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date: 04 March 2021

Confounding By Indication 

A Dictionary of Epidemiology

Miquel Porta

A type of Confounding bias that occurs when a symptom or sign of disease is judged as an indication (or a contraindication) for a given therapy, and is therefore associated both with the use of a drug or medical procedure (or its avoidance) and with a higher probability of an outcome related to the disease for which the agent is indicated (or contraindicated). The reason to initiate treatment can be assessed by a health professional, a patient (self-medication), or a relative. As a result, crude comparisons of risks for such outcomes between exposed and unexposed subjects would be biased toward a higher risk among the exposed. Confounding by indication generally arises in a common clinical situation and in ... ...

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