Mediation analysis with case-control sampling: Identification and estimation in the presence of a binary mediator

Abstract: With reference to a stratified case-control procedure based on a binary variable of primary interest, we derive the expression of the distortion induced by the sampling design on the parameters of the logistic model of a secondary variable. This is particularly relevant when performing mediation analysis (possibly in a causal framework) with stratified case-control data in settings where both the outcome and the mediator are binary. Our identification result opens the way to M-estimation and Maximum Likelihood estimation. We then conduct a simulation study showing the gain in efficiency of the estimators of both the outcome and mediator model parameters w.r. to existing methods, based on weighting. As an illustrative example, we reanalyze a German case-control dataset in order to investigate whether the effect of reduced immunocompetency on listeriosis onset is mediated by the intake of gastric acid suppressors.