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G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma
Regression-based approaches are widely used in causal mediation analysis. The presence of multiple mediators, however, increases the complexity and difficulty of mediation analysis. In such cases, regression-based approaches cannot efficiently address estimation issues. Hence, a flexible approach to...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779208/ https://www.ncbi.nlm.nih.gov/pubmed/35071157 http://dx.doi.org/10.3389/fpubh.2021.757942 |
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author | Tai, An-Shun Huang, Yen-Tsung Yang, Hwai-I Lan, Lauren V. Lin, Sheng-Hsuan |
author_facet | Tai, An-Shun Huang, Yen-Tsung Yang, Hwai-I Lan, Lauren V. Lin, Sheng-Hsuan |
author_sort | Tai, An-Shun |
collection | PubMed |
description | Regression-based approaches are widely used in causal mediation analysis. The presence of multiple mediators, however, increases the complexity and difficulty of mediation analysis. In such cases, regression-based approaches cannot efficiently address estimation issues. Hence, a flexible approach to mediation analysis is needed. Therefore, we developed a method for using g-computation algorithm to conduct causal mediation analysis in the presence of multiple ordered mediators. Compared to regression-based approaches, the proposed simulation-based approach increases flexibility in the choice of models and increases the range of the outcome scale. The Taiwanese Cohort Study dataset was used to evaluate the efficacy of the proposed approach for investigating the mediating role of early and late HBV viral load in the effect of HCV infection on hepatocellular carcinoma (HCC) in HBV seropositive patients (n = 2,878; HCV carrier n = 123). Our results indicated that early HBV viral load had a negative mediating role in HCV-induced HCC. Additionally, early exposure to a low HBV viral load affected HCC through a lag effect on HCC incidence [OR = 0.873, 95% CI = (0.853, 0.893)], and the effect of early exposure to a low HBV viral load on HCC incidence was slightly larger than that of a persistently low viral load on HCC incidence [OR = 0.918, 95% CI = (0.896, 0.941)]. |
format | Online Article Text |
id | pubmed-8779208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87792082022-01-22 G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma Tai, An-Shun Huang, Yen-Tsung Yang, Hwai-I Lan, Lauren V. Lin, Sheng-Hsuan Front Public Health Public Health Regression-based approaches are widely used in causal mediation analysis. The presence of multiple mediators, however, increases the complexity and difficulty of mediation analysis. In such cases, regression-based approaches cannot efficiently address estimation issues. Hence, a flexible approach to mediation analysis is needed. Therefore, we developed a method for using g-computation algorithm to conduct causal mediation analysis in the presence of multiple ordered mediators. Compared to regression-based approaches, the proposed simulation-based approach increases flexibility in the choice of models and increases the range of the outcome scale. The Taiwanese Cohort Study dataset was used to evaluate the efficacy of the proposed approach for investigating the mediating role of early and late HBV viral load in the effect of HCV infection on hepatocellular carcinoma (HCC) in HBV seropositive patients (n = 2,878; HCV carrier n = 123). Our results indicated that early HBV viral load had a negative mediating role in HCV-induced HCC. Additionally, early exposure to a low HBV viral load affected HCC through a lag effect on HCC incidence [OR = 0.873, 95% CI = (0.853, 0.893)], and the effect of early exposure to a low HBV viral load on HCC incidence was slightly larger than that of a persistently low viral load on HCC incidence [OR = 0.918, 95% CI = (0.896, 0.941)]. Frontiers Media S.A. 2022-01-07 /pmc/articles/PMC8779208/ /pubmed/35071157 http://dx.doi.org/10.3389/fpubh.2021.757942 Text en Copyright © 2022 Tai, Huang, Yang, Lan and Lin. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Tai, An-Shun Huang, Yen-Tsung Yang, Hwai-I Lan, Lauren V. Lin, Sheng-Hsuan G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title | G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title_full | G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title_fullStr | G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title_full_unstemmed | G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title_short | G-Computation to Causal Mediation Analysis With Sequential Multiple Mediators—Investigating the Vulnerable Time Window of HBV Activity for the Mechanism of HCV Induced Hepatocellular Carcinoma |
title_sort | g-computation to causal mediation analysis with sequential multiple mediators—investigating the vulnerable time window of hbv activity for the mechanism of hcv induced hepatocellular carcinoma |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779208/ https://www.ncbi.nlm.nih.gov/pubmed/35071157 http://dx.doi.org/10.3389/fpubh.2021.757942 |
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