On the definition of a confounder
- PMID: 25544784
- PMCID: PMC4276366
- DOI: 10.1214/12-aos1058
On the definition of a confounder
Abstract
The causal inference literature has provided a clear formal definition of confounding expressed in terms of counterfactual independence. The causal inference literature has not, however, produced a clear formal definition of a confounder, as it has given priority to the concept of confounding over that of a confounder. We consider a number of candidate definitions arising from various more informal statements made in the literature. We consider the properties satisfied by each candidate definition, principally focusing on (i) whether under the candidate definition control for all "confounders" suffices to control for "confounding" and (ii) whether each confounder in some context helps eliminate or reduce confounding bias. Several of the candidate definitions do not have these two properties. Only one candidate definition of those considered satisfies both properties. We propose that a "confounder" be defined as a pre-exposure covariate C for which there exists a set of other covariates X such that effect of the exposure on the outcome is unconfounded conditional on (X, C) but such that for no proper subset of (X, C) is the effect of the exposure on the outcome unconfounded given the subset. A variable that helps reduce bias but not eliminate bias we propose referring to as a "surrogate confounder."
Keywords: Adjustment; causal diagrams; causal inference; confounder; counterfactuals; minimal sufficiency.
Figures
Similar articles
-
Using computable knowledge mined from the literature to elucidate confounders for EHR-based pharmacovigilance.J Biomed Inform. 2021 May;117:103719. doi: 10.1016/j.jbi.2021.103719. Epub 2021 Mar 11. J Biomed Inform. 2021. PMID: 33716168 Free PMC article.
-
Instrumental variables as bias amplifiers with general outcome and confounding.Biometrika. 2017 Jun 1;104(2):291-302. doi: 10.1093/biomet/asx009. Epub 2017 Apr 17. Biometrika. 2017. PMID: 29033459 Free PMC article.
-
Principles of confounder selection.Eur J Epidemiol. 2019 Mar;34(3):211-219. doi: 10.1007/s10654-019-00494-6. Epub 2019 Mar 6. Eur J Epidemiol. 2019. PMID: 30840181 Free PMC article.
-
Introduction to causal diagrams for confounder selection.Respirology. 2014 Apr;19(3):303-11. doi: 10.1111/resp.12238. Epub 2014 Jan 22. Respirology. 2014. PMID: 24447391 Review.
-
Machine learning for improving high-dimensional proxy confounder adjustment in healthcare database studies: An overview of the current literature.Pharmacoepidemiol Drug Saf. 2022 Sep;31(9):932-943. doi: 10.1002/pds.5500. Epub 2022 Jul 5. Pharmacoepidemiol Drug Saf. 2022. PMID: 35729705 Free PMC article. Review.
Cited by
-
Using computable knowledge mined from the literature to elucidate confounders for EHR-based pharmacovigilance.J Biomed Inform. 2021 May;117:103719. doi: 10.1016/j.jbi.2021.103719. Epub 2021 Mar 11. J Biomed Inform. 2021. PMID: 33716168 Free PMC article.
-
A simulation study on matched case-control designs in the perspective of causal diagrams.BMC Med Res Methodol. 2016 Aug 20;16(1):102. doi: 10.1186/s12874-016-0206-3. BMC Med Res Methodol. 2016. PMID: 27543263 Free PMC article.
-
When remediating one artifact results in another: control, confounders, and correction.Hist Philos Life Sci. 2024 Jan 11;46(1):5. doi: 10.1007/s40656-023-00606-2. Hist Philos Life Sci. 2024. PMID: 38206408 Free PMC article.
-
Matching Methods for Confounder Adjustment: An Addition to the Epidemiologist's Toolbox.Epidemiol Rev. 2022 Jan 14;43(1):118-129. doi: 10.1093/epirev/mxab003. Epidemiol Rev. 2022. PMID: 34109972 Free PMC article. Review.
-
Corneal biomechanics and biomechanically corrected intraocular pressure in primary open-angle glaucoma, ocular hypertension and controls.Br J Ophthalmol. 2020 Jan;104(1):121-126. doi: 10.1136/bjophthalmol-2018-313493. Epub 2019 Mar 28. Br J Ophthalmol. 2020. PMID: 30923134 Free PMC article.
References
-
- Barnow BS, Cain GG, Goldberger AS. Issues in the analysis of selectivity bias. In: Stromsdorfer E, Farkas G, editors. Evaluation Studies. Vol. 5. Sage; San Francisco: 1980.
-
- Breslow NE, Day NE. Satistical Methods in Cancer Research, vol. 1: The Analysis of Case-Control Studies. International Agency for Research on Cancer; Lyon: 1980. - PubMed
-
- Cox DR. Planning of Experiments. John Wiley & Sons; New York: 1958.
-
- Dawid AP. Influence diagrams for causal modelling and inference. Int. Statist. Rev. 2002;70:161–189.
-
- Geng Z, Guo JH, Fung WK. Criteria for confounders in epidemiological studies. Journal of the Royal Statistical Society, Series B. 2002;64:3–15.
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources