Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “causal inference”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2006

Lifetime psychiatric comorbidity with substance use disorders: does healthcare use modify the strength of associations ?

BACKGROUND: The frequent psychiatric comorbidity among subjects with a substance use disorder (SUD) can be explained by an increased vulnerability to problematic drug use among subjects with a non-substance-related psychiatric disorder (NSRPD). The care of this disorder should then reduce the likelihood of a secondary SUD. OBJECTIVE: To examine how healthcare use for psychological symptoms modifies the lifetime association between SUD and NSRPD. METHODS: Two hundred and twenty four students were evaluated for mental disorders and healthcare use. Mental disorders were assessed with the Mini-International Neuropsychiatric Interview (MINI). Healthcare use included consultations with a general practitioner (GP), a psychiatrist or a psychologist. The lifetime occurrence of a SUD was analysed by lifetime number of NSRPD and healthcare use for psychological symptoms. Analyses were adjusted on gender, university affiliation, living environment and temperament and character dimensions. RESULTS: Compared to subjects without NSRPD, those with at least two NSRPD who did not use healthcare were more likely to have had a lifetime SUD (OR = 3.9). By contrast, those who had only one NSRPD seemed to be as likely as those with no NSRPD to have had a SUD. DISCUSSION: These results suggest a decreased probability of SUD among subjects with several NSRPD who used healthcare. Due to the cross-sectional design of this study, causal inferences cannot be drawn. This analysis shows the importance, however, of taking healthcare use into account in comorbidity studies.

Adult↗
PubMed1998

The role of values in the nature/nurture debate about psychiatric disorders.

This paper discusses the role that values play in our estimates of the relative importance of nature/nurture factors in the etiology of psychiatric disorders. It is argued that all parameter estimates, heritability estimates, variance explained, odds ratios, and relative risks, are based, at least in part, on value judgements that are made in the course of our research activities. Four aspects of causal inference where values are particularly influential are discussed: gene/environment interactions, environmental specificity, the distinction between causes of variation and the causes of a factor, and the reification of our measures. The value component in our research is illustrated in two areas of research: life events and depression and individual factors in violence.

Environment↗
PubMed1999

The design of Partners in Care: evaluating the cost-effectiveness of improving care for depression in primary care.

This paper describes a study design that blends health services and clinical research approaches to examine the cost-effectiveness of treatments and of quality improvement for depression in primary care, managed care practices. Six managed care organizations in Los Angeles (Calif.), San Antonio (Tex.), San Luis Valley (Colo.), Twin Cities (Minn.), and Columbia (Md.) participated. Primary care clinics were randomized to one of two quality improvement interventions or care as usual. Interventions included patient and provider education, nurse-assisted patient assessment, and resources to support appropriate medication management or access to cognitive behavioral therapy. Practices implemented the interventions with study support. Providers and patients selected treatment. Patients with depressive symptoms regardless of comorbidities were eligible. Over 27,000 primary care patients visiting the practices of 181 primary care clinicians were screened for depression, 14% were potentially eligible, and 1356 enrolled into the 2-year longitudinal study. Enrollees were similar to eligibles, but usual care clinic patients tended to be less severely depressed than intervention clinic patients, partly due to clinic staff enthusiasm. The result of the study showed that studying treatment effects and quality improvement in nonacademic settings is feasible, but requires relaxation of design features of experiments that protect internal validity. The trade-off between certainty of causal inference and generalizability to usual care conditions is discussed. The strengths and limitations of this study design are compared to those of clinical trials and recent clinical effectiveness studies.

Adolescent↗
PubMed2005

The association between self-reported physical activity and prevalence of depression and anxiety disorder in long-term survivors of testicular cancer and men in a general population sample.

GOALS OF WORK: Physical activity is claimed to have a beneficial influence on a person's mental health, though its impact may be different in cancer patients and individuals in the general population. The objective of this cross-sectional study was (1) to estimate the associations between the level of self-reported physical activity as a lifestyle factor (LPA) and the prevalence of depression and anxiety disorder in testicular cancer survivors (TCSs) and in men of similar age from the general population (GenPop), and (2) to examine whether these associations differ in the two groups. PATIENTS AND METHOD: A total of 1260 TCSs and 20,207 men from the GenPop completed a questionnaire that assessed LPA, and depression and anxiety disorder on the Hospital Anxiety and Depression Scale (HADS). MAIN RESULTS: The prevalence of HADS-defined depression was lower among those who were physically active than in those who were physically inactive (TCSs 9% vs 17%, P<0.001; GenPop 8% vs 15%, P<0.001). Among physically inactive TCSs there was a trend towards higher a prevalence of HADS-defined anxiety disorder compared to physically active TCSs (P=0.07). In the GenPop this difference was statistically significant (P<0.001). Multivariate analysis confirmed the association between LPA and HADS-defined depression in both the TCSs [adjusted odds ratio (aOR)=0.56; 95% confidence interval (CI) (0.31, 1.02)] and the GenPop [aOR=0.58; 95% CI (0.51, 0.65)], but not the association between LPA and HADS-defined anxiety disorder. The associations between LPA and HADS-defined depression and HADS-defined anxiety disorder did not differ between the TCSs and the GenPop. CONCLUSION: In both the TCSs and the GenPop, the prevalence of HADS-defined depression was higher among those who were physically inactive than among those who were physically active, with no intergroup difference. There was no association between LPA and prevalence of HADS-defined anxiety disorder in either of the groups after adjusting for background variables. Prospective studies are needed to allow causal inferences to be drawn.

Adult↗
PubMed2006

Technical intelligence in animals: the kea model.

The ability to act on information flexibly is one of the cornerstones of intelligent behavior. As particularly informative example, tool-oriented behavior has been investigated to determine to which extent nonhuman animals understand means-end relations, object affordances, and have specific motor skills. Even planning with foresight, goal-directed problem solving and immediate causal inference have been a focus of research. However, these cognitive abilities may not be restricted to tool-using animals but may be found also in animals that show high levels of curiosity, object exploration and manipulation, and extractive foraging behavior. The kea, a New Zealand parrot, is a particularly good example. We here review findings from laboratory experiments and field observations of keas revealing surprising cognitive capacities in the physical domain. In an experiment with captive keas, the success rate of individuals that were allowed to observe a trained conspecific was significantly higher than that of naive control subjects due to their acquisition of some functional understanding of the task through observation. In a further experiment using the string-pulling task, a well-probed test for means-end comprehension, we found the keas finding an immediate solution that could not be improved upon in nine further trials. We interpreted their performance as insightful in the sense of being sensitive of the relevant functional properties of the task and thereby producing a new adaptive response without trial-and-error learning. Together, these findings contribute to the ongoing debate on the distribution of higher cognitive skills in the animal kingdom by showing high levels of sensorimotor intelligence in animals that do not use tools. In conclusion, we suggest that the 'Technical intelligence hypothesis' (Byrne, Machiavellian intelligence II: extensions and evaluations, pp 289-211, 1997), which has been proposed to explain the origin of the ape/monkey grade-shift in intelligence by a selection pressure upon an increased efficiency in foraging behavior, should be extended, that is, applied to some birds as well.

Animals↗
PubMed2006

The right tool for the job: what strategies do wild New Caledonian crows use?

New Caledonian crows Corvus moneduloides (NC crows) display sophisticated tool manufacture in the wild, but the cognitive strategy underlying these skills is poorly understood. Here, we investigate what strategy two free-living NC crows used in response to a tool-length task. The crows manufactured tools to extract food from vertical holes of different depths. The first tools they made in visits were of a similar length regardless of the hole depth. The typical length was usually too short to extract food from the deep holes, which ruled out a strategy of immediate causal inference on the first attempt in a trial. When the first tool failed, the crows made second tools significantly longer than the unsuccessful first tools. There was no evidence that the crows made the lengths of first tools to directly match hole depth. We argue that NC crows may generally use a two-stage heuristic strategy to solve tool problems and that performance on the first attempt in a trial is not necessarily the 'gold standard' for assessing folk physics.

Analysis of Variance↗
PubMed2007

Effects of "dual focus" mutual aid on self-efficacy for recovery and quality of life.

Four million adults in the U.S. have co-occurring serious mental illness and a substance use disorder. Mutual aid can usefully complement treatment, but people with co-occurring disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons with dual diagnoses. Three hundred and ten persons attending 24 DTR groups in New York City during 1998 were interviewed and followed-up for two years. A mediational model was specified and results across time were summarized with generalized estimating equations (GEE). Degree of DTR Affiliation (attendance and involvement) was significantly associated with Self-efficacy for Recovery and three quality of life measures: Leisure Time Activities, Feelings of Well-Being and Social Relationships. Self-efficacy fully mediated the effects of DTR Affiliation on Leisure Time and Feelings and partially mediated DTR's effect on Social Relationships. The association of DTR involvement with self-efficacy is consistent with the processes inherent in mutual aid, although the observational nature of these data preclude causal inference. To improve outcomes, clinicians should facilitate affiliation with dual focus groups among persons with dual diagnoses as part of a comprehensive treatment approach.

Adult↗
PubMed2006

Method of delivery and neonatal mortality among very low birth weight infants in the United States.

OBJECTIVE: To examine the association between method of delivery (primary cesarean section vs. vaginal) and neonatal mortality risk (as well as causes of death) among very low-birth weight first-born infants in the United States. More specifically, to examine this association separately for breech/malpresenting and vertex-presenting infants, while adjusting for selected maternal characteristics, and pregnancy, labor and delivery complications. METHODS: The study population was derived from the 1995-1998 birth cohort linked birth/infant death data sets. Binary and multinomial logit regression analyses were performed to assess the relationship in four very low-birth weight categories. RESULTS: Among breech/malpresenting neonates, compared to those delivered vaginally, infants delivered by a primary cesarean section had significantly lower adjusted relative risks of death for all very low-birth weight categories and the decrease in relative risk tended to be larger with each increasing birth weight category. However, for vertex-presenting neonates, results are mixed, suggesting decreased relative mortality risks associated with primary cesarean section, which were significant for 500-749 g, not significant for 750-999 g, and barely significant for 1,000-1,249 g. In contrast, for vertex-presenting neonates weighing 1,250-1,499 g, there was a significantly increased adjusted relative risk associated with primary cesarean section. Differences in cause-specific neonatal mortality by method of delivery and presentation status were also discussed. CONCLUSIONS: Primary cesarean section appears to be associated with decreased neonatal mortality risks in each very low-birth weight category for breech/malpresenting infants, but results are mixed for vertex-presenting infants. Causal inferences should be avoided because this was an observational study by design.

Adult↗
PubMed2004

Use of tranquilizers and sleeping pills among cancer patients is associated with a poorer quality of life.

PURPOSE: To evaluate the association between sleeping pill/tranquilizer (SP/T) use and quality of life (QOL) among cancer patients. PATIENTS AND METHODS: Oncology patients (n = 909) in three Israeli hospitals were interviewed in clinics, day centers and in-patient departments regarding SP/T use in the previous week. Crude and adjusted QOL scores, measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), were compared in users vs. non-users. RESULTS: Sleeping pill/tranquilizer use was self-reported by 234 (25.7%) participants, but rarely documented in medical charts. Factors associated with SP/T use were female gender (adjusted Odds ratio, OR: 1.79; 95% Confidence interval, CI: 1.22-2.62, age (OR: 4.6; 95% CI: 1.66-12.53 for age 70+), place of birth (OR: 1.97; 95% CI: 1.19-3.26 for Eastern Europe compared with Israel), concomitant use of painkillers (OR: 2.88; 95% CI: 1.97-4.20) and presence of cardiovascular disease (OR: 2.41; 95% CI: 1.48-3.91). Controlling these factors as well as disease status, users had a poorer QOL on all functional scales (p < 0.001) as well as global QOL. Furthermore, users reported increased severity of symptoms, especially fatigue, insomnia, pain, dyspnea and constipation (p < 0.01), compared to non-users. CONCLUSIONS: Use of SP/T, reported by one fourth of cancer patients, was associated with substantially poorer QOL and increased severity of symptoms. Causal inference is not possible given the cross-sectional design. Periodic inquiry regarding use of these medications in the Oncology Clinic is recommended since it may identify patients with poor QOL and unmet needs.

Adolescent↗
PubMed2006

A comparison of mothers with co-occurring disorders and histories of violence living with or separated from minor children.

Data from the Women with Co-occurring Disorders and Histories of Violence Study are used to examine characteristics distinguishing mothers currently providing care for all their minor children (n = 558) from mothers separated from one or more minor children (n = 1396). Mothers are described and compared on background characteristics and experiences, well-being and current functioning, situational context, and services used. Analyses control for number of children, race, and years of education. Mothers separated from children have more children, less education, have more often been homeless, in juvenile detention or jail, and have lower incomes than mothers living with all their children. Mothers separated from children have more extensive experiences of traumatic and stressful life events, and the groups differ in current functioning and patterns of services used. While cross-sectional data do not allow causal inferences, challenges faced by mothers have significant implications for policy and programs.

Adolescent↗
PubMed2026

Multi-omics identification of therapeutic targets of compound sappan decoction in hepatocellular carcinoma.

BACKGROUND: Compound sappan decoction (CSD) is a multi-herbal traditional Chinese medicine formulation with clinical relevance in hepatocellular carcinoma (HCC). However, its therapeutic mechanisms remain unclear. METHODS: Bioactive compounds of CSD were identified and standardized using pharmacological and chemical databases. Potential targets were predicted via multiple target inference platforms. HCC-related genes were curated from comprehensive disease databases. Summary-data-based Mendelian randomization (SMR) was conducted to infer causal relationships between compound targets and HCC risk using large-scale quantitative trait loci (QTL) datasets and HCC genome-wide association study data. Colocalization analysis, protein-protein interaction (PPI) network construction, and GO/KEGG enrichment were performed on SMR-identified targets. Molecular docking evaluated binding affinities of representative compounds to prioritized targets. RESULTS: A total of 784 overlapping genes between predicted CSD targets and HCC-related genes were subjected to SMR analysis. Among these, 22 targets were significantly associated with HCC risk based on transcriptomic or proteomic QTLs and showed colocalization evidence. Notably, four targets (ADRB2, APOE, SYK, and PGF) were supported by both replication in an independent cohort and strong colocalization. These 22 targets were enriched in apoptosis, PI3K-Akt signaling, redox metabolism, and detoxification pathways. PPI analysis revealed central hubs including MMP9, BCL2, CASP1, and MCL1. Molecular docking demonstrated strong binding of APOE to quercetin, PGF to luteolin-7-olate, and SYK to kaempferol. CONCLUSIONS: CSD may exert therapeutic effects on HCC through modulation of genetically validated targets involved in tumor progression, inflammation, and metabolic reprogramming, supporting its potential clinical utility as an adjunctive treatment strategy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s12672-026-04740-8.

Caesalpinia↗
PubMed1989

Catastrophe modeling of the accident process: evaluation of an accident reduction program using the occupational hazards survey.

The report details a catastrophe theory model of the accident process with empirical validation. According to the cusp model, two distinct levels of risk can be observed for a distribution of group accident rates, one at 0.0 Occupational Safety and Health Association (OSHA)-reportable accidents per 100 person-years of exposure and one at 11.5. Changes within or between the two levels are determined by two control parameters: environmental hazard (asymmetry) and operator load (bifurcation). The sample consisted of 68 work groups from 8 Milwaukee-Chicago area sheet metal mills and foundries who completed the Occupational Hazards Survey (OHS). The OHS contributed six bifurcation variables (safety management, life stress, physical stress anxiety, beliefs about accident control, and experience) and two asymmetry variables (environmental hazards and danger). All organizations received an interpretive report of their survey responses with recommendations for accident control, and had held their reports for two to nine months at the time the follow-up accident rate data were collected. There were two additional bifurcation variables: months holding report and group size. Regression analysis determined that the cusp model (R2 = .42) was more than twice as accurate as the best log-linear or linear alternative. Accidents were successfully controlled by safety managers' attention to recommendations produced by the OHS analysis. Catastrophe theory provided some novel insights regarding the linkage between predictor variables and actual behavior. Research has shown that a substantial percentage of occupational accidents are the result of human error. In an effort to explain and predict such errors in a systematic manner, an accident process model based on the cusp catastrophe is developed and tested. The model offers several unique and useful properties: (1) It proposes that changes in accident rates for work groups are the result of a nonlinear dynamic process. (2) The distribution of accident rates is bimodal, with one model near zero and the other at some higher level. (3) Changes in accident rates are predicted from four sources: (i) ambient danger and hazard levels, (ii) variables that impact upon human performance capability, (iii) initial accident rates, and (iv) the mathematical function that interrelates those variables. (4) The mathematical model has inherent properties that allow for causal inference. Environmental and human performance factors can be operationalized as sets of more specific variables. In this application. The Occupational Hazards Survey was used to gather data from mill and foundry workers pertaining to hazards and dangers, adequacy of safety management, stress, anxiety, and beliefs about accident control.(ABSTRACT TRUNCATED AT 400 WORDS)

Accident Prevention↗
PubMed1985

Psychosocial characteristics of adolescent smokers before they started smoking: evidence of self-selection. A prospective study.

Evidence of noncomparability of self-formed smoker and nonsmoker groups of adolescents from the Child Health and Development Studies of the University of California, Berkeley, was found in a study of antecedent psychosocial characteristics (observed at age 10) before the adoption of the smoking habit. With possible confounding factors controlled, eventual smokers showed significantly greater prevalence than nonsmokers of Type A personality traits, extraversion, psychoticism, anger, and restless sleep. Eventual smokers were lower in socioeconomic status than nonsmokers, and also exhibited significantly lower mean scores for the Raven Progressive Matrices and Peabody Picture Vocabulary tests. For each trait, the trends of the data were consistent in boys and girls. Since many of these traits are shown to "track" into adult life, where they are then related to coronary heart disease, the role of self-selection requires further consideration in causal inferences about smoking and coronary heart disease.

Adolescent↗
PubMed1983

The experimental effects of "autonomy" on performance and self-reports of satisfaction.

Though the job characteristics model proposed by Hackman and his associates has provided the impetus for a large number of correlational studies, few of any studies have involved the systematic manipulation of one or more of the five-core dimensions (job properties) while noting the performance outcomes. In this study, the autonomy dimension was experimentally varied (four levels) in a laboratory setting. Four groups of undergraduate students performed a job comprised of three tasks under varying degrees of autonomy while measures of performance, "perceptions" of task properties, and other self-reports were obtained. It was found, contrary to our hypothesis, that variations in autonomy produced a negative effect on quantity of performance and no effect on quality of performance, though subjects in the more autonomous conditions reported a higher level of autonomy. Reservations regarding the strategy of drawing causal inferences from correlational analyses are discussed.

Analysis of Variance↗
PubMedDate not supplied

A brief group treatment for the modification of denial in child sexual abusers: outcome and follow-up.

We investigated whether brief structured group treatment could produce a reduction of denial of sexual offenses in males convicted of sexually offending against children. Such denial can additionally harm victims and often precludes admission into sex offender treatment programs, thus ruling out an opportunity to decrease the potential of reoffending. The group treatment contained elements of victim empathy, cognitive restructuring, sex education, assertiveness and social skills, education about sex offender therapy, and a discussion of the possible consequences of continued denial. Seventeen child sexual offenders in denial were run in two groups. Despite an average length of denial of nearly two years, by post-treatment the majority of offenders had come out of denial. Moreover, follow-up denial data indicated continued admission, and above-average compliance with subsequent sex offender therapy. Although the lack of an experimental design precludes causal inference, these results are suggestive of an effective method for modifying denial in sex offenders against children.

Adolescent↗
PubMed1989

Expert system reasoning about dynamic systems by semi-quantitative simulation.

Current symbolic knowledge representation techniques are inadequate for describing complex dynamic systems, which are time-varying and contain feedback loops. These systems are particularly difficult to represent when quantitative knowledge about the relationships within the system is incomplete. This paper describes a symbolic extension of the system dynamics method which can answer 'what if' questions about system dynamics models semi-quantitatively. The method consists of (1) definition of generic model 'building blocks' which map directly onto difference equations; (2) development of a symbolic causal model of a system in terms of the generic functional 'building blocks', any available quantitative or semi-quantitative parameters, and a set of generic default values; (3) automatic translation of the model into a system of first-order difference equations; and (4) numerical integration of the equations by standard methods. A complex model with semi-quantitative parameters, representing the human cardiovascular system, is used to illustrate the method. This method couples the descriptive abilities of mathematics with the symbolic power of causal inference methods by providing the same knowledge base for both computational levels. It also eases truth maintenance, knowledge acquisition, and explanation. It may prove useful for expert system development in a variety of application domains whose processes are time-varying and homeostatic.

Computer Simulation↗
PubMed1982

The role of cultural explanations in 'somatization' and 'psychologization'.

Ethnographic and clinical research has described Chinese views of psycho-social distress as characterized by the 'somatization' of illness complaints and the 'underutilization' of mental health services. The hypothesis which states that such observed differences in American and Chinese illness behavior, including health-care decisions, derive in part from cultural modes of explaining illness and social behavior is termed the 'interpretative hypothesis'. The 'interpretive hypothesis' is explored by eliciting causal inferences about illness and behavioral difficulties from samples of (Caucasian) American and Hong Kong Chinese students at the University of Hawaii. Explicit procedures are developed for the reliable identification of elements of meaning in explanations given by the two groups. Comparative analysis gives limited support to the 'interpretive hypothesis' in showing a more 'psychologized' American model of illness in comparison with the 'situational' explanations given by the Hong Kong Chinese. The contrasts in common sense explanations offered by each sample suggest that these differences are related to implicit cultural modes of interpreting social behavior which have been characterized by other researchers with oppositions such as 'individual-centered' vs 'situation-centered', and 'internal' vs 'external' locus of control. These speculations, however, are tempered by the finding that the Hong Kong Chinese respondents make relatively greater use of personality attributions (a kind of psychological construct) in explaining interpersonal problems. This result indicates that global characterizations of explanatory modes should be limited to specific domains of discourse.

Cross-Cultural Comparison↗
PubMed1992

T-wave amplitude: on the meaning of a psychophysiological index.

The preceding article by Furedy, Heslegrave and Scher presents a positive evaluation of T-wave amplitude (TWA) as a psychophysiologic index, and rejects the more cautious and less favorable view contained in a paper by Contrada et al. (1989). In this article I propose that the Furedy et al. perspective rests on: (1) a questionable approach to the logic of causal inference; (2) an unsatisfactory view of measurement validity; (3) the use of imprecise and therefore misleading language; (4) a disregard of valuable observations that can be drawn from the data of individual research subjects; (5) an objection to evaluative conclusions that can provide a useful stimulus to empirical inquiry. Close examination of these issues argues for a skeptical view of the state of knowledge regarding the meaning of TWA alterations.

Electrocardiography↗