Statistics > Methodology
[Submitted on 19 Sep 2018 (v1), last revised 10 Nov 2019 (this version, v4)]
Title:Educational Note: Paradoxical Collider Effect in the Analysis of Non-Communicable Disease Epidemiological Data: a reproducible illustration and web application
View PDFAbstract:Classical epidemiology has focused on the control of confounding but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g., an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed acyclic graph (DAG), a collider is the variable in the middle of an inverted fork (i.e., the variable C in A -> C <- Y). Controlling for, or conditioning an analysis on a collider (i.e., through stratification or regression) can introduce a spurious association between its causes. This potentially explains many paradoxical findings in the medical literature, where established risk factors for a particular outcome appear protective. We use an example from non-communicable disease epidemiology to contextualize and explain the effect of conditioning on a collider. We generate a dataset with 1,000 observations and run Monte-Carlo simulations to estimate the effect of 24-hour dietary sodium intake on systolic blood pressure, controlling for age, which acts as a confounder, and 24-hour urinary protein excretion, which acts as a collider. We illustrate how adding a collider to a regression model introduces bias. Thus, to prevent paradoxical associations, epidemiologists estimating causal effects should be wary of conditioning on colliders. We provide R-code in easy-to-read boxes throughout the manuscript and a GitHub repository (this https URL) for the reader to reproduce our example. We also provide an educational web application allowing real-time interaction to visualize the paradoxical effect of conditioning on a collider this http URL.
Submission history
From: Miguel Angel Luque-Fernandez [view email][v1] Wed, 19 Sep 2018 10:19:06 UTC (5,028 KB)
[v2] Mon, 22 Oct 2018 09:21:37 UTC (7,574 KB)
[v3] Tue, 5 Nov 2019 10:12:22 UTC (7,580 KB)
[v4] Sun, 10 Nov 2019 12:44:15 UTC (7,580 KB)
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