Journal article

Survival Bias When Assessing Risk Factors for Age-Related Macular Degeneration: A Tutorial with Application to the Exposure of Smoking

Myra B McGuinness, Amalia Karahalios, Jessica Kasza, Robyn H Guymer, Robert P Finger, Julie A Simpson



PURPOSE: We illustrate the effect of survival bias when investigating risk factors for eye disease in elderly populations for whom death is a competing risk. Our investigation focuses on the relationship between smoking and late age-related macular degeneration (AMD) in an observational study impacted by censoring due to death. METHODS: Statistical methodology to calculate the survivor average causal effect (SACE) as a sensitivity analysis is described, including example statistical computing code for Stata and R. To demonstrate this method, we examine the causal effect of smoking history at baseline (1990-1994) on the presence of late AMD at the third study wave (2003-2007) using data from ..

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Awarded by National Health & Medical Research Council of Australia (NHMRC)

Awarded by Capacity Building Grant

Awarded by Enabling Grant

Awarded by American Health Assistance Foundation

Awarded by National Health and Medical Research Council (NHMRC)

Awarded by NHMRC Principal Research Fellowship

Awarded by Victorian Centre for Biostatistics (NHMRC: Centre of Research Excellence grant)

Funding Acknowledgements

Cohort recruitment was funded by VicHealth and Cancer Council Victoria. Further Melbourne Collaborative Cohort Study funding: the National Health & Medical Research Council of Australia (NHMRC) Program Grant 209057, Capacity Building Grant 251533 and Enabling Grant 396414. The ophthalmic component was funded by the Ophthalmic Research Institute of Australia; American Health Assistance Foundation (M2008-082), Jack Brockhoff Foundation, John Reid Charitable Trust, Perpetual Trustees. M. McGuinness is funded by an Australian Postgraduate Award and a studentship courtesy of Victorian Centre for Biostatistics (NHMRC: Centre of Research Excellence grant 1035261). J. Simpson is funded by a National Health and Medical Research Council (NHMRC) Senior Research Fellowship 1104975, and R. Guymer by a NHMRC Principal Research Fellowship 1103013. This work was supported by infrastructure from the Cancer Council of Victoria. CERA receives operational infrastructure support from the Victorian government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.