Risk-adjusted ecological study
A risk-adjusted ecological study is an observational epidemiological design that examines associations between exposures and outcomes measured at the group or area level — such as regions, hospitals, or countries — while statistically controlling for known risk factors also measured at that level. By incorporating risk adjustment through ecological regression or standardization, the design reduces (though cannot eliminate) confounding from group-level variables, enabling more valid comparisons across populations or settings.
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- Morgenstern, H. (1982). Uses of ecologic analysis in epidemiologic research. American Journal of Public Health, 72(12), 1336–1344. · DOI 10.2105/ajph.72.12.1336
- Wakefield, J. (2008). Ecologic studies revisited. Annual Review of Public Health, 29, 75–90. · DOI 10.1146/annurev.publhealth.29.020907.090821
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