Bias-domain triangulation of non-convergent observational evidence in mental health research
Abstract
Observational estimates in mental health can diverge because exposure is structured by familial, clinical and social factors. We developed bias-domain triangulation to test whether this divergence follows specific sources of confounding. The framework separates reported adjustment sets from an independently generated causal structure, assigns variables to causal roles and maps back-door pathways into bias domains before pooling. We applied it to prenatal paracetamol exposure and offspring autism spectrum disorder or attention-deficit/hyperactivity disorder. The review included 24 articles and 39 adjusted estimates. The pooled association declined from 2.08 under weak overall control to 0.98 under strong overall control. Only strong familial/genetic control brought the pooled estimate to the null. Strong control of clinical indication and social-behavioural factors left residual associations. These results link attenuation most consistently to shared familial liability in the available evidence. Bias-domain triangulation offers a reusable, pre-pooling test of which unresolved bias structure accompanies non-convergent observational estimates. The study was registered on PROSPERO (CRD420261365276).
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.