Bayesian sensitivity analysis for unmeasured confounding in observational studies

• Published in: Statistics in medicine 2007-05, Vol.26 (11), p.2331-2347
• Main Authors: McCandless, Lawrence C., Gustafson, Paul, Levy, Adrian
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Aged; Aged, 80 and over; Bayes Theorem; Bayesian analysis; Bias; British Columbia; Cardiac Output, Low - drug therapy; Confounding Factors (Epidemiology); coverage probability; Drug therapy; Female; Humans; identifiability; Male; Medical statistics; observational studies; Probability; Sensitivity and Specificity; Studies; Treatment Outcome; unmeasured confounding
• ISSN: 0277-6715; 1097-0258
• DOI: 10.1002/sim.2711

We consider Bayesian sensitivity analysis for unmeasured confounding in observational studies where the association between a binary exposure, binary response, measured confounders and a single binary unmeasured confounder can be formulated using logistic regression models. A model for unmeasured confounding is presented along with a family of prior distributions that model beliefs about a possible unknown unmeasured confounder. Simulation from the posterior distribution is accomplished using Markov chain Monte Carlo. Because the model for unmeasured confounding is not identifiable, standard large‐sample theory for Bayesian analysis is not applicable. Consequently, the impact of different choices of prior distributions on the coverage probability of credible intervals is unknown. Using simulations, we investigate the coverage probability when averaged with respect to various distributions over the parameter space. The results indicate that credible intervals will have approximately nominal coverage probability, on average, when the prior distribution used for sensitivity analysis approximates the sampling distribution of model parameters in a hypothetical sequence of observational studies. We motivate the method in a study of the effectiveness of beta blocker therapy for treatment of heart failure. Copyright © 2006 John Wiley & Sons, Ltd.