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Additionally, some studies have investigated both confounding and effect modification by ozone.
Considerable differences in levels of air pollution and neighborhood characteristics across the six MESA metropolitan areas suggest the need to evaluate both confounding and effect modification by city.
For all models, potential covariates were identified a priori, and those that were deemed of special interest (based on subject matter knowledge) were assessed for both confounding and effect modification.
The true nature of some of the associations among these variables and whether effect modification is consistently present are still open to question because not all previous studies investigated the possibility of both confounding and effect modification by various vulnerability variables.
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Our study also restricted the analysis to primiparous births (to n = 2595 mothers), thereby eliminating both potential confounding and effect modification by birth order, pregnancy-related changes in BMI, or breast-feeding.
Adjustments will be made for confounding and effect modifying exposures.
To take into account both the confounding and modifying effects of age and sex, a stratified analysis on both sex and age at a cut-off of 70 years, was conducted.
Research regarding the causality of spousal concordance for alcohol consumption implies that both assortative mating and spousal convergence over time are involved [ 18], suggesting that alcohol use and alcohol-related problems may both confound and mediate the effect of index persons' alcohol consumption/problems on spouses' mental distress.
Greenland and Morgenstern showed that both confounding by group and effect measure modification by group could cause ecologic bias [ 15].
The bias magnification equation (equation 14), governs bias from both sources – confounding by group and effect modification of the risk difference by group – in an additive fashion, i.e., it can be applied to both sources of bias separately or together [ 11].
Both residual confounding and potential influence of effect modifiers could be responsible for a substantial attenuation of the relative risk in fully adjusted models.
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