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IJE Advance Access published online on March 4, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyn372
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Opening the Black Box: a motivation for the assessment of mediation

Danella M Hafeman and Sharon Schwartz*

Department of Epidemiology, Mailman School of Public Health, Columbia University, USA.

*Corresponding author. E-mail: sbs5{at}columbia.edu


  Abstract

Recent criticism of epidemiologic methods has focused on the limitations of ‘black box’ epidemiology, a pejorative label given to the simple identification of exposure–disease relationships. The assessment of mediation is an important tool for addressing this criticism. By using mediation analysis to open the black box, underlying mechanisms of the observed associations can be described and causal inference improved. An explicit theoretical motivation for such an analysis has been missing from the epidemiological literature. To provide this motivation, we integrate literature from epidemiology and other social sciences to describe the reasons that an investigator might want to assess mediation. We then describe the connections between these reasons and specific measures of indirect and direct effects that have been previously described.

Keywords Mediation, direct and indirect effects, counterfactual, causal inference, epidemiologic methods

Accepted 18 December 2008


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