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Mediation analysis methods used in observational research: a scoping review and recommendations

BACKGROUND: Mediation analysis methodology underwent many advancements throughout the years, with the most recent and important advancement being the development of causal mediation analysis based on the counterfactual framework. However, a previous review showed that for experimental studies the up...

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Autores principales: Rijnhart, Judith J. M., Lamp, Sophia J., Valente, Matthew J., MacKinnon, David P., Twisk, Jos W. R., Heymans, Martijn W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543973/
https://www.ncbi.nlm.nih.gov/pubmed/34689754
http://dx.doi.org/10.1186/s12874-021-01426-3
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author Rijnhart, Judith J. M.
Lamp, Sophia J.
Valente, Matthew J.
MacKinnon, David P.
Twisk, Jos W. R.
Heymans, Martijn W.
author_facet Rijnhart, Judith J. M.
Lamp, Sophia J.
Valente, Matthew J.
MacKinnon, David P.
Twisk, Jos W. R.
Heymans, Martijn W.
author_sort Rijnhart, Judith J. M.
collection PubMed
description BACKGROUND: Mediation analysis methodology underwent many advancements throughout the years, with the most recent and important advancement being the development of causal mediation analysis based on the counterfactual framework. However, a previous review showed that for experimental studies the uptake of causal mediation analysis remains low. The aim of this paper is to review the methodological characteristics of mediation analyses performed in observational epidemiologic studies published between 2015 and 2019 and to provide recommendations for the application of mediation analysis in future studies. METHODS: We searched the MEDLINE and EMBASE databases for observational epidemiologic studies published between 2015 and 2019 in which mediation analysis was applied as one of the primary analysis methods. Information was extracted on the characteristics of the mediation model and the applied mediation analysis method. RESULTS: We included 174 studies, most of which applied traditional mediation analysis methods (n = 123, 70.7%). Causal mediation analysis was not often used to analyze more complicated mediation models, such as multiple mediator models. Most studies adjusted their analyses for measured confounders, but did not perform sensitivity analyses for unmeasured confounders and did not assess the presence of an exposure-mediator interaction. CONCLUSIONS: To ensure a causal interpretation of the effect estimates in the mediation model, we recommend that researchers use causal mediation analysis and assess the plausibility of the causal assumptions. The uptake of causal mediation analysis can be enhanced through tutorial papers that demonstrate the application of causal mediation analysis, and through the development of software packages that facilitate the causal mediation analysis of relatively complicated mediation models. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12874-021-01426-3.
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spelling pubmed-85439732021-10-26 Mediation analysis methods used in observational research: a scoping review and recommendations Rijnhart, Judith J. M. Lamp, Sophia J. Valente, Matthew J. MacKinnon, David P. Twisk, Jos W. R. Heymans, Martijn W. BMC Med Res Methodol Research BACKGROUND: Mediation analysis methodology underwent many advancements throughout the years, with the most recent and important advancement being the development of causal mediation analysis based on the counterfactual framework. However, a previous review showed that for experimental studies the uptake of causal mediation analysis remains low. The aim of this paper is to review the methodological characteristics of mediation analyses performed in observational epidemiologic studies published between 2015 and 2019 and to provide recommendations for the application of mediation analysis in future studies. METHODS: We searched the MEDLINE and EMBASE databases for observational epidemiologic studies published between 2015 and 2019 in which mediation analysis was applied as one of the primary analysis methods. Information was extracted on the characteristics of the mediation model and the applied mediation analysis method. RESULTS: We included 174 studies, most of which applied traditional mediation analysis methods (n = 123, 70.7%). Causal mediation analysis was not often used to analyze more complicated mediation models, such as multiple mediator models. Most studies adjusted their analyses for measured confounders, but did not perform sensitivity analyses for unmeasured confounders and did not assess the presence of an exposure-mediator interaction. CONCLUSIONS: To ensure a causal interpretation of the effect estimates in the mediation model, we recommend that researchers use causal mediation analysis and assess the plausibility of the causal assumptions. The uptake of causal mediation analysis can be enhanced through tutorial papers that demonstrate the application of causal mediation analysis, and through the development of software packages that facilitate the causal mediation analysis of relatively complicated mediation models. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12874-021-01426-3. BioMed Central 2021-10-25 /pmc/articles/PMC8543973/ /pubmed/34689754 http://dx.doi.org/10.1186/s12874-021-01426-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Rijnhart, Judith J. M.
Lamp, Sophia J.
Valente, Matthew J.
MacKinnon, David P.
Twisk, Jos W. R.
Heymans, Martijn W.
Mediation analysis methods used in observational research: a scoping review and recommendations
title Mediation analysis methods used in observational research: a scoping review and recommendations
title_full Mediation analysis methods used in observational research: a scoping review and recommendations
title_fullStr Mediation analysis methods used in observational research: a scoping review and recommendations
title_full_unstemmed Mediation analysis methods used in observational research: a scoping review and recommendations
title_short Mediation analysis methods used in observational research: a scoping review and recommendations
title_sort mediation analysis methods used in observational research: a scoping review and recommendations
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543973/
https://www.ncbi.nlm.nih.gov/pubmed/34689754
http://dx.doi.org/10.1186/s12874-021-01426-3
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