Attributable risk estimation from matched case-control data

A methodology is proposed for obtaining summary estimators, variances, and confidence intervals for attributable risk measures from data obtained through a case-control study design where one or more controls have been matched to each case. The sampling design for obtaining these data is conceptualized as a simple random sample of cases being equivalent to a simple random sample of matched sets. By combining information across the strata determined by the matched sets, this approach provides all of the benefits associated with the Mantel-Haenszel procedure for the estimators of attributable risk among the exposed and population attributable risk. Asymptotic variances are derived under the assumption that the frequencies of the unique response patterns follow the multinomial distribution. Simulation results indicate that these methods fare very well with respect to bias and coverage probability.