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Table 3 Causal mediation analysis

From: The effect of acupuncture on exercise capacity in patients with COPD is mediated by improvements of dyspnea and leg fatigue: a causal mediation analysis using data from a randomized controlled trial

  

Mediators

 

Leg fatigue

Dyspnea

Joint mediator

Simulation-based approacha

   

  TE, m (95% CI)

81.4 (55.2–109.4)

82.3 (57.4–110.3)

82.1 (56.7–112.6)

  NDE, m (95% CI)

47.1 (4.6–85.2)

9.8 (-32.9–49.9)

-5.8 (-55.4–43.9)

  NIE, m (95% CI)

34.3 (-2.1–82.1)

72.5 (31.3–121.0)

88.9 (32.7–148.5)

  PM, %

42.1

88.1

107.0

Sensitivity analyses

   

 Addition of covariatesb

   

  TE, m (95% CI)

82.8 (53.7–113.1)

83.3 (54.1–112.9)

84.1 (54.1–114.1)

  NDE, m (95% CI)

49.4 (4.8–89.4)

11.1 (-34.7–53.9)

-5.2 (-59.3–45.5)

  NIE, m (95% CI)

33.5 (-3.7–81.8)

72.2 (25.4–123.6)

89.3 (33.7–152.9)

  PM, %

40.4

86.7

106.2

 Weighting approacha

   

  TE, m (95% CI)

80.8 (58.1–105.3)

80.8 (58.1–105.3)

80.8 (58.1–105.3)

  NDE, m (95% CI)

50.8 (6.7–89.1)

9.5 (-35.8–49.9)

-7.0 (-58.7–44.0)

  NIE, m (95% CI)

29.9 (-6.1–75.5)

71.3 (30.4–120.8)

87.8 (31.5–146.9)

  PM, %

37.1

88.3

108.6

  1. TE, total effect; NDE, natural direct effect; NIE, natural indirect effect; PM, proportion mediated; CI, confidence interval
  2. The results of the causal mediation analysis for each mediator are shown for the simulation-based approach as the main analysis and the two sensitivity analyses
  3. TE is the estimated intervention effect of acupuncture against the placebo on 6-minute walk distance, NDE is the estimated effect of intervention on 6-minute walk distance not mediated by mediators, and NIE is the estimated effect of intervention mediated by mediators. Therefore, TE is the sum of NDE and NIE. PM is the proportion of TE accounted for by NIE, calculated as NIE divided by TE
  4. aAdjusted for baseline values of 6-minute walk distance, leg fatigue, and dyspnea. bAdjusted for baseline values of 6-minute walk distance, leg fatigue, dyspnea, age, body mass index and inspiratory capacity