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Related Experiment Videos

Tests for trend and dose response: misinterpretations and alternatives.

M Maclure1, S Greenland

  • 1Department of Epidemiology, Harvard School of Public Health, Boston, MA.

American Journal of Epidemiology
|January 1, 1992
PubMed
Summary

The Mantel extension test is not a test for monotonic dose response, leading to misinterpretations in epidemiologic studies. Proper evaluation requires examining multiple statistics and regression analyses for accurate dose-response information.

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Area of Science:

  • Epidemiology
  • Biostatistics

Background:

  • The Mantel extension test is frequently misapplied to assess monotonic dose-response relationships.
  • Epidemiologic literature often overstates evidence for monotonic dose response, especially with limited exposed subjects.

Purpose of the Study:

  • To clarify the limitations of the Mantel extension test for monotonic dose-response evaluation.
  • To highlight the need for comprehensive statistical methods in dose-response assessment.

Main Methods:

  • Survey of epidemiologic articles to identify misinterpretations of the Mantel extension test.
  • Discussion of appropriate statistical methods for evaluating dose-response hypotheses.

Main Results:

  • Widespread misinterpretation of the Mantel extension test was observed in epidemiologic research.

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  • Evidence for monotonic dose response is often overstated when sample sizes of exposed subjects are small.

    • Conclusions:

    • The Mantel extension test is inappropriate for definitively establishing monotonic dose response.
    • Accurate dose-response evaluation necessitates a multifaceted approach, including various statistics and regression analyses.
    • Nonparametric or polynomial regression offers more detailed insights when sufficient data are available.