Journal article
Bias analyses to investigate the impact of differential participation: Application to a birth defects case-control study
Paediatric and perinatal epidemiology, Vol.38(6), pp.535-543
08/2024
DOI: 10.1111/ppe.13026
PMCID: PMC11301528
PMID: 38102868
Abstract
Certain associations observed in the National Birth Defects Prevention Study (NBDPS) contrasted with other research or were from areas with mixed findings, including no decrease in odds of spina bifida with periconceptional folic acid supplementation, moderately increased cleft palate odds with ondansetron use and reduced hypospadias odds with maternal smoking.
To investigate the plausibility and extent of differential participation to produce effect estimates observed in NBDPS.
We searched the literature for factors related to these exposures and participation and conducted deterministic quantitative bias analyses. We estimated case-control participation and expected exposure prevalence based on internal and external reports, respectively. For the folic acid-spina bifida and ondansetron-cleft palate analyses, we hypothesized the true odds ratio (OR) based on prior studies and quantified the degree of exposure over- (or under-) representation to produce the crude OR (cOR) in NBDPS. For the smoking-hypospadias analysis, we estimated the extent of selection bias needed to nullify the association as well as the maximum potential harmful OR.
Under our assumptions (participation, exposure prevalence, true OR), there was overrepresentation of folic acid use and underrepresentation of ondansetron use and smoking among participants. Folic acid-exposed spina bifida cases would need to have been ≥1.2× more likely to participate than exposed controls to yield the observed null cOR. Ondansetron-exposed cleft palate cases would need to have been 1.6× more likely to participate than exposed controls if the true OR is null. Smoking-exposed hypospadias cases would need to have been ≥1.2 times less likely to participate than exposed controls for the association to falsely appear protective (upper bound of selection bias adjusted smoking-hypospadias OR = 2.02).
Differential participation could partly explain certain associations observed in NBDPS, but questions remain about why. Potential impacts of other systematic errors (e.g. exposure misclassification) could be informed by additional research.
Details
- Title: Subtitle
- Bias analyses to investigate the impact of differential participation: Application to a birth defects case-control study
- Creators
- Julie M Petersen - Massachusetts Department of Public HealthJacob C Kahrs - University of North Carolina at Chapel HillNedghie Adrien - Boston UniversityMollie E Wood - University of North Carolina at Chapel HillAndrew F Olshan - University of North Carolina at Chapel HillLouisa H Smith - Roux Institute, Northeastern University, Portland, Maine, USAMeredith M Howley - Birth Defects Registry, New York State Department of Health, Albany, New York, USAElizabeth C Ailes - National Center on Birth Defects and Developmental DisabilitiesPaul A Romitti - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USAAmy H Herring - Duke UniversitySamantha E Parker - Boston UniversityGary M Shaw - Stanford University School of MedicineMaria D Politis - University of Arkansas for Medical SciencesNational Birth Defects Prevention Study
- Resource Type
- Journal article
- Publication Details
- Paediatric and perinatal epidemiology, Vol.38(6), pp.535-543
- DOI
- 10.1111/ppe.13026
- PMID
- 38102868
- PMCID
- PMC11301528
- NLM abbreviation
- Paediatr Perinat Epidemiol
- eISSN
- 1365-3016
- Grant note
- CDC HHS
- Language
- English
- Electronic publication date
- 12/15/2023
- Date published
- 08/2024
- Academic Unit
- Epidemiology; Biostatistics
- Record Identifier
- 9984530382102771
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