Identification of confounders and estimating the causal effect of place of birth on age-specific childhood vaccination
Iyassu, Ashagrie Sharew; Fenta, Haile Mekonnen; Dessie, Zelalem G; Zewotir, Temesgen T (2024-12-27)
Biomed central
27.12.2024
Iyassu, A.S., Fenta, H.M., Dessie, Z.G. et al. Identification of confounders and estimating the causal effect of place of birth on age-specific childhood vaccination. BMC Med Inform Decis Mak 24, 406 (2024). https://doi.org/10.1186/s12911-024-02827-2
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https://creativecommons.org/licenses/by-nc-nd/4.0/
© The Author(s) 2024.This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202501091104
https://urn.fi/URN:NBN:fi:oulu-202501091104
Tiivistelmä
Abstract
Background:
In causal analyses, some third factor may distort the relationship between the exposure and the outcome variables under study, which gives spurious results. In this case, treatment groups and control groups that receive and do not receive the exposure are different from one another in some other essential variables, called confounders.
Method:
Place of birth was used as exposure variable and age-specific childhood vaccination status was used as outcome variables. Three approaches of confounder selection techniques such as all pre-treatment covariates, outcome cause covariates, and common cause covariates were proposed. Multiple logistic regression was used to estimate the propensity score for inverse probability treatment weighting (IPTW) confounder adjustment techniques. The proportional odds model was used to estimate the causal effect of place of birth on age-specific childhood vaccination. To validate the result obtained from observed data, we used a plasmode simulation of resampling 1000 samples from actual data 500 times.
Result:
Outcome cause and common cause confounder identification techniques gave comparable results in terms of treatment effect in the plasmode data. However, outcome causes that contain common causes and predictors of the outcome confounder identification gave relatively better treatment effect results. The treatment effect result in the IPTW confounder adjustment method was better than that of the regression adjustment method. The effect of place of birth on log odds of cumulative probability of age-specific childhood vaccination was 0.36 with odds ratio of 1.43 for higher level vaccination status.
Conclusion:
It is essential to use plasmode simulation data to validate the reproducibility of the proposed methods on the observed data. It is important to use outcome-cause covariates to adjust their confounding effect on the outcome. Using inverse probability treatment weighting gives unbiased treatment effect results as compared to the regression method of confounder adjustment. Institutional delivery increases the likelihood of childhood vaccination at the recommended schedule.
Background:
In causal analyses, some third factor may distort the relationship between the exposure and the outcome variables under study, which gives spurious results. In this case, treatment groups and control groups that receive and do not receive the exposure are different from one another in some other essential variables, called confounders.
Method:
Place of birth was used as exposure variable and age-specific childhood vaccination status was used as outcome variables. Three approaches of confounder selection techniques such as all pre-treatment covariates, outcome cause covariates, and common cause covariates were proposed. Multiple logistic regression was used to estimate the propensity score for inverse probability treatment weighting (IPTW) confounder adjustment techniques. The proportional odds model was used to estimate the causal effect of place of birth on age-specific childhood vaccination. To validate the result obtained from observed data, we used a plasmode simulation of resampling 1000 samples from actual data 500 times.
Result:
Outcome cause and common cause confounder identification techniques gave comparable results in terms of treatment effect in the plasmode data. However, outcome causes that contain common causes and predictors of the outcome confounder identification gave relatively better treatment effect results. The treatment effect result in the IPTW confounder adjustment method was better than that of the regression adjustment method. The effect of place of birth on log odds of cumulative probability of age-specific childhood vaccination was 0.36 with odds ratio of 1.43 for higher level vaccination status.
Conclusion:
It is essential to use plasmode simulation data to validate the reproducibility of the proposed methods on the observed data. It is important to use outcome-cause covariates to adjust their confounding effect on the outcome. Using inverse probability treatment weighting gives unbiased treatment effect results as compared to the regression method of confounder adjustment. Institutional delivery increases the likelihood of childhood vaccination at the recommended schedule.
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