Effect modification. Flashcards
When does Effect Modification occur?
When the strength of association varies over different categories of a third variable in an association study.
Do you modify for effect modification?
No. It is not an error.
What OR’s do you look at when looking at effect modification?
Stratum specific OR’s.
How do you evaluate stratum specific OR’s?
- Calculate P values on homogeneity tests.
2. Evaluate overlap of CI’s on stratum specific OR’s.
What homogeneity test do you use to calculate the p values for effect modification?
Breslow-day test.
What is the conceptual definition of an effect modifier?
The effect of the exposure and potential modifier differ from the expected joint effect.
For something to be an effect modifier what must the OR be after stratifying?
Statistically different.
When will an effect modifier be described as being in the ‘grey zone’ what is overlapping?
The confidence intervals.
Apart from using the Mantel-Haenzsel OR what other way can you adjust for confounding?
Report confounders separately.
What is the equation for the null hypothesis for the Mantel-Haenzsel test?
H0= OR1=OR2
What is the alternative hypothesis for the Mantel-Haenzsel test?
H1= OR1 is not equal to OR2.
What distribution is used in the Mantel-Haenzsel test?
Chi squared to 1 dof.
In words what is the null hypothesis for the Mantel-Haenzsel test?
Stratum specific OR’s are homogenous.
What sort of regression models are used to look at additive effects?
Linear, Poisson.
What sort of regression models are used to look at multiplicative effects?
Logistic, poisson, survival (COX) analysis.
What does the side of an interaction effect influence?
The size of the sample needed to detect its effect.
What is another name for effect modification?
Biological modification.
Interactions can be seen to occur when they do not actually exist. Why? (3 things).
- Chance.
- Systematic error.
- Varying exposure doses between strata.
When does qualitative effect modification occur instead of quantitative? What does this mean?
When measures of effect in different strata have different directions. This means that effect modification occurs on both the multiplicative and additive scale.
Explain the phenomenon of reciprocity in terms of effect modifier Z, exposure E and outcome D.
If Z modifies the effect of E on D than Z also modifies the effect of E on D.
Does the following statement describe an effect modifier or a confounder?
Belongs to a specific study.
Confounder.
Does the following statement describe an effect modifier or a confounder?
Exists in nature.
Effect Modifier.
Does the following statement describe an effect modifier or a confounder?
Different effects in different strata.
Effect modifier.
Does the following statement describe an effect modifier or a confounder?
Increases biological knowledge of mechanism.
Effect modifier.
Does the following statement describe an effect modifier or a confounder?
Prevented in the design stage, controlled for in analysis stage.
Confounder.
Does the following statement describe an effect modifier or a confounder?
Creates confusion in the data.
Confounder.
Does the following statement describe an effect modifier or a confounder?
Allows targeting of public health outcome.
Effect modifier.
