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Journal of General Internal Medicine
Erschienen in:

02.10.2023 | Research and Reporting Methods

A Dose of Reality About Dose–Response Relationships

verfasst von: Donald A. Redelmeier, MD FRCPC, Jonathan S. Zipursky, MD PhD FRCPC

Erschienen in: Journal of General Internal Medicine | Ausgabe 16/2023

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Abstract

Observational research can be strengthened by examining potential dose–response relationships that correlate a clinical intervention with a patient outcome. Despite being a classic criterion for establishing causality, dose–response testing can be difficult to interpret in clinical medicine due to multiple diverse pitfalls. This review introduces a cautionary framework for investigators considering dose–response relationships in observational research to support evidence-based medicine. Each pitfall is illustrated with a specific example relevant when analyzing a dose–response relationship. Several pitfalls stem from faulty interpretation including confounding by indication and fallible range selection. Additional pitfalls relate to improper analysis including fitting a nonlinear model and misclassification error. Further pitfalls arise in special situations including subjective self-report and artifacts from survival bias. These caveats are common sources of misunderstanding in analyses that examine the link between varying exposures and the intensity of clinical outcomes. Awareness of specific pitfalls, we suggest, might help advance the conduct, application, and translation of dose–response relationships in observational research to inform evidence-based medical care.
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Metadaten
Titel
A Dose of Reality About Dose–Response Relationships
verfasst von
Donald A. Redelmeier, MD FRCPC
Jonathan S. Zipursky, MD PhD FRCPC
Publikationsdatum
02.10.2023
Verlag
Springer International Publishing
Erschienen in
Journal of General Internal Medicine / Ausgabe 16/2023
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-023-08395-x

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