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To Adjust or Not to Adjust? When a “Confounder” Is Only Measured After Exposure

Person som håller skylt med frågetecken på framför sitt ansikte
Foto från snd.gu.se

Advice regarding the analysis of observational studies of exposure effects usually is against adjustment for factors that occur after the exposure, as they may be caused by the exposure (or mediate the effect of exposure on outcome), so potentially leading to collider stratification bias. However, such factors could also be caused by unmeasured confounding factors, in which case adjusting for them will also remove some of the bias due to confounding.