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@ARTICLE{Jaeschke:181081,
      author       = {L. Jaeschke and M. Becher and I. M. Velásquez and W.
                      Ahrens and C. Bächle and H. Baurecht and J. Fricke and K.
                      H. Greiser$^*$ and K. Günther and M. Heier and A. Karch and
                      A. Kluttig and L. Krist and M. Leitzmann and K. Michels and
                      R. Mikolajczyk and A. Peters and S. Schipf and H. Völzke
                      and T. Pischon and H. Becher},
      title        = {{T}he bias from heaping on risk estimation: {E}ffect of age
                      at diagnosis of hypertension on risk of subsequent
                      cardiovascular comorbidities.},
      journal      = {Annals of epidemiology},
      volume       = {74},
      issn         = {1047-2797},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2022-01765},
      pages        = {84-96},
      year         = {2022},
      note         = {2022 Aug 5;74:84-96},
      abstract     = {To investigate (1) the bias in effect estimation due to
                      heaping, (2) the association between age at hypertension
                      diagnosis and risk of cardiovascular comorbidities, and (3)
                      the influence of heaping on risk estimates.We performed a
                      simulation study with various scenarios, binary outcome, and
                      normal or lognormal distributed covariables. We calculated
                      mean logistic coefficients under the original and heaped
                      data and their relative deviation. The association of age at
                      hypertension diagnosis and risk of ≥1 cardiovascular
                      comorbidity was investigated using logistic regression among
                      50,858 participants in the NAKO Gesundheitsstudie (German
                      National Cohort) who reported such diagnosis. We assessed
                      the proportion of heaped observations and to what extent
                      heaping may have influenced risk estimates.Based on the
                      simulation study and assuming $50\%$ of observations in the
                      variable of interest to be heaped, relative bias was $<6\%.$
                      In NAKO, a 5-year younger age at hypertension diagnosis was
                      associated with a $15\%$ increased risk of having ≥1
                      cardiovascular comorbidity. Observed heaping in age at
                      hypertension diagnosis was $12.6\%,$ and bias of the risk
                      estimate was $0.14\%.Bias$ in effect estimation due to
                      heaping is low in most common scenarios. Younger age at
                      hypertension diagnosis is associated with a higher risk of
                      cardiovascular comorbidities.},
      keywords     = {cardiovascular comorbidities (Other) / digit preference
                      (Other) / effect estimates (Other) / epidemiologic study
                      (Other) / heaping (Other) / hypertension (Other) /
                      simulation study (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35940393},
      doi          = {10.1016/j.annepidem.2022.07.012},
      url          = {https://inrepo02.dkfz.de/record/181081},
}