Methodological Challenges When Studying Distance to Care as an Exposure in Health Research.
Journal article
Authors / Editors
Research Areas
No matching items found.
Publication Details
Author list: Caniglia EC, Zash R, Swanson SA, Wirth KE, Diseko M, Mayondi G, Lockman S, Mmalane M, Makhema J, Dryden-Peterson S, Kponee-Shovein KZ, John O, Murray EJ, Shapiro RL
Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option B
Publication year: 2019
Journal: American Journal of Epidemiology (0002-9262)
Journal acronym: Am J Epidemiol
Volume number: 188
Issue number: 9
Start page: 1674
End page: 1681
Number of pages: 8
ISSN: 0002-9262
eISSN: 1476-6256
Languages: English-Great Britain (EN-GB)
Abstract
Distance to care is a common exposure and proposed instrumental variable in health research, but it is vulnerable to violations of fundamental identifiability conditions for causal inference. We used data collected from the Botswana Birth Outcomes Surveillance study between 2014 and 2016 to outline 4 challenges and potential biases when using distance to care as an exposure and as a proposed instrument: selection bias, unmeasured confounding, lack of sufficiently well-defined interventions, and measurement error. We describe how these issues can arise, and we propose sensitivity analyses for estimating the degree of bias.
Keywords
No matching items found.
Documents
No matching items found.
