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Moreover, they have been shown to be robust in the presence of multiple confounders and rare events [ 52].
Few studies (26%) reported results adjusted for multiple confounders, and in seven studies (37%) no type of adjustment was mentioned.
Another strength of the present study is the availability of data on multiple confounders and also repeated measures of all variables, which enabled us to better account for the confounding effect of changes in lifestyle factors over time.
The main strengths of this study lie in its prospective nature, size, ability to adjust for multiple confounders, and that measurement at baseline could not be biased with regards to the aim of this study.
Because age is one of the most important risk factors for dementia, the relatively large sample size of the NHANES-III permits age-stratified analysis, adjustment for multiple confounders, and, therefore, more detailed assessment of the relationship of PA with cognitive outcome.
The cohort method was implemented adjusting for multiple confounders and the self-controlled case-series relied solely on its design to adjust for fixed confounders and on the inclusion of the non-exposed group to adjust for time varying factors such as age.
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Among 1055 middle-aged Chinese men and women, we observed that reduced plasma HMW-adiponectin and sOB-R, and elevated leptin level were significantly associated with an increased risk of MetS and some of its components independent of multiple confounders including BMI and inflammatory markers.
In a similar analysis testing the independent relationship between CCS, as dependent and continuous variable, baseline adiposity measures such as, WHR, WC and total fat mass values were independent determinants after adjusting for baseline CCS and multiple confounders in DM patients(Table 3).
However, the follow up period is too short to analyze multiple confounders using survival analysis and Cox regression.
After adjustment for multiple confounders, MetS, elevated CRP, and CRPMetS were each significantly associated with increased mortality risk (HRs 1.26 [95% CI 1.15 1.38], 1.55 [1.41–1.70], and 1.34 [1.22–1.48], respectively).
In real-world settings, predictions about outcomes are subject to multiple confounders that include complexity and emergence that lead to local variations in implementation processes.
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