In teaching epidemiology, confounding is a difficult topic. The authors designed active learning objects (LO) based on manipulable three-dimensional (3D) plots to facilitate understanding of confounding. The 3D LOs help illustrate of how confounding can occur, how it generates bias and how to adjust for it. For the development of the LOs, guidelines were formulated based on epidemiology and the...

WWC STANDARDS Brief The What Works Clearinghouse (WWC) is an initiative of the U.S. Department of Education’s Institute of Education Sciences. The WWC evaluates research studies that look at the effectiveness of education programs, policies, and practices, which the WWC calls “interventions.” WWC Standards Briefs explain the rules the WWC uses to assess the quality of studies. For more informat...

U ni ve rs ity o f C al ifo rn ia , S an D ie go , C A . Hepatic steatosis, the intracellular accumulation of triglycerides (triglyceride fat) in hepatocytes, is a common and often asymptomatic condition. An estimated 20 to 80 million Americans have nonalcoholic fatty liver disease (NAFld), which is the most common chronic liver disease in the united States.1 Steatosis is now recognized to play...

Social epidemiology is the study of relations between social factors and health status in populations. Although recent decades have witnessed a rapid development of this research program in scope and sophistication, causal inference has proven to be a persistent dilemma due to the natural assignment of exposure level based on unmeasured attributes of individuals, which may lead to substantial c...

Cardiovascular disease (CVD) remains the leading cause of death in developed countries, despite the decline of CVD mortality over the last two decades. From observational, predictive research, efforts have been made to find causal risk factors for CVD. However, in recent years, some of these findings have been shown to be mistaken. Possible explanations for the discrepant findings are confoundi...

BACKGROUND Observational epidemiology has been instrumental in identifying modifiable causes of common diseases, and, in turn, substantially impacting public health. Spurious associations in observational epidemiologic studies are most commonly caused by confounding due to social, behavioral, or environmental factors and can therefore be difficult to control. They may also be due to reverse cau...