A new class of measurement-error models, with applications to dietary data

Measurement-error modelling occurs when one cannot observe a covariate, but instead has possibly replicated surrogate versions of this covariate measured with error. The vast majority of the literature in measurement-error modelling assumes (typically with good reason) that given the value of the true but unobserved (latent) covariate, the replicated surrogates are unbiased for latent covariate and conditionally independent. In the area of nutritional epidemiology, there is some evidence from biomarker studies that this simple conditional independence model may break down due to two causes: (a) systematic biases depending on a person's body mass index, and (b) an additional random component of bias, so that the error structure is the same as a one-way random-effects model. We investigate this problem in the context of (1) estimating distribution of usual nutrient intake, (2) estimating the correlation between a nutrient instrument and usual nutrient intake, and (3) estimating the true relative risk from an estimated relative risk using the error-prone covariate. While systematic bias due to body mass index appears to have little effect, the additional random effect in the variance structure is shown to have a potentially important effect on overall results, both on corrections for relative risk estimates and in estimating the distribution of usual nutrient intake. However, the effect of dietary measurement error on both factors is shown via examples to depend strongly on the data set being used. Indeed, one of our data sets suggests that dietary measurement error may be masking a strong risk of fat on breast cancer, while for a second data set this masking is not so clear. Until further understanding of dietary measurement is available, measurement-error corrections must be done on a study-specific basis, sensitivity analyses should be conducted, and even then results of nutritional epidemiology studies relating diet to disease risk should be interpreted cautiously.