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Record W4415147053 · doi:10.1093/aje/kwaf228

Potential for extreme bias due to outcome misclassification in relative measures of effect for rare time-to-event outcomes

2025· article· en· W4415147053 on OpenAlexaff
Guy Cafri, Peter C. Austin, Joshua J. Gagne

Bibliographic record

VenueAmerican Journal of Epidemiology · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsSunnybrook HospitalInstitute of Health Services and Policy ResearchUniversity of TorontoInstitute for Work & HealthInstitute for Clinical Evaluative SciencesSunnybrook Health Science Centre
Fundersnot available
KeywordsRelative riskOutcome (game theory)Incidence (geometry)EpidemiologyRelative survivalInferenceCausal inferenceAbsolute risk reductionSurvival analysis

Abstract

fetched live from OpenAlex

Time-to-event outcomes are widely used in clinical and epidemiological research. For instance, studies of medical product safety often involve comparative analyses of rare time-to-event outcomes. The effects of misclassified outcomes and error in survival times for time-to-event data have not been widely investigated. In this Monte Carlo simulation study, we compared the relative bias of absolute and relative measures of effect under varying degrees of outcome misclassification, outcome incidences, direction of error in survival times, and the time point of inference. Relative measures of effect were susceptible to considerable downward bias, which was larger when the outcome incidence and specificity were lower, error in survival times led to earlier times, time point of inference was earlier, and the estimation excluded samples for which an estimate could not be obtained. For absolute measures of effect, the pattern of bias was much simpler, greater downward bias was primarily a function of the degree of sensitivity. The results suggest when the outcome incidence is rare, specificity and sensitivity are high, absolute measures of effect may be preferable to relative measures of effect.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.415
metaresearch head score (Gemma)0.692
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.585
Threshold uncertainty score0.722

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.4150.692
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0040.006
Bibliometrics0.0040.004
Science and technology studies0.0010.006
Scholarly communication0.0050.005
Open science0.0030.005
Research integrity0.0030.006
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.466
GPT teacher head0.487
Teacher spread0.022 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.

Study designSimulation or modeling
DomainMethods
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes1
Has abstractyes

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