The Peril of Power: A Tutorial on Using Simulation to Better Understand When and How We Can Estimate Mediating Effects

Kara E. Rudolph, Dana E. Goin, Elizabeth A. Stuart

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Mediation analyses are valuable for examining mechanisms underlying an association, investigating possible explanations for nonintuitive results, or identifying interventions that can improve health in the context of nonmanipulable exposures. However, designing a study for the purpose of answering a mediation-related research question remains challenging because sample size and power calculations for mediation analyses are typically not conducted or are crude approximations. Consequently, many studies are probably conducted without first establishing that they have the statistical power required to detect a meaningful effect, potentially resulting in wasted resources. In an effort to advance more accurate power calculations for estimating direct and indirect effects, we present a tutorial demonstrating how to conduct a flexible, simulation-based power analysis. In this tutorial, we compare power to estimate direct and indirect effects across various estimators (the Baron and Kenny estimator (J Pers Soc Psychol. 1986;51(6):1173-1182), inverse odds ratio weighting, and targeted maximum likelihood estimation) using various data structures designed to mimic important features of real data. We include step-by-step commented R code (R Foundation for Statistical Computing, Vienna, Austria) in an effort to lower implementation barriers to ultimately improving power assessment in mediation studies.

Original languageEnglish (US)
Pages (from-to)1559-1567
Number of pages9
JournalAmerican journal of epidemiology
Issue number12
StatePublished - Dec 1 2020


  • mediation
  • natural direct effect
  • power
  • simulation
  • statistics
  • stochastic direct effect

ASJC Scopus subject areas

  • Epidemiology


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