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      Bias in odds ratios by logistic regression modelling and sample size

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          Abstract

          Background

          In epidemiological studies researchers use logistic regression as an analytical tool to study the association of a binary outcome to a set of possible exposures.

          Methods

          Using a simulation study we illustrate how the analytically derived bias of odds ratios modelling in logistic regression varies as a function of the sample size.

          Results

          Logistic regression overestimates odds ratios in studies with small to moderate samples size. The small sample size induced bias is a systematic one, bias away from null. Regression coefficient estimates shifts away from zero, odds ratios from one.

          Conclusion

          If several small studies are pooled without consideration of the bias introduced by the inherent mathematical properties of the logistic regression model, researchers may be mislead to erroneous interpretation of the results.

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          Most cited references7

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          A hierarchical step-model for causation of bias-evaluating cancer treatment with epidemiological methods.

          As epidemiological methods are used increasingly to evaluate the effects of cancer treatment, guidelines for the application of such methods in clinical research settings are necessary. Towards this end, we present a hierarchical step-model for causation of bias, which depicts a real-life study as departing from a perfect setting and proceeding step-wise towards a calculated, often adjusted, effect-parameter. Within this model, a specific error (which influences the effect-measure according to one of four sets of rules) is introduced on one (and only one) of the model's four steps. This hierarchical step-model for causation of bias identifies all sources of bias in a study, each of which depicts one or several errors which can be further categorized into one of the model's four steps. Acceptance of this model has implications for ascertaining the degree to which a study effectively evaluates the effects of cancer treatment (level of scientific evidence).
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            Approximate bias correction in econometrics

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              Small-sample bias of point estimators of the odds ratio from matched sets.

              N. Jewell (1984)
              The bias of several point estimators of the odds ratio arising from matched-pair data is investigated for small samples. Simple alternatives to the traditional maximum likelihood estimator are suggested, on both the original scale and the logarithm scale. In each case the suggested estimators possess a superior performance in terms of mean square error. Generalizations are given for 1:R matched data sets.
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                Author and article information

                Journal
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central
                1471-2288
                2009
                27 July 2009
                : 9
                : 56
                Affiliations
                [1 ]Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska Academy, University of Gothenburg, Sweden
                [2 ]Division of Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Sweden
                Article
                1471-2288-9-56
                10.1186/1471-2288-9-56
                2724427
                19635144
                e8d94af0-02b7-436b-91e4-7faed9bf2093
                Copyright ©2009 Nemes et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 March 2009
                : 27 July 2009
                Categories
                Research Article

                Medicine
                Medicine

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