The individualistic fallacy, ecological studies and instrumental variables: a causal interpretation

Emerging Themes in Epidemiology
Tom Loney, Nico J Nagelkerke

Abstract

The validity of ecological studies in epidemiology for inferring causal relationships has been widely challenged as observed associations could be biased by the Ecological Fallacy. We reconsider the important design components of ecological studies, and discuss the conditions that may lead to spurious associations. Ecological associations are useful and valid when the ecological exposures can be interpreted as Instrumental Variables. A suitable example may be a time series analysis of environmental pollution (e.g. particulate matter with an aerodynamic diameter of <10 micrometres; PM10) and health outcomes (e.g. hospital admissions for acute myocardial infarction) as environmental pollution levels are a cause of individual exposure levels and not just an aggregate measurement. Ecological exposures may also be employed in situations (perhaps rare) where individual exposures are known but their associations with health outcomes are confounded by unknown or unquantifiable factors. Ecological associations have a notorious reputation in epidemiology and individualistic associations are considered superior to ecological associations because of the "ecological fallacy". We have argued that this is incorrect in situations in which ecol...Continue Reading

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Citations

Oct 4, 2017·Israel Journal of Health Policy Research·Yehuda Neumark
Dec 7, 2018·Environmental Science and Pollution Research International·Alina Svechkina, Boris A Portnov
Nov 16, 2017·Annals of the American Thoracic Society·Michael S SchechterUNKNOWN Scientific Advisory Group and the Investigators and Coordinators of the Epidemiologic Study of Cystic Fibrosis
Apr 20, 2018·International Journal of Environmental Research and Public Health·Chiara LoriniGuglielmo Bonaccorsi
Aug 21, 2018·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Armand R J GirbesLars Hein
Jun 19, 2018·European Heart Journal. Quality of Care & Clinical Outcomes·Chris Wilkinson, J Campbell Cowan
Dec 11, 2019·International Journal of Environmental Research and Public Health·Yangwoo KimSoo-Jin Lee
Jul 28, 2020·International Journal of Environmental Research and Public Health·Maureen VowlesLinda Mason
Mar 7, 2018·International Journal of Public Health·Katarzyna OrlewskaEwa Orlewska
Aug 3, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ronald T CottonNader N Massarweh
Jan 27, 2019·International Journal of Environmental Research and Public Health·Katarina LokarVesna Zadnik
May 13, 2017·Annals of Surgery·Meredith C MasonNader N Massarweh
Nov 26, 2020·JAMA Ophthalmology·Ning CheungTien Yin Wong
Feb 12, 2021·Nephrology·Stefanos RoumeliotisGiovanni Tripepi
Mar 7, 2020·Journal of Hypertension·Fosca Quarti TrevanoGuido Grassi
Mar 18, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Yi-Te LeeJu Dong Yang
Nov 25, 2019·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·T LytrasS Tsiodras
Oct 16, 2020·Gastroenterology·Junjie HuangMartin C S Wong

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