Corrigendum to: Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs): a novel and systematic method for building directed acyclic graphs

Ferguson, Karl; McCann, Mark; Katikireddi, Srinivasa Vittal; Thomson, Hilary; Green, Michael J.; Smith, Daniel J.; Lewsey, James

doi:10.1093/ije/dyz220

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…In addition, our reduced sample size might have led to low statistical power, which impose limitations on the interpretation of null findings and observed differences (Gelman & Carlin, 2014). While it is possible that the quality of reporting in health studies, as well as the use of DAG, has improved in recent studies, particularly after the publications on the reporting and construction of DAG (Ferguson et al, 2020;Tennant et al, 2021), our sample size does not allow an investigation on the effect measure modification by publication year and research area.…”

Section: Discussionmentioning

confidence: 99%

“…Briefly, we first constructed a highly connected DAG based on a review of the literature on factors associated with the reporting of causal assumptions, study limitations, and hedging. After mapping the main potential causes of exposure and outcomes, we assessed the plausibility of each directed relationship in the saturated DAG (Ferguson et al, 2020). At this stage, we also assessed the evidence (of a null effect) for excluding arrows and the potential for node recombination to reduce model complexity (Ferguson et al, 2020).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…After mapping the main potential causes of exposure and outcomes, we assessed the plausibility of each directed relationship in the saturated DAG (Ferguson et al, 2020). At this stage, we also assessed the evidence (of a null effect) for excluding arrows and the potential for node recombination to reduce model complexity (Ferguson et al, 2020). Finally, the causal structure was revised to establish its connection with the observed data (i.e., identifying unmeasured variables, proxies and study selection mechanisms) (Petersen & van der Laan, 2014).…”

Section: Statistical Analysesmentioning

confidence: 99%

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The reporting of study limitations and hedging in articles with and without causal diagrams

Cortes

Silveira

Schlüssel

et al. 2023

Preprint

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Causal directed acyclic graphs (DAG) are known to constitute a useful tool to improve the methodological and reporting quality of observational studies. At the same time, there are concerns that their (mis)use may lead to overconfident inferences. In this study, we investigate the reporting of study bias and limitations, and the use of hedging in articles with and without causal DAG. We performed a keyword search in two electronic databases (Medline and Web of Science) and one full-text repository (PubMed Central). The search strategy aimed to identify biomedical studies with an analytical observational design, that reported use of causal DAG. We selected a random sample of the articles that presented a graphic structure. We pair-matched individually 130 DAG with 130-Non-DAG papers on journal and issue. The number of research limitations acknowledged by the authors and of hedging terms per 100 words were analyzed using multiple linear regression models. From 2000 to 2020, we identified 2256 publications reporting the use of causal DAG, of which 1131 (50%) contained the actual graph structure. The number of study limitations acknowledged by the authors and the frequency of hedging were found to be similar in both samples. However, quantitative evaluations of study limitations were more frequently reported in studies with DAG (51 % vs. 25 %), while bias modeling techniques were uncommon in both groups (18% in DAG and 6% in non-DAG). In order to contextualize our findings, we used causal diagrams to discuss potential mechanisms for the communication of causal assumptions and related uncertainties in observational studies.

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Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

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The reporting of study limitations and hedging in articles with and without causal diagrams

Cortes

Silveira

Schlüssel

et al. 2023

Preprint

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“…We built a Directed Acyclic Graph (DAG) to identify the minimal sufficient adjustment set necessary for estimating the effect of symptom valorisation on patient delay, based on the “Evidence Synthesis for Constructing Directed Acyclic Graphs” (ESC-DAGs) methodology [ 31 – 33 ]. Briefly, the process encompasses two stages: mapping and translation.…”

Section: Methodsmentioning

confidence: 99%

Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal

de Morais,

Sousa,

Marques

et al. 2023

BMC Public Health

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Background Diagnosis delay contributes to increased tuberculosis (TB) transmission and morbimortality. TB incidence has been decreasing in Portugal, but median patient delay (PD) has risen. Symptom valorisation may determine PD by influencing help-seeking behaviour. We aimed to analyse the association between symptom valorisation and PD, while characterising individuals who disregarded their symptoms. Methods A cross-sectional study was conducted among TB patients in Lisbon and Oporto in 2019 – 2021. Subjects who delayed seeking care because they did not value their symptoms or thought these would go away on their own were considered to have disregarded their symptoms. PD was categorised using a 21-day cut-off, and a 30-day cut-off for sensitivity analysis. We estimated the effect of symptom valorisation on PD through a directed acyclic graph. Then, a multivariable regression analysis characterised patients that disregarded their symptoms, adjusting for relevant variables. We fitted Poisson regression models to estimate crude and adjusted prevalence ratios (PR). Results The study included 75 patients. Median PD was 25 days (IQR 11.5–63.5), and 56.0% of participants had PD exceeding 21 days. Symptom disregard was reported by 38.7% of patients. Patients who did not value their symptoms had higher prevalence of PD exceeding 21 days compared to those who valued their symptoms [PR 1.59 (95% CI 1.05–2.42)]. The sensitivity analysis showed consistent point estimates but wider confidence intervals [PR 1.39 (95% CI 0.77–2.55)]. Being a smoker was a risk factor for symptom disregard [PR 2.35 (95% CI 1.14–4.82)], while living in Oporto [PR 0.35 (95% CI 0.16–0.75)] and having higher household incomes [PR 0.39 (95% CI 0.17–0.94)] were protective factors. Conclusions These findings emphasise the importance of symptom valorisation in timely TB diagnosis. Patients who did not value their symptoms had longer PD, indicating a need for interventions to improve symptom recognition. Our findings also corroborate the importance of the socioeconomic determinants of health, highlighting tobacco as a risk factor both for TB and for PD.

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“…Each research question and each exposure-outcome relation has its own set of confounders, depending on clinical context and the design of the study (10). The direction and magnitude of the observed confounder-outcome relation may be informative about the apparent validity or quality of the data.…”

Section: No Unique Set Of Confoundersmentioning

confidence: 99%

METHODOLOGY FOR THE ENDOCRINOLOGIST: Basic aspects of confounding adjustment

Dekkers

2020

European Journal of Endocrinology

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The results of observational studies of causal effects are potentially biased due to confounding. Various methods have been proposed to control for confounding in observational studies. Eight basic aspects of confounding adjustment are described, with a focus on correction for confounding through covariate adjustment using regression analysis. These aspects should be considered when planning an observational study of causal effects or when assessing the validity of the results of such a study.

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Corrigendum to: Evidence synthesis for constructing directed acyclic graphs (ESC-DAGs): a novel and systematic method for building directed acyclic graphs

Cited by 6 publications

References 25 publications

The reporting of study limitations and hedging in articles with and without causal diagrams

The reporting of study limitations and hedging in articles with and without causal diagrams

Investigating the role of symptom valorisation in tuberculosis patient delay in urban areas in Portugal

METHODOLOGY FOR THE ENDOCRINOLOGIST: Basic aspects of confounding adjustment

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