug Eruptions - etiology
Female
Humans
Hypertension - complications
Infant, Low Birth Weight

Infant, Low Birth Weight
Infant, Newborn
Maternal-Fetal Exchange
Models, Statistical
Pregnancy
Pregnancy Complications, Cardiovascular
Risk Factors
Sensitivity and Specificity

Associated Chemicals: Allopurinol (315-30-0)

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