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research article

Using Negative Control Populations to Assess Unmeasured Confounding and Direct Effects

Piccininni, Marco
•
Stensrud, Mats Julius  
May 1, 2024
Epidemiology

Sometimes treatment effects are absent in a subgroup of the population. For example, penicillin has no effect on severe symptoms in individuals infected by resistant Staphylococcus aureus, and codeine has no effect on pain in individuals with certain polymorphisms in the CYP2D6 enzyme. Subgroups where a treatment is ineffective are often called negative control populations or placebo groups. They are leveraged to detect bias in different disciplines. Here we present formal criteria that justify the use of negative control populations to rule out unmeasured confounding and mechanistic (direct) causal effects. We further argue that negative control populations, satisfying our formal conditions, are available in many settings, spanning from clinical studies of infectious diseases to epidemiologic studies of public health interventions. Negative control populations can also be used to rule out placebo effects in unblinded randomized experiments. As a case study, we evaluate the effect of mobile stroke unit dispatches on functional outcomes at discharge in individuals with suspected stroke, using data from a large trial. Our analysis supports the hypothesis that mobile stroke units improve functional outcomes in these individuals.

  • Details
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Type
research article
DOI
10.1097/EDE.0000000000001724
Web of Science ID

WOS:001249410000015

Author(s)
Piccininni, Marco
Stensrud, Mats Julius  
Date Issued

2024-05-01

Publisher

Lippincott Williams & Wilkins

Published in
Epidemiology
Volume

35

Issue

3

Start page

313

End page

319

Subjects

Life Sciences & Biomedicine

•

Negative Control Populations

•

Mendelian Randomization

•

Unmeasured Confounding

•

Placebo Effect

•

Mobile Stroke Unit

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
BIOSTAT  
Available on Infoscience
July 3, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/209101
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