Probe variables: a tool for identification of unmeasured confounders in an observational study

Abstract

There are usually unknown or unmeasured confounders in the observational study, which is a significant challenge in epidemiological causal association research. This paper presents a tool for identification and effect assessment of unknown/unmeasured confounders in observational studies: probe variables. It can be divided into three forms: exposure probe variable, outcome probe variable, and mediation probe variable. The first two types can identify unknown/unmeasured confounding factors and estimate their size of effect to reveal the real correlation between exposure and outcome. The mediation probe variable controls for "mediating factors" to identify unmeasured confounders between exposure and results. The most significant difficulty in this theory's practice is selecting and determining "probe variables." Improper probe variables may introduce unknown confounders, which may lead to false identification of unmeasured confounders. Probe variables can be recommended as a sensitivity analysis in observational studies to help readers truly understand the association between exposure and outcomes and to increase the strength of evidence in observational epidemiological studies.