A guide for planning triangulation studies to investigate complex causal questions in behavioural and psychiatric research.

IF 5.9 2区 医学 Q1 PSYCHIATRY
Jorien L Treur, Eva Lukas, Hannah M Sallis, Robyn E Wootton
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引用次数: 0

Abstract

Aims: At the basis of many important research questions is causality - does X causally impact Y? For behavioural and psychiatric traits, answering such questions can be particularly challenging, as they are highly complex and multifactorial. 'Triangulation' refers to prospectively choosing, conducting and integrating several methods to investigate a specific causal question. If different methods, with different sources of bias, all indicate a causal effect, the finding is much less likely to be spurious. While triangulation can be a powerful approach, its interpretation differs across (sub)fields and there are no formal guidelines. Here, we aim to provide clarity and guidance around the process of triangulation for behavioural and psychiatric epidemiology, so that results of existing triangulation studies can be better interpreted, and new triangulation studies better designed.

Methods: We first introduce the concept of triangulation and how it is applied in epidemiological investigations of behavioural and psychiatric traits. Next, we put forth a systematic step-by-step guide, that can be used to design a triangulation study (accompanied by a worked example). Finally, we provide important general recommendations for future studies.

Results: While the literature contains varying interpretations, triangulation generally refers to an investigation that assesses the robustness of a potential causal finding by explicitly combining different approaches. This may include multiple types of statistical methods, the same method applied in multiple samples, or multiple different measurements of the variable(s) of interest. In behavioural and psychiatric epidemiology, triangulation commonly includes prospective cohort studies, natural experiments and/or genetically informative designs (including the increasingly popular method of Mendelian randomization). The guide that we propose aids the planning and interpreting of triangulation by prompting crucial considerations. Broadly, its steps are as follows: determine your causal question, draw a directed acyclic graph, identify available resources and samples, identify suitable methodological approaches, further specify the causal question for each method, explicate the effects of potential biases and, pre-specify expected results. We illustrated the guide's use by considering the question: 'Does maternal tobacco smoking during pregnancy cause offspring depression?'.

Conclusions: In the current era of big data, and with increasing (public) availability of large-scale datasets, triangulation will become increasingly relevant in identifying robust risk factors for adverse mental health outcomes. Our hope is that this review and guide will provide clarity and direction, as well as stimulate more researchers to apply triangulation to causal questions around behavioural and psychiatric traits.

在行为学和精神病学研究中,规划三角测量研究以调查复杂因果问题的指南。
目的:许多重要研究问题的基础是因果关系--X 是否会对 Y 产生因果影响?对于行为和精神特质而言,回答这类问题尤其具有挑战性,因为它们非常复杂,而且是多因素的。三角测量 "指的是前瞻性地选择、实施和整合几种方法来研究特定的因果问题。如果具有不同偏差来源的不同方法都能显示出因果效应,那么这一发现的虚假性就会大大降低。虽然三角测量是一种强大的方法,但不同(子)领域对它的解释各不相同,也没有正式的指导原则。在此,我们旨在为行为和精神流行病学的三角测量过程提供明确的指导,以便更好地解释现有三角测量研究的结果,更好地设计新的三角测量研究:我们首先介绍了三角测量的概念,以及如何将其应用于行为和精神特征的流行病学调查。接下来,我们提出了一个系统的分步指南,可用于设计三角测量研究(附带一个工作示例)。最后,我们为今后的研究提供了重要的一般性建议:虽然文献中有不同的解释,但三角测量一般是指通过明确结合不同的方法来评估潜在因果发现的稳健性的调查。这可能包括多种类型的统计方法、在多个样本中应用相同的方法或对相关变量进行多种不同的测量。在行为和精神流行病学中,三角测量通常包括前瞻性队列研究、自然实验和/或遗传信息设计(包括日益流行的孟德尔随机化方法)。我们提出的指南通过提示关键的注意事项来帮助规划和解释三角测量。大体上,其步骤如下:确定因果问题,绘制有向无环图,确定可用资源和样本,确定合适的方法,进一步明确每种方法的因果问题,解释潜在偏差的影响,以及预先指定预期结果。我们以 "母亲在怀孕期间吸烟是否会导致后代抑郁?在当前的大数据时代,随着大规模数据集的(公开)可用性不断提高,三角测量法在确定不良心理健康结果的可靠风险因素方面将变得越来越重要。我们希望这篇综述和指南能提供清晰的思路和方向,并激励更多研究人员将三角测量法应用于行为和精神特征的因果问题。
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来源期刊
CiteScore
7.80
自引率
1.20%
发文量
121
审稿时长
>12 weeks
期刊介绍: Epidemiology and Psychiatric Sciences is a prestigious international, peer-reviewed journal that has been publishing in Open Access format since 2020. Formerly known as Epidemiologia e Psichiatria Sociale and established in 1992 by Michele Tansella, the journal prioritizes highly relevant and innovative research articles and systematic reviews in the areas of public mental health and policy, mental health services and system research, as well as epidemiological and social psychiatry. Join us in advancing knowledge and understanding in these critical fields.
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