Chanelle J Howe1, Petra M Sander, Michael W Plankey, Stephen R Cole. 1. Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina, McGavran-Greenberg Hall, Campus Box 7435, Chapel Hill, NC 27599-7435, USA. cjhowe@email.unc.edu
Abstract
OBJECTIVE: Discuss issues related to time-varying exposures using as an example the recently meta-analyzed literature (Baliunas et al. in Int J Public Health, 2009) on alcohol consumption and risk of HIV infection. METHODS: Cataloged sources of bias and imprecision in the context of time-varying exposures. RESULTS: Confounding, selection, or measurement bias may occur when standard regression approaches are used to estimate effects of time-varying exposures. The reviewed literature on alcohol consumption and HIV infection suffer from one or more of these biases. CONCLUSIONS: Detailed prospective data and thoughtful implementation of appropriate statistical methods are needed to obtain unbiased estimates of time-varying exposures, such as alcohol consumption.
OBJECTIVE: Discuss issues related to time-varying exposures using as an example the recently meta-analyzed literature (Baliunas et al. in Int J Public Health, 2009) on alcohol consumption and risk of HIV infection. METHODS: Cataloged sources of bias and imprecision in the context of time-varying exposures. RESULTS: Confounding, selection, or measurement bias may occur when standard regression approaches are used to estimate effects of time-varying exposures. The reviewed literature on alcohol consumption and HIV infection suffer from one or more of these biases. CONCLUSIONS: Detailed prospective data and thoughtful implementation of appropriate statistical methods are needed to obtain unbiased estimates of time-varying exposures, such as alcohol consumption.
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