Mediation analysis in epidemiology: methods, interpretation and bias

In epidemiological studies it is often necessary to disentangle the pathways that link an exposure to an outcome. Typically the aim is to identify the total effect of the exposure on the outcome, the effect of the exposure that acts through a given set of mediators of interest (indirect effect) and the effect of the exposure unexplained by those same mediators (direct effect). The traditional approach to mediation analysis is based on adjusting for the mediator in standard regression models to estimate the direct effect. However, several methodological papers have shown that under a number of circumstances this traditional approach may produce flawed conclusions. Through a better understanding of the causal…

• MD
  Ministero dell’Istruzione, dell’Università e della Ricerca

  Awards: PRIN 2009, PRIN 2009 X8YCBN
• AI
  Associazione Italiana per la Ricerca sul Cancro

  Award: PRIN 2009