CommentaryShould Patients with Chronic Disease Be Told to Gain Weight? The Obesity Paradox and Selection Bias
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Acknowledgment
We thank Sonia Hernández-Díaz for comments to an earlier manuscript version.
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2022, Journal of Clinical EpidemiologyCitation Excerpt :In this example, the bias would tend to attenuate any true effect of number of sexual partners on cervical cancer. Similar selection processes have been implicated in many conundrums previously described as “paradoxes,” including the birthweight paradox [11] and the obesity paradox [12]. Although greatly outweighed by their strengths, DAGs do have limitations.
Impact of Low Body Mass Index on Features of Coronary Culprit Plaques and Outcomes in Patients With Acute Coronary Syndrome
2021, American Journal of CardiologyCitation Excerpt :There are several possible reasons why cardiac outcomes in underweight patients are worse in an established coronary artery disease cohort. First, it has been suggested that 2 types of selection bias known as reverse-causation and collider bias artificially create the obesity paradox.7,25–27 In analyses using baseline weight as exposure, reverse-causation means being underweight does not cause critical conditions, but critical patients are instead underweight.
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2021, Revue NeurologiqueCitation Excerpt :A previous secondary stroke prevention trial did not show an independent associaton between obesity and risk of stroke recurrence over a 2.5-year follow-up period, [14,18] but another study on black subject population found an association between these 2 variables [17]. The discrepancy of results between studies may result from the selection of population of patients [4,23] or from the age factor modifying young onset stroke and mortality among young stroke survivors [8]. It is intelligible that obesity itself performs its deleterious effect by various mechanisms on the risk of primary and secondary stroke.
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Funding: NIH grant R01HL080644 and the Bernard Lown Scholar Program in Cardiovascular Health.
Conflict of Interest: ML has a nonrestricted investigator-initiated grant from AstraZeneca and, within the last 2 years, minor research support from Swiss Re. All other authors declare none.
Authorship: All authors had a role in writing the manuscript.