Mediation analysis is indispensable for investigating how a treatment causally affects an outcome via intervening variables. Existing discussions on the validity of causal inference drawn from mediation analysis have prioritized single mediator settings. In this article, we focus on improving causal inference when investigating multiple mediators. We pay particular attention to the prevalent practice of exploring mediated effects along various paths linking several mediators. Such approaches are fraught with stringent—yet often overlooked—causal assumptions that predicate valid inference of indirect or mediated effects. To mitigate the risk of incorrect inference, we introduce a conceptually and substantively novel approach from the causal inference literature: interventional indirect effects. Interventional indirect effects focus on the contributions of each distinct mediator to the treatment effect on the outcome. An appealing feature of this approach is that valid causal in ference of mediation analysis with multiple mediators can be attained without assuming a (correct) causal structure among the mediators. Using a social psychology experiment as a running example, we illustrate how researchers can readily estimate and interpret the proposed interventional effects in practice. We hope this article will encourage explaining and substantiating the causal assumptions underpinning mediation analysis with multiple mediators to fortify causal inference in psychology research.
Squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA) are used to screen and monitor oral cancer patients. However, recent studies have reported that tumour markers become elevated as renal function decreases, regardless of tumour progression. A retrospective study was performed of 423 oral cancer patients who underwent blood testing for these tumour markers and other blood analytes during a 10-year period. The values of SCC-Ag and CYFRA increased significantly with decreasing renal function (P (Source: International Journal of Oral and Maxillofacial Surgery)
Publication date: Available online 11 September 2022
Source: American Journal of Otolaryngology
Author(s): Fabio Ferreli, Matteo Di Bari, Antoine Moya-Plana, Federica Canzano, Emanuela Morenghi, Armando De Virgilio, Giuseppe Mercante, Giuseppe Spriano, Giovanni Colombo