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Simulation studies show that estimates which are corrected for major confounders are affected minimally after additional correction for more possible confounders [ 18].
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The MBRs offer extensive information on maternal and fetal variables making it possible to control for more potential confounders than earlier studies.
The WHI data analysed contained information on more than 800 possible confounders including information that made it possible to accurately predict HT use.
While controlled studies are not available, the results from properly designed longitudinal cohort studies, although not randomized, shed more light on possible confounders.
More risk factors and possible confounders should be investigated in further studies.
Information on comorbid conditions (depression and mental health) should be collected in future studies to more fully control for possible confounders.
To be more conservative in the of possible confounders, those with a p-value less than 0.25 in at least one category were considered as probable confounders [ 11].
However, a relatively limited number of correlations were explored, so that the probability of chance findings was low, and more importantly the role of possible confounders has been addressed at the stage both of design (random sampling) and of analysis (use of multivariate statistical techniques and of goodness-of-fitness test to assess the models' performance).
Since physicians use cardiac risk factors to help determine the extent of cardiac testing, a more rigorous case matching may have eliminated several possible confounders.
14 However, the study was not able to control for possible confounders, including visual measurements, and only examined more severe falls.
Among other possible confounders only urogenital infections changed the estimate more than 10%, but only in Greenland, where urogenital infections are much more prevalent (83%) than in the other regions (Swedish fishermen 21% and Warsaw and Kharkiv 5%).
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