Correction the Effect of

Measurement Error

RATNA DJUWITA
DEPARTMENT OF EPIDEMIOLOGY
FACULTY OF PUBLIC HEALTH
UNIVERSITY OF INDONESIA

Measurement Error
Correction

Correction of standar deviation

Correction of epidemiologic measures
of association for measurement error
Correction of correlation coefficients
Correction of regression coefficients
Correction of relative risks
Categorical variable
Continous variable

Correction for measurement error in

confounding variables

Cont.
True relation between exposure and disease
defined by 2x2 table :
Exposed
(E)

Unexposed Total (E+U)

(U)

Diseased (D)

a = 400

b = 600

1,000

Well (W)

c = 200

d = 800

1,000

OR = ad/bc = (400x800)/(600x200) = 2.67

Imperfect measurement
error
= sensitivity
the proportion of of truly exposed
subjects who are classified as
exposed by the epidemiologiic
method
= specificity
the proportion of subjects who are
truly unexposed who are classified
as unexposed by the epidemiologiic
method

Imperfect measurement error

Exposure has sensivity 0.6 and specificity
0.9
From 400 diseased, 400x0.6 = 240 exposed
and 400-240 = 160 unexposed
From 600 diseased, 600x0.9 = 540
unexposed and 600-540 = 60 exposed
Thus, 240+60 = 300 exposed and 540+160 =
700 unexposed among the disease

Imperfect measurement error

Exposure has sensivity 0.6 and specificity
0.9
From 200 WELL, 200x0.6 = 120 exposed and
200-120 = 80 unexposed
From 800 WELL, 800x0.9 = 720 unexposed
and 800-720 = 80 exposed
Thus, 120+80 = 200 exposed and 720+80 =
800 unexposed among the WELL

EXPOSED
(E)

UNEXPOSED
(U)

DISEASE

240
+
60

540
+
160

WELL

120
+
80

720
+
80

OR = (300:700)/(200:800) = 1/71

Exposed (E)

Unexposed (U)

Diseased (D)

300

700

Well (W)

200

800

OR = ad/bc = (300x800)/(700x200) = 1.71

lower than the true OR due to measurement error

Cont.
Bross (1954) and Diamond and Lilienfeld (1962)
provided simple method for correcting relative
risks for exposure misclassification in a 2x2 table
when errors exist in the measurement of
exposure and disease.
Baron (1977) has described his method in terms
of matrix algebra. It is assumed that no error
exists in the diagnosis of disease, and the
method of correction is presented in simple
algebraic form.
Reconstruct the true relationship

True relation

Diseased (D)

Exposed (E)
a*

Unexposed (U)
d*

Well (W)

c*

d*

Imperfect measurement error

Exposed (E)

Total (E+U)

Diseased (D) a

Unexposed
(U)
b

Well (W)

c+d = nW

a+b = nD

a* = (nD-b)/(+-1)
b* = (nD -a)/(+-1)
c* = (nW-d)/(+-1)
d* = (nW -c)/(+-1)

a* = (1,000x0.9-700)/(0.6+0.9-1) = 400
b* = (1,000x0.6-300)/(0.6x0.9-1) = 600
c* = (1,000x0.9-800)/(0.6x0.9-1) = 200
d* = (1,000x0.6-200)/(0.6x0.9-1) = 800

Strength
Straightforward
Provide a simple estimate of the effect of
misclassification
Limitation
In practical epidemiologic application,
seldomly interested in a single 2x2 tables
Typically age, gender, and other risk factors
need to be controlled in any analysis
Not provide corresponding confidence
limits
Extended to multidimensional tables
Greenland method for confidence intervals for
corrected odd ratios

REFFERENCE
Willet W. Correction for the Effects of
Measurement Error in
Nutritional
Epidemiology .3rd edition Monographs in
Epidemiology
and
Biostatistics
vol
40.Oxford University Press .2013,chapter
12.p 278 - 304