Are the Relationships of Physical Activity and Television Viewing Time With Mortality Robust to Confounding? A Study, Utilizing E-Values, From the Melbourne Collaborative Cohort Study.
IF 2.9 4区 医学Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Baldwin Pok Man Kwan, Brigid M Lynch, Lara Edbrooke, Allison Hodge, Christopher T V Swain
{"title":"Are the Relationships of Physical Activity and Television Viewing Time With Mortality Robust to Confounding? A Study, Utilizing E-Values, From the Melbourne Collaborative Cohort Study.","authors":"Baldwin Pok Man Kwan, Brigid M Lynch, Lara Edbrooke, Allison Hodge, Christopher T V Swain","doi":"10.1123/jpah.2024-0218","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Physical activity and sedentary behavior are associated with health outcomes. However, evidence may be affected by confounding bias. This study aimed to examine the relationships of physical activity and television (TV) viewing time with all-cause, cardiovascular, and cancer mortality in a cohort of Australian adults, and determine the robustness of these relationships to residual and unmeasured confounding.</p><p><strong>Methods: </strong>Data from 27,317 Melbourne Collaborative Cohort Study participants (mean age = 66) were used. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form and categorized as insufficient, sufficient, or more than sufficient. TV viewing time was categorized as low, moderate, or high. Multivariable Cox regression models were used to evaluate associations of interest. E-values were calculated to assess the strength of unmeasured confounders required to negate the observed results.</p><p><strong>Results: </strong>For highest versus lowest physical activity category, the hazard ratio was 0.67 (95% confidence interval, 0.56-0.81) for all-cause mortality; E-values ranged between 1.79 and 2.44. Results were similar for cardiovascular mortality; however, hazard ratios were lower (0.72; 95% confidence interval, 0.51-1.01) and E-values much smaller (1.00-2.12) for cancer mortality. For highest versus lowest TV viewing time category, the hazard ratio was 1.08 (1.01-1.15) for all-cause mortality; E-values ranged between 1.00 and 1.37. Results were similar for cardiovascular and cancer mortality.</p><p><strong>Conclusions: </strong>Physical activity and TV viewing time were associated with mortality. The robustness to unmeasured/residual confounding was moderate for physical activity (all-cause and cardiovascular mortality), but weaker for physical activity (cancer mortality) and TV viewing time in this study of Australian adults.</p>","PeriodicalId":16812,"journal":{"name":"Journal of physical activity & health","volume":" ","pages":"1105-1113"},"PeriodicalIF":2.9000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of physical activity & health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1123/jpah.2024-0218","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Physical activity and sedentary behavior are associated with health outcomes. However, evidence may be affected by confounding bias. This study aimed to examine the relationships of physical activity and television (TV) viewing time with all-cause, cardiovascular, and cancer mortality in a cohort of Australian adults, and determine the robustness of these relationships to residual and unmeasured confounding.
Methods: Data from 27,317 Melbourne Collaborative Cohort Study participants (mean age = 66) were used. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form and categorized as insufficient, sufficient, or more than sufficient. TV viewing time was categorized as low, moderate, or high. Multivariable Cox regression models were used to evaluate associations of interest. E-values were calculated to assess the strength of unmeasured confounders required to negate the observed results.
Results: For highest versus lowest physical activity category, the hazard ratio was 0.67 (95% confidence interval, 0.56-0.81) for all-cause mortality; E-values ranged between 1.79 and 2.44. Results were similar for cardiovascular mortality; however, hazard ratios were lower (0.72; 95% confidence interval, 0.51-1.01) and E-values much smaller (1.00-2.12) for cancer mortality. For highest versus lowest TV viewing time category, the hazard ratio was 1.08 (1.01-1.15) for all-cause mortality; E-values ranged between 1.00 and 1.37. Results were similar for cardiovascular and cancer mortality.
Conclusions: Physical activity and TV viewing time were associated with mortality. The robustness to unmeasured/residual confounding was moderate for physical activity (all-cause and cardiovascular mortality), but weaker for physical activity (cancer mortality) and TV viewing time in this study of Australian adults.
期刊介绍：
The Journal of Physical Activity and Health (JPAH) publishes original research and review papers examining the relationship between physical activity and health, studying physical activity as an exposure as well as an outcome. As an exposure, the journal publishes articles examining how physical activity influences all aspects of health. As an outcome, the journal invites papers that examine the behavioral, community, and environmental interventions that may affect physical activity on an individual and/or population basis. The JPAH is an interdisciplinary journal published for researchers in fields of chronic disease.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
