The bias from heaping on risk estimation: Effect of age at diagnosis of hypertension on risk of subsequent cardiovascular comorbidities

Item Type:	Article
Title:	The bias from heaping on risk estimation: Effect of age at diagnosis of hypertension on risk of subsequent cardiovascular comorbidities
Creators Name:	Jaeschke, L. and Becher, M. and Moreno Velásquez, I. and Ahrens, W. and Bächle, C. and Baurecht, H. and Fricke, J. and Greiser, K.H. and Günther, K. and Heier, M. and Karch, A. and Kluttig, A. and Krist, L. and Leitzmann, M. and Michels, K. and Mikolajczyk, R. and Peters, A. and Schipf, S. and Völzke, H. and Pischon, T. and Becher, H.
Abstract:	PURPOSE: To investigate (1) the bias in effect estimation due to heaping, (2) the association between age at hypertension diagnosis and risk of cardiovascular comorbidities, and (3) the influence of heaping on risk estimates. METHODS: We performed a simulation study with various scenarios, binary outcome, and normal or lognormal distributed covariables. We calculated mean logistic coefficients under the original and heaped data and their relative deviation. The association of age at hypertension diagnosis and risk of ≥1 cardiovascular comorbidity was investigated using logistic regression among 50,858 participants in the NAKO Gesundheitsstudie (German National Cohort) who reported such diagnosis. We assessed the proportion of heaped observations and to what extent heaping may have influenced risk estimates. RESULTS: Based on the simulation study and assuming 50% of observations in the variable of interest to be heaped, relative bias was <6%. In NAKO, a 5-year younger age at hypertension diagnosis was associated with a 15% increased risk of having ≥1 cardiovascular comorbidity. Observed heaping in age at hypertension diagnosis was 12.6%, and bias of the risk estimate was 0.14%. CONCLUSIONS: Bias in effect estimation due to heaping is low in most common scenarios. Younger age at hypertension diagnosis is associated with a higher risk of cardiovascular comorbidities.
Keywords:	Heaping, Digit Preference, Simulation Study, Effect Estimates, Epidemiologic Study, Hypertension, Cardiovascular Comorbidities
Source:	Annals of Epidemiology
ISSN:	1047-2797
Publisher:	Elsevier
Volume:	74
Page Range:	84-96
Date:	October 2022
Official Publication:	https://doi.org/10.1016/j.annepidem.2022.07.012
PubMed:	View item in PubMed

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