Methodological Challenges When Studying Distance to Care as an Exposure in Health Research.
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ABSTRACT:
SUBMITTER: Caniglia EC
PROVIDER: S-EPMC6735874 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Publications
Methodological Challenges When Studying Distance to Care as an Exposure in Health Research.
Caniglia Ellen C EC Zash Rebecca R Swanson Sonja A SA Wirth Kathleen E KE Diseko Modiegi M Mayondi Gloria G Lockman Shahin S Mmalane Mompati M Makhema Joseph J Dryden-Peterson Scott S Kponee-Shovein Kalé Z KZ John Oaitse O Murray Eleanor J EJ Shapiro Roger L RL
American journal of epidemiology 20190901 9
Distance to care is a common exposure and proposed instrumental variable in health research, but it is vulnerable to violations of fundamental identifiability conditions for causal inference. We used data collected from the Botswana Birth Outcomes Surveillance study between 2014 and 2016 to outline 4 challenges and potential biases when using distance to care as an exposure and as a proposed instrument: selection bias, unmeasured confounding, lack of sufficiently well-defined interventions, and ...[more]
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