Using propensity score modeling to minimize the influence of confounding risks related to prenatal tobacco exposure.

Introduction: Despite efforts to control for confounding variables using stringent sampling plans, selection bias typically exists in observational studies, resulting in unbalanced comparison groups. Ignoring selection bias can result in unreliable or misleading estimates of the causal effect.Method...

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Publicado en:Nicotine & Tobacco Research Vol. 12; no. 12; pp. 1211 - 1220
Autores principales: Fang H, Johnson C, Chevalier N, Stopp C, Wiebe S, Wakschlag LS, Espy KA, Fang, Hua, Johnson, Craig, Chevalier, Nicolas, Stopp, Christian, Wiebe, Sandra, Wakschlag, Lauren S, Espy, Kimberly Andrews
Formato: research Journal Article
Publicado: Oxford University Press / USA Dec2010
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Using propensity score modeling to minimize the influence of confounding risks related to prenatal tobacco exposure.
      aug:
        au:
          Fang H
          Johnson C
          Chevalier N
          Stopp C
          Wiebe S
          Wakschlag LS
          Espy KA
          Fang, Hua
          Johnson, Craig
          Chevalier, Nicolas
          Stopp, Christian
          Wiebe, Sandra
          Wakschlag, Lauren S
          Espy, Kimberly Andrews
        affil: Division of Biostatistics and Health Services Research, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
      sug:
        subj:
          Data Analysis, Statistical
          Pregnancy Outcomes
          Prenatal Exposure Delayed Effects
          Smoking Epidemiology
          Passive Smoking
          Adult
          Bias (Research)
          Birth Weight
          Prospective Studies
          Female
          Human
          Infant Behavior
          Infant, Newborn
          Pregnancy
          Young Adult
          Adult: 19-44 years
          Infant, Newborn: birth-1 month
          Female
      ab: Introduction: Despite efforts to control for confounding variables using stringent sampling plans, selection bias typically exists in observational studies, resulting in unbalanced comparison groups. Ignoring selection bias can result in unreliable or misleading estimates of the causal effect.Methods: Generalized boosted models were used to estimate propensity scores from 42 confounding variables for a sample of 361 neonates. Using emergent neonatal attention and orientation skills as an example developmental outcome, we examined the impact of tobacco exposure with and without accounting for selection bias. Weight at birth, an outcome related to tobacco exposure, also was used to examine the functionality of the propensity score approach.Results: Without inclusion of propensity scores, tobacco-exposed neonates did not differ from their nonexposed peers in attention skills over the first month or in weight at birth. When the propensity score was included as a covariate, exposed infants had marginally lower attention and a slower linear change rate at 4 weeks, with greater quadratic deceleration over the first month. Similarly, exposure-related differences in birth weight emerged when propensity scores were included as a covariate.Conclusions: The propensity score method captured the selection bias intrinsic to this observational study of prenatal tobacco exposure. Selection bias obscured the deleterious impact of tobacco exposure on the development of neonatal attention. The illustrated analytic strategy offers an example to better characterize the impact of prenatal tobacco exposure on important developmental outcomes by directly modeling and statistically accounting for the selection bias from the sampling process.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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