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PSM · Study designs
Sample itemWhat is confounding in an observational study?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Distortion of an exposure-outcome association by a related third factor
Confounding occurs when another factor is associated with both the exposure and outcome and is not on the causal pathway, creating or masking an apparent association unless addressed by design or analysis.
Option by option
A. Distortion of an exposure-outcome association by a related third factor (correct)
Correct: a related third factor can distort the observed association.
B. Selection bias from non-comparable enrollment
Selection bias arises from how participants are enrolled or retained, not from a third factor mixing effects.
C. Random sampling variation around an estimate
Sampling variation is random error and does not require a third factor related to exposure and outcome.
D. Measurement error from a miscalibrated instrument
Miscalibration causes information error rather than confounding by a covariate.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.