Causal Inference in Epidemiology Using Bayesian Methods: The Example of Meta-Analysis of Statins and Fracture Risk

• Activity Number: 455
• Type: Invited
• Date/Time: Wednesday, August 7, 2013 : 8:30 AM to 10:20 AM
• Sponsor: Section on Bayesian Statistical Science
• Author(s): Lawrence C. McCandless*+
• Companies: Simon Fraser University
• Keywords: Bayesian analysis ; causal inference ; meta-analysis

Abstract

Numerous epidemiologic studies indicate that statin use reduces the risk of fractures in the elderly. However, a causal relationship is not supported by data from randomized trials. Healthy user bias is implicated as a likely culprit for the controversy. It is a type of unmeasured confounding that results from failure to measure and adjust for patient-level tendencies to engage in healthy behaviours (e.g. use of alcohol and tobacco). In this talk, I will summarize the evidence supporting an association between statins and fractures, and then explore sensitivity to bias from confounding using Bayesian techniques. I will draw parallels with bias modelling in observational studies, and discuss prior elicitation, nonidentifiability and Bayesian computation.