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      Against quantiles: categorization of continuous variables in epidemiologic research, and its discontents

      research-article
      1 , 2 ,
      BMC Medical Research Methodology
      BioMed Central

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          Abstract

          Background

          Quantiles are a staple of epidemiologic research: in contemporary epidemiologic practice, continuous variables are typically categorized into tertiles, quartiles and quintiles as a means to illustrate the relationship between a continuous exposure and a binary outcome.

          Discussion

          In this paper we argue that this approach is highly problematic and present several potential alternatives. We also discuss the perceived drawbacks of these newer statistical methods and the possible reasons for their slow adoption by epidemiologists.

          Summary

          The use of quantiles is often inadequate for epidemiologic research with continuous variables.

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          Most cited references18

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          Dose-response and trend analysis in epidemiology: alternatives to categorical analysis.

          Standard categorical analysis is based on an unrealistic model for dose-response and trends and does not make efficient use of within-category information. This paper describes two classes of simple alternatives that can be implemented with any regression software: fractional polynomial regression and spline regression. These methods are illustrated in a problem of estimating historical trends in human immunodeficiency virus incidence. Fractional polynomial and spline regression are especially valuable when important nonlinearities are anticipated and software for more general nonparametric regression approaches is not available.
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            • Article: not found

            Smoking and carcinoma of the lung; preliminary report.

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              Avoiding power loss associated with categorization and ordinal scores in dose-response and trend analysis.

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                Author and article information

                Journal
                BMC Med Res Methodol
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central
                1471-2288
                2012
                29 February 2012
                : 12
                : 21
                Affiliations
                [1 ]Pharmaceutical Outcomes Research and Policy Program, University of Washington, Box 357630, Seattle, WA 98195-7630, USA
                [2 ]Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63 rd St, New York, NY 10065, USA
                Article
                1471-2288-12-21
                10.1186/1471-2288-12-21
                3353173
                22375553
                6550d00d-f411-47a6-950f-77dd42bb3d1d
                Copyright ©2012 Bennette and Vickers; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 8 August 2011
                : 29 February 2012
                Categories
                Debate

                Medicine
                Medicine

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