Why the study?
Potential confounding and effect modification from anatomic variations, age, genetic syndromes, and noncardiac comorbidities represent major obstacles to measuring true treatment effects in pediatric/congenital interventional cardiology.
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Design
Review
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Clinicians should interpret pediatric interventional findings cautiously; leaves open optimal methods to address confounding in congenital cardiology research.
Measuring the effect of a treatment on outcomes is an important goal for research in pediatric/congenital interventional cardiology. The breadth of anatomic and physiologic variations, patient ages, and genetic syndromes and noncardiac comorbid conditions all represent sources of potential confounding and effect modification that are major obstacles to this goal. If not accounted for, these factors can obscure the "true" treatment effect and lead to spurious conclusions about the relative efficacy and/or safety of therapies. In this review, we discuss the importance of confounding and effect modification in pediatric/congenital interventional cardiology research. We define these terms and discuss strategies (both in study design and data analysis) to mitigate error introduced by confounding and effect modification. The importance of confounding by indication in pediatric/congenital cardiology is discussed along with specific methods to address it.
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O’Byrne et al. (2021) studied this question.
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