T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115; email:
Annu Rev Public Health. 2016;37:17-32. doi: 10.1146/annurev-publhealth-032315-021402. Epub 2015 Nov 30.
This article provides an overview of recent developments in mediation analysis, that is, analyses used to assess the relative magnitude of different pathways and mechanisms by which an exposure may affect an outcome. Traditional approaches to mediation in the biomedical and social sciences are described. Attention is given to the confounding assumptions required for a causal interpretation of direct and indirect effect estimates. Methods from the causal inference literature to conduct mediation in the presence of exposure-mediator interactions, binary outcomes, binary mediators, and case-control study designs are presented. Sensitivity analysis techniques for unmeasured confounding and measurement error are introduced. Discussion is given to extensions to time-to-event outcomes and multiple mediators. Further flexible modeling strategies arising from the precise counterfactual definitions of direct and indirect effects are also described. The focus throughout is on methodology that is easily implementable in practice across a broad range of potential applications.
本文概述了中介分析的最新进展,即用于评估暴露对结果影响的不同途径和机制的相对大小的分析。描述了生物医学和社会科学中传统的中介分析方法。关注因果推断文献中提出的方法,以在存在暴露-中介相互作用、二分类结局、二分类中介和病例对照研究设计的情况下进行中介分析。引入了针对未测量混杂和测量误差的敏感性分析技术。讨论了扩展到生存结局和多个中介的问题。还描述了源于直接和间接效应的精确反事实定义的进一步灵活建模策略。全文的重点是在广泛的潜在应用中,易于在实践中实施的方法。
Annu Rev Public Health. 2015-11-30
Am J Epidemiol. 2017-7-15
Stat Methods Med Res. 2017-9-7
Stat Methods Med Res. 2010-12-16
Int J Epidemiol. 2013-9-9
Health Care Sci. 2025-8-3
Medicine (Baltimore). 2025-8-22