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A comprehensive assessment of potential confounding influences is important in these studies because inadequate assessment of confounders can threaten the validity of causal inferences drawn from the data.
Rigorous study design, assessment of potential confounding factors, and fuller reporting of methods and results in future studies will facilitate understanding of whether PCB exposure is associated with changes in thyroid function.
Furthermore, the field would benefit from hypothesis-driven outcomes research based on a priori specification of the spiritual dimensions under investigation and their longitudinal relationship with key palliative outcomes, the use of validated measures of predictors and outcomes, and rigorous assessment of potential confounding variables.
Three [12 14] of five trials were quasi-experimental, with limited to no assessment of potential confounding factors.
Incomplete assessment of potential confounding variables, including physical activity, also needs to be taken into account.
Three [ 12– 14] of five trials were quasi-experimental, with limited to no assessment of potential confounding factors.
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Furthermore, most studies had one or more critical limitations, such as the obscurity of temporal information about exposure and outcome, the methodology of ARA exposure assessment, and inadequate treatment of potential confounding factors.
Assessment of potential confounders.
*Confounding factor bias was done by evaluation of each studies' assessment of potential confounders by four methods (see footnote to table 9).
The risk assessment of bias highlighted that the quality of the included trials was generally low and prone to areas of potential confounding.
The detailed assessment of SES and background psychiatric, cognitive, and physical health problems means that appropriate adjustment was made for a wide range of potential confounding variables.
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