Bayesian modelling of lung cancer risk and bitumen fume exposure adjusted for unmeasured confounding by smoking.

OBJECTIVES: Residual confounding can be present in epidemiological studies because information on confounding factors was not collected. A Bayesian framework, which has the advantage over frequentist methods that the uncertainty in the association between the confounding factor and exposure and dise...

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Published in:Occupational & Environmental Medicine Vol. 66; no. 8; pp. 502 - 509
Main Authors: de Vocht F, Kromhout H, Ferro G, Boffetta P, Burstyn I
Format: research Journal Article
Published: BMJ Publishing Group Aug2009
Online Access:View this record in EBSCOhost
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      dt: Aug2009
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        atl: Bayesian modelling of lung cancer risk and bitumen fume exposure adjusted for unmeasured confounding by smoking.
      aug:
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          de Vocht F
          Kromhout H
          Ferro G
          Boffetta P
          Burstyn I
        affil: Frank de Vocht, Occupational and Environmental Health Research Group, School of Translational Medicine, Faculty of Medical and Human Sciences, The University of Manchester, Manchester M13 8GE, UK; frank.devocht@manchester.ac.uk.
      sug:
        subj:
          Hydrocarbons
          Lung Neoplasms Etiology
          Occupational Diseases Etiology
          Occupational Exposure Adverse Effects
          Probability
          Smoking
          Air Pollutants, Occupational
          Bias (Research)
          Confounding Variable
          Environmental Exposure
          Europe
          Israel
          Lung Neoplasms Epidemiology
          Male
          Occupational Diseases Epidemiology
          Occupational Exposure
          Prospective Studies
          Relative Risk
          Smoke Adverse Effects
          Smoking Epidemiology
          Human
          Male
      ab: OBJECTIVES: Residual confounding can be present in epidemiological studies because information on confounding factors was not collected. A Bayesian framework, which has the advantage over frequentist methods that the uncertainty in the association between the confounding factor and exposure and disease can be reflected in the credible intervals of the risk parameter, is proposed to assess the magnitude and direction of this bias. METHODS: To illustrate this method, bias from smoking as an unmeasured confounder in a cohort study of lung cancer risk in the European asphalt industry was assessed. A Poisson disease model was specified to assess lung cancer risk associated with career average, cumulative and lagged bitumen fume exposure. Prior distributions for the exposure strata, as well as for other covariates, were specified as uninformative normal distributions. The priors on smoking habits were specified as Dirichlet distributions based on smoking prevalence estimates available for a sub-cohort and assumptions about precision of these estimates. RESULTS: Median bias in this example was estimated at 13%, and suggested an attenuating effect on the original exposure-disease associations. Nonetheless, the results still implied an increased lung cancer risk, especially for average exposure. CONCLUSIONS: This Bayesian framework provides a method to assess the bias from an unmeasured confounding factor taking into account the uncertainty surrounding the estimate and from random sampling error. Specifically for this example, the bias arising from unmeasured smoking history in this asphalt workers' cohort is unlikely to explain the increased lung cancer risk associated with average bitumen fume exposure found in the original study.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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