Indirect adjustment for multiple missing variables applicable to environmental epidemiology

Shin, HH; Cakmak, S; Brion, O; Villeneuve, P; Turner, MC; Goldberg, MS; Jerrett, M; Chen, H; Crouse, D; Peters, P; Pope, CA; Burnett, RT

HERO ID

2537632

Reference Type

Journal Article

Year

2014

Language

English

PMID

24972508

HERO ID 2537632
In Press No
Year 2014
Title Indirect adjustment for multiple missing variables applicable to environmental epidemiology
Authors Shin, HH; Cakmak, S; Brion, O; Villeneuve, P; Turner, MC; Goldberg, MS; Jerrett, M; Chen, H; Crouse, D; Peters, P; Pope, CA; Burnett, RT
Journal Environmental Research
Volume 134
Page Numbers 482-487
Abstract <strong>OBJECTIVES: </strong>Develop statistical methods for survival models to indirectly adjust hazard ratios of environmental exposures for missing risk factors.<br /><br /><strong>METHODS: </strong>A partitioned regression approach for linear models is applied to time to event survival analyses of cohort study data. Information on the correlation between observed and missing risk factors is obtained from ancillary data sources such as national health surveys. The relationship between the missing risk factors and survival is obtained from previously published studies. We first evaluated the methodology using simulations, by considering the Weibull survival distribution for a proportional hazards regression model with varied baseline functions, correlations between an adjusted variable and an adjustment variable as well as selected censoring rates. Then we illustrate the method in a large, representative Canadian cohort of the association between concentrations of ambient fine particulate matter and mortality from ischemic heart disease.<br /><br /><strong>RESULTS: </strong>Indirect adjustment for cigarette smoking habits and obesity increased the fine particulate matter-ischemic heart disease association by 3%-123%, depending on the number of variables considered in the adjustment model due to the negative correlation between these two risk factors and ambient air pollution concentrations in Canada. The simulations suggested that the method yielded small relative bias (&lt;40%) for most cohort designs encountered in environmental epidemiology.<br /><br /><strong>CONCLUSIONS: </strong>This method can accommodate adjustment for multiple missing risk factors simultaneously while accounting for the associations between observed and missing risk factors and between missing risk factors and health endpoints.
Doi 10.1016/j.envres.2014.05.016
Pmid 24972508
Wosid WOS:000346817100065
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword Indirect adjustment; Cohort study; Air pollution; Survival analysis; Simulation