Abstract
Methods to estimate direct and indirect effects have been rapidly expanding.1–14 It is now well documented that such mediation analyses are subject to strong no-confounding assumptions and that an unmeasured confounder of the mediator-outcome relationship can lead to substantial bias in direct and indirect effect estimates.1,2,6,7,14,15 Much less attention has been given to the question of how measurement error may bias estimates of direct and indirect effects. le Cessie and colleagues.16 have done a service to investigators interested in direct effects by providing simple correction formulas for direct effects estimates in a variety of mediator measurement-error scenarios. Here we will consider the implications of these and other results as they relate to making inferences, not just about direct effects, but also about mediation and indirect effects.
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