Readers should systematically assess methods used to identify, measure and analyze confounding in observational cohort studies

Klein-Geltink, Julie; Rochon, Paula A.; Dyer, Stella; Laxer, M.; Anderson, Geoffrey M.

doi:10.1016/j.jclinepi.2006.11.008

Cited by 31 publications

(28 citation statements)

References 38 publications

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“…The clogit command fits conditional (fixed effects) logistic regression models to matched case-control or cohort groups. We included three confounders (low income, single, and immigrant status) on theoretical grounds, based on related work in severe mental illness, 20,27 and also tested whether they were each independently associated with either case (epilepsy diagnosis) or control and outcome measures, respectively, in univariate analyses at the 5% level of significance 28 …”

Section: Methodsmentioning

confidence: 99%

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

et al. 2013

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SummaryBackgroundEpilepsy is associated with high rates of premature mortality, but the contribution of psychiatric comorbidity is uncertain. We assessed the prevalence and risks of premature mortality from external causes such as suicide, accidents, and assaults in people with epilepsy with and without psychiatric comorbidity.MethodsWe studied all individuals born in Sweden between 1954 and 2009 with inpatient and outpatient diagnoses of epilepsy (n=69 995) for risks and causes of premature mortality. Patients were compared with age-matched and sex-matched general population controls (n=660 869) and unaffected siblings (n=81 396). Sensitivity analyses were done to investigate whether these odds differed by sex, age, seizure types, comorbid psychiatric diagnosis, and different time periods after epilepsy diagnosis.Results6155 (8.8%) people with epilepsy died during follow-up, at a median age of 34·5 (IQR 21·0–44·0) years with substantially elevated odds of premature mortality (adjusted odds ratio [aOR] of 11·1 [95% CI 10·6–11·6] compared with general population controls, and 11·4 [10·4–12·5] compared with unaffected siblings). Of those deaths, 15·8% (n=972) were from external causes, with high odds for non-vehicle accidents (aOR 5·5, 95 % CI 4·7–6·5) and suicide (3·7, 3·3–4·2). Of those who died from external causes, 75·2% had comorbid psychiatric disorders, with strong associations in individuals with co-occurring depression (13·0, 10·3–16·6) and substance misuse (22·4, 18·3–27·3), compared with patients with no epilepsy and no psychiatric comorbidity.InterpretationReducing premature mortality from external causes of death should be a priority in epilepsy management. Psychiatric comorbidity plays an important part in the premature mortality seen in epilepsy. The ability of health services and public health measures to prevent such deaths requires review.FundingWellcome Trust, the Swedish Prison and Probation Service, and the Swedish Research Council.

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Section: Methodsmentioning

confidence: 99%

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

et al. 2013

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“…Among the general population and sibling controls, violent crime was counted only if it occurred after the date of diagnosis in the matched cases. We included three confounders (low income, single, and immigrant status) on theoretical grounds, based on related work in severe mental illness [35],[41], and also tested whether they were each independently associated with caseness and violent crime, respectively, in univariate analyses at the 5% level of significance [42]. In a further analysis, we additionally adjusted for comorbid substance abuse.…”

Section: Methodsmentioning

confidence: 99%

Risk of Violent Crime in Individuals with Epilepsy and Traumatic Brain Injury: A 35-Year Swedish Population Study

et al. 2011

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Seena Fazel and colleagues report findings from a longitudinal follow-up study in Sweden that evaluated the risks of violent crime subsequent to hospitalization for epilepsy, or traumatic brain injury. The researchers control for familial confounding with sibling controls. The analyses call into question an association between epilepsy and violent crime, although they do suggest that there may be a relationship between traumatic brain injury and violent crime.

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“…It is not ruled out the construction of a Cox regression model for mental health, overburden, and establishment of the corresponding hazard ratio according to predictor variables related to the type of assistance received and factors of the caregiver. In order to control possible confounding factors, it shall be applied the criterion of in regards to the data analysis [34]. …”

Section: Methodsmentioning

confidence: 99%

Effect of the act on promotion of personal autonomy and care for dependent persons on their family caregivers

Fernández‐Gallego

Morales-Asencio

Santos

et al. 2012

BMC Health Serv Res

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BackgroundThe need of home care services is becoming an increasingly common scenario. These cares are mainly provided by the dependents’ relatives specifically, by the women part of the family. This situation might take years, decreasing the physical and psychological health of the caregiver. In Spain, the Act of Promotion of Personal Autonomy and Care for dependent persons, guarantees those dependent persons and their caregivers to have access to social services or to financial grants. The aim of this study is to Know the possible effects of the benefits provided by this Act in regards to the mental health, the quality of life and use of health services by the family caregivers assisting their relatives in situation of dependency.Methods and designA longitudinal descriptive study following-up a cohort of patients and caregivers. The study shall be carried out in Andalusia. It shall include the baseline assessment of the variables in those caregivers free from the exposure factor (reception of assistance pursuant to the Act). Following, once the benefits have been received, this cohort shall be followed-up.The study shall take three years, and the starting date for its development as well as its funding is January 2011.DiscussionThe longitudinal assessment of the rate of change of the variables studied shall allow us to know the implications which might be potentially generated as well as the natural evolution of those.

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Readers should systematically assess methods used to identify, measure and analyze confounding in observational cohort studies

Cited by 31 publications

References 38 publications

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

Risk of Violent Crime in Individuals with Epilepsy and Traumatic Brain Injury: A 35-Year Swedish Population Study

Effect of the act on promotion of personal autonomy and care for dependent persons on their family caregivers

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