Salas M, Hofman A, Stricker B H
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Am J Epidemiol. 1999 Jun 1;149(11):981-3. doi: 10.1093/oxfordjournals.aje.a009758.
Confounding by indication is a term used when a variable is a risk factor for a disease among nonexposed persons and is associated with the exposure of interest in the population from which the cases derive, without being an intermediate step in the causal pathway between the exposure and the disease. However, in the literature, the term confounding by indication is not always used consistently. The authors found three different situations in which the term has been applied or might have been used but was not: confounding by indication as protopathic bias, as confounding by severity, or as a form of selection bias. It might be helpful to limit use of the term confounding by indication to the situation in which the disease that forms the indication acts as a confounder irrespective of its severity and to apply the term confounding by severity if the severity of this disease acts as a confounder. Protopathic bias and selection bias should not be confused with these terms. The use of appropriate terms ultimately will improve communication among researchers and contribute to the clarity of their papers.
指征性混杂是一个术语，用于描述某个变量在未暴露人群中是疾病的危险因素，并且与病例来源人群中感兴趣的暴露因素相关，但并非暴露与疾病之间因果路径的中间环节。然而，在文献中，指征性混杂这一术语的使用并不总是一致的。作者发现了三种不同的情况，该术语已被应用或可能被使用但未被使用：指征性混杂作为原发病偏倚、作为严重程度混杂或作为一种选择偏倚形式。将指征性混杂这一术语的使用限制于形成指征的疾病无论其严重程度如何都作为混杂因素的情况，并在该疾病的严重程度作为混杂因素时应用严重程度混杂这一术语，可能会有所帮助。原发病偏倚和选择偏倚不应与这些术语混淆。使用恰当的术语最终将改善研究人员之间的沟通，并有助于论文的清晰性。
