Research on injury compensation and health outcomes : ignoring the problem of reverse causality led to a biased conclusion

Spearing, Natalie M., Connelly, Luke B., Nghiem, Hong S., & Pobereskin, Louis (2012) Research on injury compensation and health outcomes : ignoring the problem of reverse causality led to a biased conclusion. Journal of Clinical Epidemiology, 65(11), pp. 1219-1226.

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Abstract

Objective

This study highlights the serious consequences of ignoring reverse causality bias in studies on compensation-related factors and health outcomes and demonstrates a technique for resolving this problem of observational data.

Study Design and Setting

Data from an English longitudinal study on factors, including claims for compensation, associated with recovery from neck pain (whiplash) after rear-end collisions are used to demonstrate the potential for reverse causality bias. Although it is commonly believed that claiming compensation leads to worse recovery, it is also possible that poor recovery may lead to compensation claims—a point that is seldom considered and never addressed empirically. This pedagogical study compares the association between compensation claiming and recovery when reverse causality bias is ignored and when it is addressed, controlling for the same observable factors.

Results

When reverse causality is ignored, claimants appear to have a worse recovery than nonclaimants; however, when reverse causality bias is addressed, claiming compensation appears to have a beneficial effect on recovery, ceteris paribus.

Conclusion

To avert biased policy and judicial decisions that might inadvertently disadvantage people with compensable injuries, there is an urgent need for researchers to address reverse causality bias in studies on compensation-related factors and health.

Impact and interest:

13 citations in Scopus
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12 citations in Web of Science®

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ID Code: 82246
Item Type: Journal Article
Refereed: Yes
Keywords: Association; Reverse causality; Simultaneity; Whiplash; Compensation; Observational studies
DOI: 10.1016/j.jclinepi.2012.05.012
ISSN: 0895-4356
Subjects: Australian and New Zealand Standard Research Classification > ECONOMICS (140000) > APPLIED ECONOMICS (140200) > Health Economics (140208)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 05 Mar 2015 23:24
Last Modified: 11 Mar 2015 04:22

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