Measurement error is common in epidemiologic research and may affect the validity of research results. It is therefore important to scrutinise the effects of measurement error in epidemiologic... Show moreMeasurement error is common in epidemiologic research and may affect the validity of research results. It is therefore important to scrutinise the effects of measurement error in epidemiologic research. Even simple forms of measurement error, for instance random measurement error in an exposure, can introduce bias in exposure-outcome associations. And even though there are situations in which measurement error does not introduce bias in the exposure-outcome association, for instance in case of random measurement error in a continuous outcome, it nearly always affects the precision and power of a study. In addition, other forms of measurement error, for example systematic measurement error or differential measurement error in an exposure, covariate or outcome, can affect exposure-outcome associations in complex ways that may not easily be anticipated. Adjusting for measurement error using measurement error correction methods may thus be necessary to obtain reliable estimates of exposure-outcome associations.To facilitate measurement error correction, information about the underlying measurement error mechanism (i.e., model) and its parameters is needed. The measurement error model can sometimes be estimated from internal or external validation data, replicates data or calibration data. Collection and the use of such measurement error mechanism data will likely improve the quality of epidemiologic analyses in the presence of measurement error. This can be done through the application of measurement error correction methods, which adjust the analyses taking into account the information from the measurement error mechanism. Alternatively, in the absence of concrete data about the mechanisms or the parameters of measurement error, sensitivity analysis for measurement error can be used, in which the impact on the epidemiologic analyses of one or a range of hypothesised measurement error mechanisms or their parameters can be investigated. The studies described in the thesis were set out to improve the understanding of the impact of measurement error, to facilitate the application of measurement error correction methods, to improve the design of epidemiologic studies when measurement error in a variable is suspected and, to develop tools to quantitatively assess the impact of measurement error in epidemiologic research. Show less
Nab, L.; Smeden, M. van; Keogh, R.H.; Groenwold, R.H.H. 2021
Measurement error in a covariate or the outcome of regression models is common, but is often ignored, even though measurement error can lead to substantial bias in the estimated covariate-outcome... Show moreMeasurement error in a covariate or the outcome of regression models is common, but is often ignored, even though measurement error can lead to substantial bias in the estimated covariate-outcome association. While several texts on measurement error correction methods are available, these methods remain seldomly applied. To improve the use of measurement error correction methodology, we developed mecor , an R package that implements measurement error correction methods for regression models with a continuous outcome. Measurement error correction requires information about the measurement error model and its parameters. This information can be obtained from four types of studies, used to estimate the parameters of the measurement error model: an internal validation study, a replicates study, a calibration study and an external validation study. In the package mecor , regression calibration methods and a maximum likelihood method are implemented to correct for measurement error in a continuous covariate in regression analyses. Additionally, methods of moments methods are implemented to correct for measurement error in the continuous outcome in regression analyses. Variance estimation of the corrected estimators is provided in closed form and using the bootstrap. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ ) Show less
Objectives: Epidemiologic studies often suffer from incomplete data, measurement error (or misclassification), and confounding. Each of these can cause bias and imprecision in estimates of exposure... Show moreObjectives: Epidemiologic studies often suffer from incomplete data, measurement error (or misclassification), and confounding. Each of these can cause bias and imprecision in estimates of exposure-outcome relations. We describe and compare statistical approaches that aim to control all three sources of bias simultaneously.Study Design and Setting: We illustrate four statistical approaches that address all three sources of bias, namely, multiple imputation for missing data and measurement error, multiple imputation combined with regression calibration, full information maximum likelihood within a structural equation modeling framework, and a Bayesian model. In a simulation study, we assess the performance of the four approaches compared with more commonly used approaches that do not account for measurement error, missing values, or confounding.Results: The results demonstrate that the four approaches consistently outperform the alternative approaches on all performance metrics (bias, mean squared error, and confidence interval coverage). Even in simulated data of 100 subjects, these approaches perform well.Conclusion: There can be a large benefit of addressing measurement error, missing values, and confounding to improve the estimation of exposure-outcome relations, even when the available sample size is relatively small. (C) 2020 The Authors. Published by Elsevier Inc. Show less