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Confounding — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsConfoundingUSMLE Step 3

An observational study finds that coffee drinkers have higher lung cancer rates than non-coffee drinkers. After adjustment for smoking, the association disappears. Smoking was more common among coffee drinkers. Which of the following is the most likely explanation for this patient's findings?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: DConfounding by smoking

A confounder is associated with both exposure and outcome and can create or distort an observed association.

Reference: USMLE Step 3 biostatistics and population health content outline: https://www.usmle.org/exam-resources/step-3-materials/step-3-content-outline-and-specifications