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World Health Organization : Year 1991, World Health Organization, Programme for the Control of Diarrhoeal Diseases Edp, No. 91.3: A Source of Bias in Studies of Bi-Directional Associations ; Hypothetical Example of Malnutrition and Diarrhea

By Simon N. Cousen

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Book Id: WPLBN0000082722
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Reproduction Date: 2005
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Title: World Health Organization : Year 1991, World Health Organization, Programme for the Control of Diarrhoeal Diseases Edp, No. 91.3: A Source of Bias in Studies of Bi-Directional Associations ; Hypothetical Example of Malnutrition and Diarrhea  
Author: Simon N. Cousen
Volume:
Language: English
Subject: Health., Public health, Wellness programs
Collections: Medical Library Collection, World Health Collection
Historic
Publication Date:
Publisher: World Health Organization

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Cousen, S. N. (n.d.). World Health Organization : Year 1991, World Health Organization, Programme for the Control of Diarrhoeal Diseases Edp, No. 91.3. Retrieved from http://hawaiilibrary.net/


Description
Medical Reference Publication

Excerpt
In order to study whether a factor A increases the risk of developing an outcome B, epidemiologists frequently employ the following strategy: 1. Identify a group of individuals with A and a group of individuals without A; 2. Follow both groups of individuals over a period of time in order to observe who develops B; 3. Compare the rate at which B occurs in individuals with A with the rate at which it occurs in individuals without A; I. If a higher rate of B is observed to occur in individuals with A (after taking account of confounding factors), then infer chat A causes B. This strategy is known as a cohort or follow-up study and one of its perceived advantages is that: the temporal sequence between exposure (A) and outcome (B) can be more clearly established (Hennekens and Buring, 1987). The ioference that A causes B may, however, be problematic. Rose and Shipley (19801, discussing an apparent link between low plasma cholesterol levels and increased risk of cancer, have pointed out that such an observation may arise if early, pre-clinical disease leads to low cholesterol levels - i.e., unobserved B causes A which is then followed by the observation of B. One infers that A causes B when, in fact, the reverse is true.

Table of Contents
CONTENTS &!&% SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 THE ASSOCIATXON BETWEEN DIARRHOEA AND HALNUTRITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 THE REVERSE CAUSALIlY PROBLEM ........................................................ b THE MODEL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b DISCUSSION ........................................................................... 11 ACKNOWLEDGEMENTS ..................................................................... 12 REFERENCES ........................................................................... 13

 

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