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首页> 外文期刊>Clinical and experimental allergy : >Reverse causation and confounding-by-indication: do they or do they not explain the association between childhood antibiotic treatment and subsequent development of respiratory illness?
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Reverse causation and confounding-by-indication: do they or do they not explain the association between childhood antibiotic treatment and subsequent development of respiratory illness?

机译：逆转因果和混淆逐步：他们是否不解释儿童抗生素治疗和随后的呼吸疾病发展之间的关联？

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Several studies have investigated the association between antibiotic use during infancy and the subsequent development of respiratory illness. Despite all the efforts investigating this important issue, a firm statement about whether or not there is a causal link between both factors is still lacking. This has much to do with the complex phenomenons of 'reverse causation' and 'confounding-by-indication', concepts that will form the basis of this editorial.For those who are not familiar with these concepts we will give a brief clarification. 'Reverse causation' deals with establishing the causality of an association by assessing the time relation between an exposure and outcome: does the cause (exposure) precede the effect (outcome)? For example, an association between antibiotic intake and respiratory disease may be explained by the fact that the antibiotics were actually prescribed because of the respiratory symptoms. This is different from 'confounding-by-indication'. To cause confounding bias, a variable must be a risk factor for a disease among non-exposed persons, must be associated with the exposure of interest in the population from which the cases derive, but must not be an intermediate step in the causal pathway between the exposure and the disease [1]. The implication is that confounding-by-indication should refer to those situations in which the indication for treatment acts as a confounder. In those cases, an association between antibiotic intake and respiratory disease may be confounded (explained) bya third factor that it is an indication for antibiotics prescription while at the same time being a risk factor for asthma. Consequently, the validity of epidemiologic research concerning the role of antibiotics intake in relation to the development of respiratory symptoms is affected. 'Confounding-by-indication' in daily epidemiologic practice is sometimes used interchangeably with just 'confounding' or 'reverse causation'.
机译：几项研究已经研究了婴儿期抗生素使用与随后的呼吸疾病发展之间的关联。尽管所有努力调查了这一重要问题，但仍然缺乏关于这两个因素之间是否存在因果关系的公司陈述。这与“逆转因果关系”和“混淆逐个迹象”的复杂现象有很大关系，这是为了构成这一的基础的概念。对于那些不熟悉这些概念的人来说，我们将简要澄清。 “反向因果关系”通过评估暴露和结果之间的时间关系来涉及建立关联的因果关系：原因（暴露）是否在效果（结果）之前？例如，抗生素摄入和呼吸系统疾病之间的关联可以通过抗生素由于呼吸道症状进行抗生素来解释。这与'逐个迹象表达不同。为了引起混杂偏见，变量必须是非暴露人群中疾病的危险因素，必须与案件导出的人口的兴趣感到有关，但不能成为因果通路之间的中间步骤暴露和疾病[1]。暗示的是，逐种拟示应该指的是那些治疗指示作为混杂者的迹象。在这些情况下，抗生素摄入和呼吸系统疾病之间的关联可能被混淆（解释）BYA第三个因素，它是抗生素处方的指示，同时是哮喘的危险因素。因此，有关抗生素摄入与呼吸系统症状发展的作用的流行病学研究的有效性受到影响。每日流行病学实践中的“逐步指示”有时会与“混淆”或“逆转因果关系”互换使用。

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