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. 2021 Aug 15;36(9):889–898. doi: 10.1007/s10654-021-00794-w

Table 1.

Three examples of observational studies included in this review are shown

Example 1 [14] Example 2 [15] Example 3 [16]
Research question “The aim is to determine the impact of vascular disease burden on longer-term transplant and patient survival after kidney transplantation” “The aim of the present study was to assess predictors of a combined atherosclerotic cardiovascular end point” “…to develop a risk score that predicted the 5-, 10-, and 20-year individual dementia risk in older individuals
Assessment The objective seems to be causal The objective is fitting for a predictor finding study The objective is to develop a risk score to improve prediction of an outcome
Statistical approach “Covariates associated with the outcome with P < 0.10 in unadjusted analyses were included in multivariable-adjusted analyses” “All variables with a P < 0.1 for univariate association with the atherosclerotic end point were included in a backwards stepwise Cox regression model to obtain the independent risk factors” “We first used univariate models for each candidate risk factor. Following this step, we employed a multivariate model to estimate the coefficients of selected significant risk factors”
Assessment Co-variates selected based on ability to predict the outcome, fitting for a prediction study Co-variates selected based on ability to predict the outcome, fitting for a prediction study Co-variates selected based on ability to predict the outcome, fitting for a prediction study
Presentation of results “Recipients with vascular diseases were at increased risk for death by at least 1.4 times compared with recipients without vascular disease (adjusted HRs of 1.40).” “In multivariable analysis age, male sex, diabetes and prevalent CVD significantly predicted the atherosclerotic end point” “Age, marital status, BMI, stroke, diabetes, ischemic attacks, and cancer were found to be independently predictive of event risk in the final multivariate model and were used to construct the risk algorithm.” “The C-statistic of the final model was 0.716”
Assessment Effect measure given, inviting etiological interpretation Unclear; the current wording could be found in both a prediction or etiological study Risk score performance measure given, fitting for prediction study
Discussion and interpretation of results “Kidney transplant recipients with vascular disease experienced a survival disadvantage” “Although adjustments were done for multiple confounding factors, there were likely to be unmeasured residual confounders” “Markers of inflammation and oxidative stress were significant predictors, future studies should evaluate whether they may be targets for novel treatment strategies” “However, residual confounding due to measurement error, unmeasured risk factors and the lack of adjustment for time-varying covariates constitutes important limitations” “The dementia risk score permits prediction of an individual’s risk of developing dementia” “…many risk factors we have examined represent modifiable health and lifestyle behaviors.” “Higher BMI demonstrated some protective effects in this study.” “This risk estimate system … helps individuals to identify their potential risk profile and prevent or delay the future incidence of dementia”
Assessment Etiological interpretation. Authors intended to correct for all measured confounders Etiological interpretation by identifying modifiable risk factors and considering residual confounding Both predictive and etiological interpretation. The potential causal mechanism between each predictor and the outcome is discussed
Overall assessment Conflated: Mainly etiological study with conflation in methods by selecting ‘confounders’ based only on their predictive ability (p-values) Conflated: Mainly prediction study, yet a causal conclusion is made from a data-driven predictive model and residual confounding is mentioned as limitation Conflated: Prediction model development study with causal interpretation of predictors

Each of these studies contains conflation and quotes from each domain of the article are given that exemplify this. The table should be read vertically

Some quotes are paraphrased slightly to shorten them and abbreviations are written full-out