Quantifying the potential role of unmeasured confounders: the example of influenza vaccination

International Journal of Epidemiology
R H H GroenwoldEelko Hak

Abstract

The validity of non-randomized studies using healthcare databases is often challenged because they lack information on potentially important confounders, such as functional health status and socioeconomic status. In a study quantifying the effects of influenza vaccination among community-dwelling elderly we assessed whether additional information on not routinely available covariates was indeed associated with exposure to influenza vaccination and could, therefore, have led to residual confounding in healthcare databases. We randomly selected 500 persons aged 65 years and older from the computerized Utrecht General Practitioner database. Information on exposure status and on demographics, co-morbidity status, prior healthcare use and medication use was extracted from the database. A questionnaire was used to obtain additional information on not routinely available risk factors [e.g. functional health status (SF-20), smoking status and alcohol consumption]. Missing data from the questionnaire was imputed and multivariable logistic regression analysis was applied to quantify the influence of covariates on the prediction of exposure to influenza vaccination. Within an existing dataset the potential impact of functional health stat...Continue Reading

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Citations

Sep 4, 2012·American Journal of Epidemiology·Salvatore ManninoKenneth J Rothman
Mar 19, 2013·BMC Public Health·Iván Martínez-BazUNKNOWN Primary Health Care Sentinel Network of Navarre
Sep 13, 2012·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Tuen-Ching ChanLeung-Wing Chu
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Nov 13, 2015·Annals of Epidemiology·Rolf H H GroenwoldOlaf H Klungel
Sep 29, 2011·Pharmacoepidemiology and Drug Safety·Rolf H H GroenwoldOlaf H Klungel
Apr 3, 2016·Pharmacoepidemiology and Drug Safety·Md Jamal UddinOlaf H Klungel
Feb 13, 2015·The Lancet Infectious Diseases·Eelko Hak
Apr 20, 2016·International Journal of Clinical Pharmacy·Md Jamal UddinOlaf H Klungel
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May 16, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Iván Martínez-BazJesús Castilla

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