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Ross RK, Cole SR, Edwards JK, Zivich PN, Westreich D, Daniels JL, Price JT, Stringer JSA. Leveraging External Validation Data: The Challenges of Transporting Measurement Error Parameters. Epidemiology 2024; 35:196-207. [PMID: 38079241 PMCID: PMC10841744 DOI: 10.1097/ede.0000000000001701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Approaches to address measurement error frequently rely on validation data to estimate measurement error parameters (e.g., sensitivity and specificity). Acquisition of validation data can be costly, thus secondary use of existing data for validation is attractive. To use these external validation data, however, we may need to address systematic differences between these data and the main study sample. Here, we derive estimators of the risk and the risk difference that leverage external validation data to account for outcome misclassification. If misclassification is differential with respect to covariates that themselves are differentially distributed in the validation and study samples, the misclassification parameters are not immediately transportable. We introduce two ways to account for such covariates: (1) standardize by these covariates or (2) iteratively model the outcome. If conditioning on a covariate for transporting the misclassification parameters induces bias of the causal effect (e.g., M-bias), the former but not the latter approach is biased. We provide proof of identification, describe estimation using parametric models, and assess performance in simulations. We also illustrate implementation to estimate the risk of preterm birth and the effect of maternal HIV infection on preterm birth. Measurement error should not be ignored and it can be addressed using external validation data via transportability methods.
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Affiliation(s)
- Rachael K Ross
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Stephen R Cole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Paul N Zivich
- Institute of Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, NC
| | - Daniel Westreich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Julie L Daniels
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Joan T Price
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Jeffrey S A Stringer
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC
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Shah MP, Chebore W, Lyles RH, Otieno K, Zhou Z, Plucinski M, Waller LA, Odongo W, Lindblade KA, Kariuki S, Samuels AM, Desai M, Mitchell RM, Shi YP. Novel application of one-step pooled molecular testing and maximum likelihood approaches to estimate the prevalence of malaria parasitaemia among rapid diagnostic test negative samples in western Kenya. Malar J 2022; 21:319. [PMID: 36336700 PMCID: PMC9638440 DOI: 10.1186/s12936-022-04323-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/07/2022] [Indexed: 11/08/2022] Open
Abstract
Abstract
Background
Detection of malaria parasitaemia in samples that are negative by rapid diagnostic tests (RDTs) requires resource-intensive molecular tools. While pooled testing using a two-step strategy provides a cost-saving alternative to the gold standard of individual sample testing, statistical adjustments are needed to improve accuracy of prevalence estimates for a single step pooled testing strategy.
Methods
A random sample of 4670 malaria RDT negative dried blood spot samples were selected from a mass testing and treatment trial in Asembo, Gem, and Karemo, western Kenya. Samples were tested for malaria individually and in pools of five, 934 pools, by one-step quantitative polymerase chain reaction (qPCR). Maximum likelihood approaches were used to estimate subpatent parasitaemia (RDT-negative, qPCR-positive) prevalence by pooling, assuming poolwise sensitivity and specificity was either 100% (strategy A) or imperfect (strategy B). To improve and illustrate the practicality of this estimation approach, a validation study was constructed from pools allocated at random into main (734 pools) and validation (200 pools) subsets. Prevalence was estimated using strategies A and B and an inverse-variance weighted estimator and estimates were weighted to account for differential sampling rates by area.
Results
The prevalence of subpatent parasitaemia was 14.5% (95% CI 13.6–15.3%) by individual qPCR, 9.5% (95% CI (8.5–10.5%) by strategy A, and 13.9% (95% CI 12.6–15.2%) by strategy B. In the validation study, the prevalence by individual qPCR was 13.5% (95% CI 12.4–14.7%) in the main subset, 8.9% (95% CI 7.9–9.9%) by strategy A, 11.4% (95% CI 9.9–12.9%) by strategy B, and 12.8% (95% CI 11.2–14.3%) using inverse-variance weighted estimator from poolwise validation. Pooling, including a 20% validation subset, reduced costs by 52% compared to individual testing.
Conclusions
Compared to individual testing, a one-step pooled testing strategy with an internal validation subset can provide accurate prevalence estimates of PCR-positivity among RDT-negatives at a lower cost.
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Ackerman B, Siddique J, Stuart EA. Calibrating validation samples when accounting for measurement error in intervention studies. Stat Methods Med Res 2021; 30:1235-1248. [PMID: 33620006 DOI: 10.1177/0962280220988574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Many lifestyle intervention trials depend on collecting self-reported outcomes, such as dietary intake, to assess the intervention's effectiveness. Self-reported outcomes are subject to measurement error, which impacts treatment effect estimation. External validation studies measure both self-reported outcomes and accompanying biomarkers, and can be used to account for measurement error. However, in order to account for measurement error using an external validation sample, an assumption must be made that the inferences are transportable from the validation sample to the intervention trial of interest. This assumption does not always hold. In this paper, we propose an approach that adjusts the validation sample to better resemble the trial sample, and we also formally investigate when bias due to poor transportability may arise. Lastly, we examine the performance of the methods using simulation, and illustrate them using PREMIER, a lifestyle intervention trial measuring self-reported sodium intake as an outcome, and OPEN, a validation study measuring both self-reported diet and urinary biomarkers.
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Affiliation(s)
- Benjamin Ackerman
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Juned Siddique
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Manuel CM, Sinha S, Wang S. Matched case-control data with a misclassified exposure: what can be done with instrumental variables? Biostatistics 2021; 22:1-18. [PMID: 31086943 DOI: 10.1093/biostatistics/kxz012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/13/2019] [Accepted: 04/02/2019] [Indexed: 11/14/2022] Open
Abstract
Matched case-control studies are used for finding the association between a disease and an exposure after controlling the effect of important confounding variables. It is a known fact that the disease-exposure association parameter estimators are biased when the exposure is misclassified, and a matched case-control study is of no exception. Any bias correction method relies on validation data that contain the true exposure and the misclassified exposure value, and in turn the validation data help to estimate the misclassification probabilities. The question is what we can do when there are no validation data and no prior knowledge on the misclassification probabilities, but some instrumental variables are observed. To answer this unexplored and unanswered question, we propose two methods of reducing the exposure misclassification bias in the analysis of a matched case-control data when instrumental variables are measured for each subject of the study. The significance of these approaches is that the proposed methods are designed to work without any validation data that often are not available when the true exposure is impossible or too costly to measure. A simulation study explores different types of instrumental variable scenarios and investigates when the proposed methods work, and how much bias can be reduced. For the purpose of illustration, we apply the methods to a nested case-control data sampled from the 1989 US birth registry.
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Affiliation(s)
- Christopher M Manuel
- Department of Statistics, Texas A&M University, College Station, TX 77843-3143, USA
| | - Samiran Sinha
- Department of Statistics, Texas A&M University, College Station, TX 77843-3143, USA
| | - Suojin Wang
- Department of Statistics, Texas A&M University, College Station, TX 77843-3143, USA
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Josberger RE, Wu M, Nichols EL. Birth Certificate Validity and the Impact on Primary Cesarean Section Quality Measure in New York State. J Community Health 2018; 44:222-229. [DOI: 10.1007/s10900-018-0577-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lian Q, Hodges JS, MacLehose R, Chu H. A Bayesian approach for correcting exposure misclassification in meta-analysis. Stat Med 2018; 38:115-130. [PMID: 30251263 DOI: 10.1002/sim.7969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/12/2018] [Accepted: 08/22/2018] [Indexed: 02/05/2023]
Abstract
In observational studies, misclassification of exposure is ubiquitous and can substantially bias the estimated association between an outcome and an exposure. Although misclassification in a single observational study has been well studied, few papers have considered it in a meta-analysis. Meta-analyses of observational studies provide important evidence for health policy decisions, especially when large randomized controlled trials are unethical or unavailable. It is imperative to account properly for misclassification in a meta-analysis to obtain valid point and interval estimates. In this paper, we propose a novel Bayesian approach to filling this methodological gap. We simultaneously synthesize two (or more) meta-analyses, with one on the association between a misclassified exposure and an outcome (main studies), and the other on the association between the misclassified exposure and the true exposure (validation studies). We extend the current scope for using external validation data by relaxing the "transportability" assumption by means of random effects models. Our model accounts for heterogeneity between studies and can be extended to allow different studies to have different exposure measurements. The proposed model is evaluated through simulations and illustrated using real data from a meta-analysis of the effect of cigarette smoking on diabetic peripheral neuropathy.
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Affiliation(s)
- Qinshu Lian
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455
| | - James S Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455
| | - Richard MacLehose
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455
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Ahrens K, Lash TL, Louik C, Mitchell AA, Werler MM. Correcting for exposure misclassification using survival analysis with a time-varying exposure. Ann Epidemiol 2012; 22:799-806. [PMID: 23041654 DOI: 10.1016/j.annepidem.2012.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 08/25/2012] [Accepted: 09/06/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Survival analysis is increasingly being used in perinatal epidemiology to assess time-varying risk factors for various pregnancy outcomes. Here we show how quantitative correction for exposure misclassification can be applied to a Cox regression model with a time-varying dichotomous exposure. METHODS We evaluated influenza vaccination during pregnancy in relation to preterm birth among 2267 non-malformed infants whose mothers were interviewed as part of the Slone Birth Defects Study during 2006 through 2011. The hazard of preterm birth was modeled using a time-varying exposure Cox regression model with gestational age as the time-scale. The effect of exposure misclassification was then modeled using a probabilistic bias analysis that incorporated vaccination date assignment. The parameters for the bias analysis were derived from both internal and external validation data. RESULTS Correction for misclassification of prenatal influenza vaccination resulted in an adjusted hazard ratio (AHR) slightly higher and less precise than the conventional analysis: Bias-corrected AHR 1.04 (95% simulation interval, 0.70-1.52); conventional AHR, 1.00 (95% confidence interval, 0.71-1.41). CONCLUSIONS Probabilistic bias analysis allows epidemiologists to assess quantitatively the possible confounder-adjusted effect of misclassification of a time-varying exposure, in contrast with a speculative approach to understanding information bias.
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Beavers DP, Stamey JD. Bayesian sample size determination for binary regression with a misclassified covariate and no gold standard. Comput Stat Data Anal 2012. [DOI: 10.1016/j.csda.2012.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Validation data-based adjustments for outcome misclassification in logistic regression: an illustration. Epidemiology 2011; 22:589-97. [PMID: 21487295 DOI: 10.1097/ede.0b013e3182117c85] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Misclassification of binary outcome variables is a known source of potentially serious bias when estimating adjusted odds ratios. Although researchers have described frequentist and Bayesian methods for dealing with the problem, these methods have seldom fully bridged the gap between statistical research and epidemiologic practice. In particular, there have been few real-world applications of readily grasped and computationally accessible methods that make direct use of internal validation data to adjust for differential outcome misclassification in logistic regression. In this paper, we illustrate likelihood-based methods for this purpose that can be implemented using standard statistical software. Using main study and internal validation data from the HIV Epidemiology Research Study, we demonstrate how misclassification rates can depend on the values of subject-specific covariates, and we illustrate the importance of accounting for this dependence. Simulation studies confirm the effectiveness of the maximum likelihood approach. We emphasize clear exposition of the likelihood function itself, to permit the reader to easily assimilate appended computer code that facilitates sensitivity analyses as well as the efficient handling of main/external and main/internal validation-study data. These methods are readily applicable under random cross-sectional sampling, and we discuss the extent to which the main/internal analysis remains appropriate under outcome-dependent (case-control) sampling.
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Babanezhad M, Vansteelandt S, Goetghebeur E. Comparison of causal effect estimators under exposure misclassification. J Stat Plan Inference 2010. [DOI: 10.1016/j.jspi.2009.11.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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11
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Burd L, Hofer R. Biomarkers for detection of prenatal alcohol exposure: A critical review of fatty acid ethyl esters in meconium. ACTA ACUST UNITED AC 2008; 82:487-93. [DOI: 10.1002/bdra.20464] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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