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Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?

In this issue of the Journal, von Ehrenstein et al. (Am J Epidemiol. 2021;190(5):728–737) add to the large and growing literature on the potentially causal association between prenatal exposure to maternal smoking and neuropsychiatric health. In addition to statewide, prospectively collected data, a...

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Autor principal: Frisell, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096426/
https://www.ncbi.nlm.nih.gov/pubmed/32830847
http://dx.doi.org/10.1093/aje/kwaa183
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author Frisell, Thomas
author_facet Frisell, Thomas
author_sort Frisell, Thomas
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description In this issue of the Journal, von Ehrenstein et al. (Am J Epidemiol. 2021;190(5):728–737) add to the large and growing literature on the potentially causal association between prenatal exposure to maternal smoking and neuropsychiatric health. In addition to statewide, prospectively collected data, a particular strength was their ability to perform a sibling-comparison design, contrasting the rate of autism spectrum disorder in siblings discordantly exposed to maternal smoking. Unfortunately, the estimate from the sibling pairs could neither confirm nor refute the conclusions based on the full cohort. Interpretation was hampered by broad confidence limits, and even had power been higher, the authors acknowledge a range of potential biases that would have made it difficult to draw any firm conclusions from a similarity or difference in the sibling-pair estimate and estimate from the full cohort. Was the addition of the sibling comparison actually worth the effort? In this commentary, I will briefly summarize the benefits and limitations of this design, and, with some caveats, argue that its inclusion in the study by von Ehrenstein et al. was indeed a strength and not just an ornamentation.
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spelling pubmed-80964262021-05-10 Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort? Frisell, Thomas Am J Epidemiol Invited Commentary In this issue of the Journal, von Ehrenstein et al. (Am J Epidemiol. 2021;190(5):728–737) add to the large and growing literature on the potentially causal association between prenatal exposure to maternal smoking and neuropsychiatric health. In addition to statewide, prospectively collected data, a particular strength was their ability to perform a sibling-comparison design, contrasting the rate of autism spectrum disorder in siblings discordantly exposed to maternal smoking. Unfortunately, the estimate from the sibling pairs could neither confirm nor refute the conclusions based on the full cohort. Interpretation was hampered by broad confidence limits, and even had power been higher, the authors acknowledge a range of potential biases that would have made it difficult to draw any firm conclusions from a similarity or difference in the sibling-pair estimate and estimate from the full cohort. Was the addition of the sibling comparison actually worth the effort? In this commentary, I will briefly summarize the benefits and limitations of this design, and, with some caveats, argue that its inclusion in the study by von Ehrenstein et al. was indeed a strength and not just an ornamentation. Oxford University Press 2020-08-24 /pmc/articles/PMC8096426/ /pubmed/32830847 http://dx.doi.org/10.1093/aje/kwaa183 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Invited Commentary
Frisell, Thomas
Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title_full Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title_fullStr Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title_full_unstemmed Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title_short Invited Commentary: Sibling-Comparison Designs, Are They Worth the Effort?
title_sort invited commentary: sibling-comparison designs, are they worth the effort?
topic Invited Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096426/
https://www.ncbi.nlm.nih.gov/pubmed/32830847
http://dx.doi.org/10.1093/aje/kwaa183
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