{"id":2627,"date":"2020-01-01T00:00:00","date_gmt":"2020-01-01T00:00:00","guid":{"rendered":"https:\/\/essaybishops.com\/bias-and-confounding-in-research\/"},"modified":"2020-01-01T00:00:00","modified_gmt":"2020-01-01T00:00:00","slug":"bias-and-confounding-in-research","status":"publish","type":"post","link":"https:\/\/www.colapapers.com\/uk\/bias-and-confounding-in-research\/","title":{"rendered":"BIAS AND CONFOUNDING IN RESEARCH"},"content":{"rendered":"<p>BIAS AND CONFOUNDING IN RESEARCH<br \/>\nModule 5 &#8211; Home<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<br \/>\nBias and confounding are two important concepts in research that can influence the validity and reliability of research findings.<\/p>\n<p>Bias refers to any systematic error or deviation in the design, conduct, or analysis of a research study that can affect the results. There are several types of bias that can occur in research, including:<\/p>\n<p>Sampling bias: This occurs when the sample of participants in a study is not representative of the population being studied. For example, if a study only includes participants of a certain age or gender, the results may not be applicable to other age or gender groups.<\/p>\n<p>Selection bias: This occurs when the selection of participants or the allocation of treatments in a study is not random, and is influenced by some other factor. For example, if a study only includes participants who have a certain condition or characteristic, the results may not be applicable to those who do not have that condition or characteristic.<\/p>\n<p>Measurement bias: This occurs when the measurement of a variable is not accurate or reliable. For example, if a study uses a self-report questionnaire to measure a variable, the results may be influenced by participants&#8217; willingness or ability to accurately report their experiences or behaviors.<\/p>\n<p>Confounding refers to the presence of a third variable that is related to both the independent variable (the variable being manipulated in the study) and the dependent variable (the variable being measured in the study). Confounding can occur when the relationship between the independent and dependent variables is obscured or distorted by the presence of the confounding variable. For example, if a study is examining the relationship between a new medication and blood pressure, and the participants also happen to be exercising more or eating a healthier diet, this could confound the relationship between the medication and blood pressure, making it difficult to determine the true effect of the medication.<\/p>\n<p>Bias and confounding can have significant impacts on the validity and reliability of research findings. It is important for researchers to be aware of these issues and to take steps to minimize their influence, such as using appropriate sampling and selection methods, using reliable measurement tools, and controlling for confounding variables.<br \/>\nModular Learning Outcomes<\/p>\n<p>Upon successful completion of this module, the student will be able to satisfy the following outcomes:<\/p>\n<p>Case<br \/>\nIdentify possible sources of bias and confounding in research.<br \/>\nApply knowledge about sources of error to peer-reviewed articles on foodborne disease.<br \/>\nSLP<br \/>\nIdentify possible sources of bias and confounding in research.<br \/>\nDiscussion<br \/>\nSuperior Essay Writers Describe the effect of non-differential misclassification on studies.<\/p>\n<p>Module Overview<\/p>\n<p>When a statistically significant association between a factor and health outcome has been demonstrated, the association may be of three types: 1) artifactual, 2) indirect, or 3) causal. The focus of Module 3 was the assessment of a causal relationship. This module will focus on artifactual association, indirect association, and effect modification.<\/p>\n<p>Artifactual Association<\/p>\n<p>An artifactual association is a false association that can result from chance occurrence or bias in study methods. In a certain proportion of studies, an outcome may be found statistically significant even though it results from random fluctuation (Type I error). Bias can also result in an artifactual association, through flaws in study design, methods used to collect data, or the way that a study group is selected.&nbsp;Bias&nbsp;is defined as a systematic error which results in an incorrect or invalid estimate of the measure of association. Some of the common types of bias are selection bias and information bias.<\/p>\n<p>Selection Bias<\/p>\n<p>Selection bias arises when participants of a study group are systematically excluded due to a particular attribute. This exclusion may influence the statistical significance of the test. For example, selecting individuals from a treatment clinic may result in selection bias, since the characteristics from the control group are not representative of the population. Also, allowing individuals to refer themselves to the study may result in selection bias, since the reasons for the referral may be associated with the outcome.<\/p>\n<p>Information Bias<\/p>\n<p>Information bias arises from errors in measuring exposure or disease. Some common types of information bias include:<\/p>\n<p>Interviewer bias (i.e., when the interviewer influences questions)<br \/>\nObserver bias (i.e., when an observer has preconceived expectations)<br \/>\nReporting bias (i.e., when individuals with more severe disease are more likely to report than those with less severe disease)<br \/>\nRecall bias (i.e., when those who are ill are more likely to recall an exposure than those who were are not ill)<br \/>\nFollow-up bias (i.e., those who are lost to follow-up are different from those who are retained)<\/p>\n<p>Measurement error can also be a bias in studies. Therefore, it is important to assess the quality of measurements, which involves examining validity and reliability. For more information, click on&nbsp;Measurement Error.<\/p>\n<p>Controlling for Bias<\/p>\n<p>There are a number of methods that can help control for bias. Selecting a random sample reduces the likelihood of selection bias. Strategies for controlling for information bias include:<\/p>\n<p>Blinding of subjects, interviewers, and\/or analyst<br \/>\nIncluding similar questions on a questionnaire to verify validity<br \/>\nTraining of observers and\/or data collectors<br \/>\nLimit the number of observers and\/or data collectors<br \/>\nRandom assignments for interviewers and\/or data collectors<br \/>\nMinimize loss to follow-up<br \/>\nUtilizing case definitions<\/p>\n<p>Additionally, replication of studies minimizes the likelihood of an artifactual association.<\/p>\n<p>Indirect Association<\/p>\n<p>An indirect association refers to when an exposure appears to be associated with an outcome; however, there is a third variable that is related to both the factor and outcome. The relationship between the exposure and outcome is&nbsp;confounded&nbsp;by this third factor.<\/p>\n<p>(Howell, 2019)<\/p>\n<p>Confounding can be controlled in study design by using random selection, matching, and restricting subjects according to confounder. In data analysis, confounding may be controlled through methods such as stratification and model fitting.<\/p>\n<p>Effect Modification<\/p>\n<p>Effect modification (interaction) refers to when the effect of an exposure on the outcome differs depending if the effect modifier is present. If the presence of an effect modifier strengthens the effect, the interaction is synergistic (positive interaction). If the presence of an effect modifier weakens or eliminates the effect, the interaction is antagonistic (negative interaction)<\/p>\n<p>Confounding vs. Effect Modification<\/p>\n<p>When a statistically significant association between a factor and health outcome has been demonstrated, the crude odds ratio should be compared with the adjusted odds ratio. A considerable difference in the odds ratios suggests that there is either confounding or interaction. significantly, then there is confounding or interaction. Stratification can be used to distinguish between whether there is confounding or interaction. If there is is different odds ratio between strata, then an interaction is occurring. If the odds ratio is similar between strata, then confounding is occurring. For more information on confounding and interaction, refer to the Background Reading.<br \/>\nModule 5 &#8211; Measurement Error<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<\/p>\n<p>Introduction<\/p>\n<p>Order Term Paper Writing Service &#038; Research Report Writing &#8211; Three important goals of data collection and analysis are the promotion of&nbsp;accuracy and precision, the reduction of&nbsp;differential and non-differential errors&nbsp;(that is, nonrandom and random errors), and the reduction in&nbsp;inter-observer and intra-observer variability&nbsp;(that is, variability between the findings of two observers or between the findings of one observer on two different occasions).<\/p>\n<p>Various statistical methods are available to study the accuracy and usefulness of screening tests and diagnostic tests in clinical medicine. In general, tests with a high degree of&nbsp;sensitivity&nbsp;and a corresponding low false-negative error rate are helpful for screening patients, while tests with a high degree of&nbsp;specificity&nbsp;and a corresponding low false-positive error rate are useful for confirming the diagnosis in patients suspected of having a particular disease.<\/p>\n<p>Promoting Accuracy and Precision<\/p>\n<p>Accuracy&nbsp;refers to the ability of a measurement to be correct on the average. If a measure is not accurate, it is biased.&nbsp;Precision, sometimes known as&nbsp;reproducibility&nbsp;or&nbsp;reliability, is the ability of a measurement to give the same result or a very similar result with repeated measurements of the same thing. Random error alone, if large, will result in lack of precision.<\/p>\n<p>Reducting Differential and Non-Differential Errors<\/p>\n<p>Bias&nbsp;is a non-random, systematic, or consistent error in which the values tend to be inaccurate in a particular direction. Bias results, for example, from measuring the heights of patients with their shoes on or from measuring blood pressures with an arm cuff that reads too high or too low. Statistical analysis cannot correct for bias unless the amount of bias in each individual measurement is known. In the example of the patients&#8217; height measurements, bias could be corrected only if the height of each patient&#8217;s heel was known and subtracted from that patient&#8217;s reported measurement.<\/p>\n<p>While measuring patients in their bare feet could eliminate bias, it would not necessarily eliminate random errors or&nbsp;non-differential errors. When data have only random errors, some observations will be too high and some will be too low. It is possible for random errors to produce biased results. However, if there are enough observations, data with random errors may produce a correct estimate of the mean.<\/p>\n<p>Reducing Intra-Observer and Inter-Observer Variability<\/p>\n<p>A goal of data collection and analysis is to reduce the amount of intra-observer (within observer) and inter-observer (between observers) variability. If the same physician takes successive measurements of the blood pressure and height of the same person or if the same physician examines the same x-ray several times without knowing that it is the same x-ray, there will usually be some differences in the measurements or interpretations obtained. This is known as&nbsp;intra-observer variability. If two different physicians measure the same blood pressure or examine the same x-ray independently, there will usually be some differences. This is called&nbsp;inter-observer variability.<\/p>\n<p>Characteristics of Screening Tests<\/p>\n<p>Screening tests are the basic tool in the early detection of disease. Important characteristics include validity, predictive value, reliability, and yield.<\/p>\n<p>Validity<\/p>\n<p>Screening tests should provide a good preliminary indication of which individuals have the disease and which do not. This is referred to as&nbsp;validity. Validity has two components: sensitivity and specificity.&nbsp;Sensitivity&nbsp;is defined as the ability of a test to identify correctly those who have a disease. Those who have a disease may either correctly test positive for a disease (true positive) or incorrectly test negative for a disease (false negative).&nbsp;Specificity&nbsp;is defined as the ability of a test to identify correctly those who do not have a disease. Those who do not have a disease may either correctly test negative for a disease (true negative) or incorrectly test positive for a disease (false positive). The formulas for sensitivity and specificity are:<\/p>\n<p>Sensitivity = True Positives\/All With Disease = True Pos\/(True pos + False neg)<\/p>\n<p>Specificity = True Negatives\/All Without Disease = True Neg\/(True neg + False pos)<\/p>\n<p>An ideal screening test would be 100% sensitive and 100% specific. In practice, this does not occur because they are usually inversely related.<\/p>\n<p>Predictive Value<\/p>\n<p>The ability to predict the presence or absence of a disease from test results is referred to as&nbsp;predictive value. It is dependent on the prevalence of a disease in the population tested, as well as the sensitivity and specificity of the test. The higher the prevalence, the more likely it is that a positive test is predictive of a disease. The predictive value of a positive and negative test can be calculated as follows:<\/p>\n<p>PV (pos) = True positives\/All positives = True pos\/(True pos + False pos)<\/p>\n<p>PV (neg) = True negatives\/All negatives = True neg\/(True neg + False neg)<\/p>\n<p>For example, if Disease X has a prevalence of 10% in a population of 1000 people, and the sensitivity of the test is 90% and the specificity is 60%, the predictive value would be calculated as follows:<\/p>\n<p>Write down all formulas containing the given variables and plug in the values above.<\/p>\n<p>PV (pos) = True pos\/(True pos + False pos)<\/p>\n<p>PV (neg) = True neg\/(True neg + False neg)<\/p>\n<p>Sensitivity = .90 = True pos\/All with disease = True pos\/(True pos + False neg)<\/p>\n<p>Specificity = .60 = True neg\/All without disease = True neg\/(True neg + False pos)<\/p>\n<p>Prevalence = .10 = All with disease\/Total pop = #cases\/1000<br \/>\nCalculate the variables needed for the predictive value by rearranging the formulas and plugging in the calculated values.<\/p>\n<p>All with disease = Prevalence x Total pop = (.10)(1000) = 100<\/p>\n<p>True pos = sensitivity x All with disease = (.90)( 100) = 90<\/p>\n<p>False neg = All with disease &#8211; True pos = 100 &#8211; 90 = 10<\/p>\n<p>All without disease = Population &#8211; All with disease = 1000 &#8211; 100 = 900<\/p>\n<p>True neg = specificity x All without disease = (.60)(900) = 540<\/p>\n<p>False pos = All without disease &#8211; True neg = 900 &#8211; 540 = 360<br \/>\nPlug in calculated values for the predictive value.<\/p>\n<p>PV (pos) = 90\/(90 + 360) = 20%<\/p>\n<p>PV (neg) = 540\/(540 + 10) = 98%<\/p>\n<p>Reliability<\/p>\n<p>Reliability&nbsp;is defined as consistency in screening test results when the test is performed more than once on the same individual under the same conditions. Two major factors affect reliability:&nbsp;variability&nbsp;in the method&nbsp;(e.g. stability of reagents) and&nbsp;observer variation. These variations can be reduced by standardization of procedures, training of observers, and periodic checks on their work.<\/p>\n<p>Yield<\/p>\n<p>Yield&nbsp;is defined as the amount of previously unrecognized disease that is diagnosed and brought to treatment as a result of screening. The following factors affect the yield of a screening program:<\/p>\n<p>Sensitivity of the test<br \/>\nPrevalence of unrecognized disease<br \/>\nFrequency of screening<br \/>\nParticipation in screening and follow-up<\/p>\n<p>Evaluation of Screening Programs<\/p>\n<p>Because of the high costs and risks, screening programs should be conducted only when it has the potential to lead to a significant decrease in the rates of death or disability. Outcome measures such as the disease-specific death rate, physiological variables (e.g. blood cholesterol level), and case-fatality rate should be compared between screened and unscreened groups. The least biased method for evaluating a screening program would be a random, experimental study (i.e. randomly assigning individuals in a study sample to either a group that provides free screening or a control group).<\/p>\n<p>Sources of Bias in Screening Programs<\/p>\n<p>Unfortunately, randomized, experimental studies are rarely done. Instead, observational studies are often conducted, which are subject to several different sources of bias:<\/p>\n<p>Lead Time Bias. Lead time is defined as the interval between a time a condition is detected through screening and the time it would normally have been detected by the reporting of symptoms. A screening test may lead to early detection without delaying the time of death, and as a result, the screened case group may appear to have a higher survival rate than the control group.<br \/>\nPatient Self-Selection. Individuals who choose to participate in early detection programs may differ from those who do not in characteristics that may be related to survival. For example, participants may be more health-conscious, more likely to be compliant with prescribed therapy, etc.<\/p>\n<p>Module 5 &#8211; Background<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<br \/>\nRequired Reading<\/p>\n<p>Stratified Analysis: Introduction to Confounding and Interaction Retrieved February 21, 2012, at:<br \/>\nhttp:\/\/www.sjsu.edu\/faculty\/gerstman\/StatPrimer\/stratified.PDF<\/p>\n<p>Cruz, M. A., Katz, D.J ., Suarez, J. A. (2001). An assessment of the ability of routine restaurant inspections to predict food-borne outbreaks in Miami-Dade County, Florida. American Page Essay &#8211; Journal of Public Health, 91(5). Retrieved February 21, 2012, at ProQuest<\/p>\n<p>Shrier, I. &amp; Pang, M. (2015). Confounding, effect modification and the odds ratio: Common misinterpretation.&nbsp;Page Essay &#8211; Journal of Clinical Epidemiology, 68(4), 470-474. Retrieved August 24, 2019 from&nbsp;https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4882164\/<\/p>\n<p>Simon, P., Leslie, P., Run, G., Jin, G.Z. et al (2005). Impact of Restaurant Hygiene Grade Cards on Foodborne-Disease Hospitalizations in Los Angeles County. Page Essay &#8211; Journal of Environmental Health, 67(7). Retrieved February 21, 2012, at ProQuest<\/p>\n<p>M. Tevfik DORAK Paediatric &amp; Lifecourse Epidemiology Research Group School of Clinical Medical Sciences (Child Health) Newcastle University England, U.K. Presentation Retrieved February 21, 2012, at:<br \/>\nhttp:\/\/www.dorak.info\/epi\/bc.ppt<br \/>\nAdditional Reading<\/p>\n<p>Bernstein, J., Chollet, D., &amp; Peterson, G. (2010) Encouraging Appropriate Use of Preventive Health Services. Mathematica Policy Research, Inc., 2, 1-5. Retrieved August 24, 2019 from&nbsp;https:\/\/www.mathematica-mpr.com\/our-publications-and-findings\/publications\/encouraging-appropriate-use-of-preventive-health-services<\/p>\n<p>Schneeweiss, S., Seeger, J., Maclure, M., Wang, P., Avorn, J., &amp; Glynn, R. (2001). Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data.&nbsp;American Page Essay &#8211; Journal of Epidemiology, 154(9), 854-864. Retrieved August 24, 2019 from&nbsp;https:\/\/academic.oup.com\/aje\/article\/154\/9\/854\/124960<\/p>\n<p>Confounding. Super Course. Retrieved February 21, 2012, at:&nbsp;http:\/\/www.pitt.edu\/~super1\/lecture\/lec7091\/index.htm<br \/>\nModule 5 &#8211; Measurement Error<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<\/p>\n<p>Introduction<\/p>\n<p>Order Term Paper Writing Service &#038; Research Report Writing &#8211; Three important goals of data collection and analysis are the promotion of&nbsp;accuracy and precision, the reduction of&nbsp;differential and non-differential errors&nbsp;(that is, nonrandom and random errors), and the reduction in&nbsp;inter-observer and intra-observer variability&nbsp;(that is, variability between the findings of two observers or between the findings of one observer on two different occasions).<\/p>\n<p>Various statistical methods are available to study the accuracy and usefulness of screening tests and diagnostic tests in clinical medicine. In general, tests with a high degree of&nbsp;sensitivity&nbsp;and a corresponding low false-negative error rate are helpful for screening patients, while tests with a high degree of&nbsp;specificity&nbsp;and a corresponding low false-positive error rate are useful for confirming the diagnosis in patients suspected of having a particular disease.<\/p>\n<p>Promoting Accuracy and Precision<\/p>\n<p>Accuracy&nbsp;refers to the ability of a measurement to be correct on the average. If a measure is not accurate, it is biased.&nbsp;Precision, sometimes known as&nbsp;reproducibility&nbsp;or&nbsp;reliability, is the ability of a measurement to give the same result or a very similar result with repeated measurements of the same thing. Random error alone, if large, will result in lack of precision.<\/p>\n<p>Reducting Differential and Non-Differential Errors<\/p>\n<p>Bias&nbsp;is a non-random, systematic, or consistent error in which the values tend to be inaccurate in a particular direction. Bias results, for example, from measuring the heights of patients with their shoes on or from measuring blood pressures with an arm cuff that reads too high or too low. Statistical analysis cannot correct for bias unless the amount of bias in each individual measurement is known. In the example of the patients&#8217; height measurements, bias could be corrected only if the height of each patient&#8217;s heel was known and subtracted from that patient&#8217;s reported measurement.<\/p>\n<p>While measuring patients in their bare feet could eliminate bias, it would not necessarily eliminate random errors or&nbsp;non-differential errors. When data have only random errors, some observations will be too high and some will be too low. It is possible for random errors to produce biased results. However, if there are enough observations, data with random errors may produce a correct estimate of the mean.<\/p>\n<p>Reducing Intra-Observer and Inter-Observer Variability<\/p>\n<p>A goal of data collection and analysis is to reduce the amount of intra-observer (within observer) and inter-observer (between observers) variability. If the same physician takes successive measurements of the blood pressure and height of the same person or if the same physician examines the same x-ray several times without knowing that it is the same x-ray, there will usually be some differences in the measurements or interpretations obtained. This is known as&nbsp;intra-observer variability. If two different physicians measure the same blood pressure or examine the same x-ray independently, there will usually be some differences. This is called&nbsp;inter-observer variability.<\/p>\n<p>Characteristics of Screening Tests<\/p>\n<p>Screening tests are the basic tool in the early detection of disease. Important characteristics include validity, predictive value, reliability, and yield.<\/p>\n<p>Validity<\/p>\n<p>Screening tests should provide a good preliminary indication of which individuals have the disease and which do not. This is referred to as&nbsp;validity. Validity has two components: sensitivity and specificity.&nbsp;Sensitivity&nbsp;is defined as the ability of a test to identify correctly those who have a disease. Those who have a disease may either correctly test positive for a disease (true positive) or incorrectly test negative for a disease (false negative).&nbsp;Specificity&nbsp;is defined as the ability of a test to identify correctly those who do not have a disease. Those who do not have a disease may either correctly test negative for a disease (true negative) or incorrectly test positive for a disease (false positive). The formulas for sensitivity and specificity are:<\/p>\n<p>Sensitivity = True Positives\/All With Disease = True Pos\/(True pos + False neg)<\/p>\n<p>Specificity = True Negatives\/All Without Disease = True Neg\/(True neg + False pos)<\/p>\n<p>An ideal screening test would be 100% sensitive and 100% specific. In practice, this does not occur because they are usually inversely related.<\/p>\n<p>Predictive Value<\/p>\n<p>The ability to predict the presence or absence of a disease from test results is referred to as&nbsp;predictive value. It is dependent on the prevalence of a disease in the population tested, as well as the sensitivity and specificity of the test. The higher the prevalence, the more likely it is that a positive test is predictive of a disease. The predictive value of a positive and negative test can be calculated as follows:<\/p>\n<p>PV (pos) = True positives\/All positives = True pos\/(True pos + False pos)<\/p>\n<p>PV (neg) = True negatives\/All negatives = True neg\/(True neg + False neg)<\/p>\n<p>For example, if Disease X has a prevalence of 10% in a population of 1000 people, and the sensitivity of the test is 90% and the specificity is 60%, the predictive value would be calculated as follows:<\/p>\n<p>Write down all formulas containing the given variables and plug in the values above.<\/p>\n<p>PV (pos) = True pos\/(True pos + False pos)<\/p>\n<p>PV (neg) = True neg\/(True neg + False neg)<\/p>\n<p>Sensitivity = .90 = True pos\/All with disease = True pos\/(True pos + False neg)<\/p>\n<p>Specificity = .60 = True neg\/All without disease = True neg\/(True neg + False pos)<\/p>\n<p>Prevalence = .10 = All with disease\/Total pop = #cases\/1000<br \/>\nCalculate the variables needed for the predictive value by rearranging the formulas and plugging in the calculated values.<\/p>\n<p>All with disease = Prevalence x Total pop = (.10)(1000) = 100<\/p>\n<p>True pos = sensitivity x All with disease = (.90)( 100) = 90<\/p>\n<p>False neg = All with disease &#8211; True pos = 100 &#8211; 90 = 10<\/p>\n<p>All without disease = Population &#8211; All with disease = 1000 &#8211; 100 = 900<\/p>\n<p>True neg = specificity x All without disease = (.60)(900) = 540<\/p>\n<p>False pos = All without disease &#8211; True neg = 900 &#8211; 540 = 360<br \/>\nPlug in calculated values for the predictive value.<\/p>\n<p>PV (pos) = 90\/(90 + 360) = 20%<\/p>\n<p>PV (neg) = 540\/(540 + 10) = 98%<br \/>\nModule 5 &#8211; Case<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<br \/>\nCase Assignment<\/p>\n<p>Please answer the following questions in a paper of at least 6 pages:<br \/>\nA researcher is studying the effect of factors that may contribute to a birth defect. The following is a table summarizing the results of bivariate and multivariate analysis.<\/p>\n<p>Table 1. Bivariate versus Multivariate<\/p>\n<p>Variable<\/p>\n<p>Crude OR<\/p>\n<p>95% CI<\/p>\n<p>Adjusted OR<\/p>\n<p>95% CI<\/p>\n<p>Gene X<\/p>\n<p>0.986<\/p>\n<p>0.974\u20130.998<\/p>\n<p>0.985<\/p>\n<p>0.971\u20130.999<\/p>\n<p>Gene Y<\/p>\n<p>4.317<\/p>\n<p>1.916\u20139.727<\/p>\n<p>3.430<\/p>\n<p>1.377\u20138.547<\/p>\n<p>Gene Z<\/p>\n<p>2.02<\/p>\n<p>1.081\u20133.891<\/p>\n<p>1.34<\/p>\n<p>0.854\u20132.115<\/p>\n<p>Gene T<\/p>\n<p>3.365<\/p>\n<p>1.021\u201311.088<\/p>\n<p>6.236<\/p>\n<p>1.562\u201324.892<br \/>\nIdentify variables from Table 1 that should be further analyzed (to rule out whether they are confounders or effect modifiers). Briefly provide rationale.<br \/>\nStratified analysis was conducted on one of the genes in Table 1 and odds ratios were obtained. What do these results suggest:<\/p>\n<p>Drug A=0: OR=2.2 for birth defect given presence of gene<\/p>\n<p>Drug A=1: OR=1.4 for birth defect given presence of gene<br \/>\nCritically review the following controversial paper published (and later retracted) by Wakefield et al, which implicated MMR vaccine as a possible etiologic contributor to Autism, etc. You may use either version for your review.Page Paper Describe potential sources of bias and other limitations in the study:<\/p>\n<p>Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children A J Wakefield, S H Murch, A Anthony, J Linnell, D M Casson, M Malik, M Berelowitz, A P Dhillon,<br \/>\nM A Thomson, P Harvey, A Valentine, S E Davies, J A Walker-Smith<br \/>\nThe Lancet, Volume 351, Number 9103 28 February 1998<\/p>\n<p>Pro 7 Con Arguments: \u201cShould any vaccines be required for children? Retrieved from&nbsp;http:\/\/vaccines.procon.org\/&nbsp;on November 5, 2013.<br \/>\nAssignment Expectations<\/p>\n<p>Length: Case Assignments should be at least 6 pages (1,300 words) in length.<\/p>\n<p>References: Required readings should be included. All references need to be cited using APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help.<\/p>\n<p>Organization: Subheadings should be used to organize your paper according to question.<\/p>\n<p>Format &#8211; Best Help Writing My 99 Papers\u2014owl Essay Samples: APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help is required for all assignments at the Ph.D. level. See Syllabus page for more information on APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help.<\/p>\n<p>Grammar and Spelling: While no points are deducted for minor errors, assignments are expected to adhere to standards guidelines of grammar, spelling, punctuation, and sentence syntax. Points may be deducted if grammar and spelling impact clarity.<\/p>\n<p>The following items will be assessed in particular:<br \/>\nRelevance\u2014all content is connected to the question.<br \/>\nPrecision\u2014specific question is addressed. Statements, facts, and statistics are specific and accurate.<br \/>\nDepth of discussion\u2014present and integrate points that lead to deeper issues.<br \/>\nBreadth\u2014multiple perspectives and references, multiple issues\/factors considered.<br \/>\nEvidence\u2014points are well-supported with facts, statistics, and references.<br \/>\nLogic\u2014presented discussion makes sense; conclusions are logically supported by premises, statements, or factual information.<br \/>\nClarity\u2014writing is concise, understandable, and contains sufficient detail or examples.<br \/>\nObjectivity\u2014avoid use of first person and subjective bias.<\/p>\n<p>Additional expectations for the assignment:<br \/>\nYour references and citations should be consistent with a particular formatting style, such as APA.<br \/>\nYour response should be based on scholarly material, such as peer-reviewed articles, white papers, technical papers, etc. Do not include information from non-scholarly materials such as Wikis, encyclopedias, www.freearticles.com (or similar websites).<br \/>\nYour response should incorporate the objectives of the module with the requirements of this assignment.<\/p>\n<p>Your Case paper will be further evaluated based on the following criteria:<br \/>\nPrecision (Excellent; Good; Average; Poor)<br \/>\nEach question and\/or assignment requirement is addressed in the paper.<br \/>\nAccuracy of your answers, key points, and supporting discussion.<br \/>\nClarity (Excellent; Good; Average; Poor)<br \/>\nThe paper is well organized, concise, reads clearly, and it is not confusing.<br \/>\nBreadth (Excellent; Good; Average; Poor)<br \/>\nThe paper presents appropriate breadth covering the assignment questions\/requirements.<br \/>\nDepth (Excellent; Good; Average; Poor)<br \/>\nPresents key points that lead to deeper matters and issues.<br \/>\nIntegrates several points into coherent conclusions.<br \/>\nCritical Thinking (Excellent; Good; Average; Poor)<br \/>\nThe paper demonstrates good understanding and synthesis of the module background material.<br \/>\nLogically incorporates key concepts presented in the background material into the overall analyses, key points, and supporting discussions.<br \/>\nPresents well-reasoned conclusions and positions as well as convincing arguments in support of the same.<br \/>\nWriting Mechanics<br \/>\nGrammar (Excellent; Good; Average; Poor)<br \/>\nSpelling (Excellent; Good; Average; Poor)<br \/>\nVocabulary (Excellent; Good; Average; Poor)<br \/>\nReferencing (Excellent; Good; Average; Poor)<\/p>\n<p>Additional considerations to keep in mind while working on your Case Assignments:<br \/>\nOriginality and Use of directly quoted material<br \/>\nThe purpose of each assignment is for you to present your understanding and synthesis of the background material and key concepts. Accordingly, this must be accomplished substantially in your own words.<br \/>\nUse directly quoted material sparingly and only when preserving the exact words of an author is necessary. For purposes of this course, rarely should directly quoted material represent more than 5\u201310 percent of your entire case paper\u2019s content. Composing a paper patched together from mostly quoted material is not acceptable.<br \/>\nBe sure to properly reference all directly quoted material and include in-text citations.<br \/>\nGrades<br \/>\nA paper that answers all assignment questions with good key points, well-supported discussions, and quality references will earn a solid \u201cB\u201d grade.<br \/>\n\u201cA\u201d papers are exceptional works that go beyond just answering the questions by providing insightful answers.<br \/>\nLimit response to a minimum of 6 pages<\/p>\n<p>Module 5 &#8211; SLP<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<br \/>\nLimitations of Studies<\/p>\n<p>This assignment involves identifying limitations of your proposed study. In approximately 2\u20133 pages, describe the limitations of the study you proposed in Module 4. Your discussion of limitations should include the following (use subheadings for each section):<\/p>\n<p>Limitations of Proposed Study Design. Discuss potential bias and limitations.<br \/>\nLimitations of Proposed Sampling Method. Discuss potential bias and limitations.<br \/>\nLimitations of Proposed Data Sources\/Data Collection Methods. Discuss potential bias and limitations.<br \/>\nLimitations of Proposed Analytic Methods. Discuss potential bias and limitations.<br \/>\nDiscuss potential confounding factors in your proposed study.<\/p>\n<p>Please upload this SLP component at the end of Module 5.&nbsp;(Your other SLP components should be uploaded under the previous corresponding modules, rather than under Module 5).<br \/>\nSLP Assignment Expectations<\/p>\n<p>Length: This SLP assignment should be at least 2 pages (500 words) in length.<\/p>\n<p>References: References should be from academic sources and cited using APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help.<\/p>\n<p>Organization: Subheadings should be used to organize your paper as indicated above<\/p>\n<p>Format &#8211; Best Help Writing My 99 Papers\u2014owl Essay Samples: APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help is required for all assignments at the Ph.D. level. See Syllabus page for more information on APA Paper Writing Service by Expert Writers Pro Paper Help: Online Research Essay Help.<\/p>\n<p>Grammar and Spelling: While no points are deducted for minor errors, assignments are expected to adhere to standards guidelines of grammar, spelling, punctuation, and sentence syntax. Points may be deducted if grammar and spelling impact clarity.<\/p>\n<p>The following items will be assessed in particular:<\/p>\n<p>Relevance\u2014all content is connected to the question.<br \/>\nPrecision\u2014specific question is addressed. Statements, facts, and statistics are specific and accurate.<br \/>\nDepth of discussion\u2014present and integrate points.<br \/>\nBreadth\u2014range of limitations included.<br \/>\nEvidence\u2014points are well-supported with facts, statistics, or references.<br \/>\nLogic\u2014presented discussion makes sense; conclusions are logically supported by premises, statements, or factual information.<br \/>\nClarity\u2014writing is concise, understandable, and contains sufficient detail or examples.<br \/>\nObjectivity\u2014avoid use of first person and subjective bias.<\/p>\n<p>Reliability<\/p>\n<p>Reliability&nbsp;is defined as consistency in screening test results when the test is performed more than once on the same individual under the same conditions. Two major factors affect reliability:&nbsp;variability&nbsp;in the method&nbsp;(e.g. stability of reagents) and&nbsp;observer variation. These variations can be reduced by standardization of procedures, training of observers, and periodic checks on their work.<\/p>\n<p>Yield<\/p>\n<p>Yield&nbsp;is defined as the amount of previously unrecognized disease that is diagnosed and brought to treatment as a result of screening. The following factors affect the yield of a screening program:<\/p>\n<p>Sensitivity of the test<br \/>\nPrevalence of unrecognized disease<br \/>\nFrequency of screening<br \/>\nParticipation in screening and follow-up<\/p>\n<p>Evaluation of Screening Programs<\/p>\n<p>Because of the high costs and risks, screening programs should be conducted only when it has the potential to lead to a significant decrease in the rates of death or disability. Outcome measures such as the disease-specific death rate, physiological variables (e.g. blood cholesterol level), and case-fatality rate should be compared between screened and unscreened groups. The least biased method for evaluating a screening program would be a random, experimental study (i.e. randomly assigning individuals in a study sample to either a group that provides free screening or a control group).<\/p>\n<p>Sources of Bias in Screening Programs<\/p>\n<p>Unfortunately, randomized, experimental studies are rarely done. Instead, observational studies are often conducted, which are subject to several different sources of bias:<\/p>\n<p>Lead Time Bias. Lead time is defined as the interval between a time a condition is detected through screening and the time it would normally have been detected by the reporting of symptoms. A screening test may lead to early detection without delaying the time of death, and as a result, the screened case group may appear to have a higher survival rate than the control group.<br \/>\nPatient Self-Selection. Individuals who choose to participate in early detection programs may differ from those who do not in characteristics that may be related to survival. For example, participants may be more health-conscious, more likely to be compliant with prescribed therapy, etc.<\/p>\n<p>Module 5 &#8211; Outcomes<br \/>\nBIAS AND CONFOUNDING IN RESEARCH<\/p>\n<p>Module<br \/>\nIdentify possible sources of bias and confounding in clinical research.<br \/>\nCase<br \/>\nIdentify possible sources of bias and confounding in research.<br \/>\nApply knowledge about sources of error to peer-reviewed articles on foodborne disease.<br \/>\nSLP<br \/>\nIdentify possible sources of bias and confounding in research.<br \/>\nDiscussion<br \/>\nSuperior Essay Writers Describe the effect of non-differential misclassification on studies.<\/p>\n<p>Discussion: Non-Differential Misclassification<br \/>\nDiscussion  Homework Help &#8211; Topic<br \/>\n&nbsp;Task: Reply to this topic<\/p>\n<p>&#8220;Many investigators write as if non-differential exposure misclassification inevitably leads to a reduction in the strength of an estimated exposure\u2013disease association. Unfortunately, non-differentiality alone is insufficient to guarantee bias towards the null. Furthermore, because bias refers to the average estimate across study repetitions rather than the result of a single study, bias towards the null is insufficient to guarantee that an observed estimate will be an underestimate. Thus, as noted before, exposure misclassification can spuriously increase the observed strength of an association even when the misclassification process is non-differential and the bias it produced is towards the null.&#8221;<\/p>\n<p>Jurek, A., Greenland, S., Maldonado, G., Church, T. (2005).  Proper interpretation of non-differential misclassification effects: expectations vs observations. International Page Essay &#8211; Journal of Epidemiology, 34(3). Retrieved from http:\/\/ije.oxfordjournals.org\/content\/34\/3\/680.full.<\/p>\n<p>What effect does non-differential exposure misclassification have on studies?&nbsp;<\/p>\n<p>Do you agree with these authors that it does not necessarily bias towards the null or do you agree with other investigators that it reduces the strength of an association?  Why?<\/p>\n<p>Please post your response and then you will be able to comment on student&#8217;s responses.<\/p>\n<p>As required for all discussion questions, your response must be referenced and supported.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>BIAS AND CONFOUNDING IN RESEARCH Module 5 &#8211; Home BIAS AND CONFOUNDING IN RESEARCH Bias and confounding are two important concepts in research that can influence the validity and reliability of research findings. Bias refers to any systematic error or deviation in the design, conduct, or analysis of a research study that can affect the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1356,1365,1363,1357,1392,1387,1388,1386,1364,1355,1358,1361,1360,1389,1393,1359,1390,1394,1391,1362],"tags":[1402,1377,1398,1379,1248,1380,1382,350,1403,1399,1381,1397,1383,1400,1384],"class_list":["post-2627","post","type-post","status-publish","format-standard","hentry","category-1-dissertation-writing-service-in-uk","category-assignment-paper-help","category-australia-assessment-task-help","category-best-usa-dissertation-help-service","category-canada-essay-writers","category-cheap-essay-writer-australia","category-cheap-essay-writer-canada","category-cheap-essay-writer-uk","category-essay-bay-acer","category-essay-bishop","category-essay-writing-help-in-china","category-essaysbishop","category-essypro","category-homework-help-writing-service-usa","category-ireland-essay-writers","category-ksa-and-uae","category-nursing-help-writing-service-usa","category-uae-essay-writers","category-usa-essay-writers","category-write-my-essay-bay","tag-assignment-help-websites","tag-best-essay-writing-service-canada","tag-do-my-assignment","tag-do-my-assignment-for-me","tag-do-my-essay","tag-essay-writer","tag-no-1-assignment-help-uae-best-assignment-writing-services","tag-student-assignment-help","tag-university-assignment-help","tag-write-my-college-essay","tag-write-my-essay-for-me-best-website","tag-write-my-essay-for-me-cheap","tag-write-my-essay-online","tag-write-my-term-paper","tag-write-my-thesis-paper"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/posts\/2627","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/comments?post=2627"}],"version-history":[{"count":0,"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/posts\/2627\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/media?parent=2627"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/categories?post=2627"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/uk\/wp-json\/wp\/v2\/tags?post=2627"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}